function enable_disable_a() {
	if (document.getElementById("a_general_dentist").checked == true) {
		document.getElementById("a_1").disabled = true;
		document.getElementById("a_2_yes").disabled = false;
		document.getElementById("a_2_no").disabled = false;
	} else if (document.getElementById("a_specialist").checked == true) {
		document.getElementById("a_1").disabled = false;			
		document.getElementById("a_2_yes").disabled = true;
		document.getElementById("a_2_no").disabled = true;
	} 
}
function enable_disable_a_2() {
	if (document.getElementById("a_2_yes").checked == true) {
		document.getElementById("a_3").disabled = false;
	} else if (document.getElementById("a_2_no").checked == true) {
		document.getElementById("a_3").disabled = true;
	} 
}	
function enable_disable_d_3() {
	if (document.getElementById("d_3").checked == true) {
		document.getElementById("d_3_description").disabled = false;
	} else	{
		document.getElementById("d_3_description").disabled = true;
	} 
}	
function enable_disable_e_2() {
	if (document.getElementById("e_1_full-time").checked == true) {
		document.getElementById("e_2").disabled = false;
	} else if (document.getElementById("e_1_part-time").checked == true) {
		document.getElementById("e_2").disabled = false;
	} 
}	
function enable_disable_g_2() {
	if (document.getElementById("g_1_yes").checked == true) {
		document.getElementById("g_2").disabled = false;
	} else {
		document.getElementById("g_2").disabled = true;
	} 
}	
function enable_disable_h_2() {
	if (document.getElementById("h_1_yes").checked == true) {
		document.getElementById("h_2").disabled = false;
	} else {
		document.getElementById("h_2").disabled = true;
	} 
}	
function enable_disable_i_2() {
	if (document.getElementById("i_1_yes").checked == true) {
		document.getElementById("i_2").disabled = false;
	} else {
		document.getElementById("i_2").disabled = true;
	} 
}	
function enable_disable_claims_made() {
	if (document.getElementById("claims_made").checked == true) {
		document.getElementById("claims_made_month").disabled = false;
		document.getElementById("claims_made_year").disabled = false;
		document.getElementById("claims_made_day").disabled = false;		
	} else {
		document.getElementById("claims_made_month").disabled = true;
		document.getElementById("claims_made_year").disabled = true;
		document.getElementById("claims_made_day").disabled = true;	
	} 
}	


function verify(dental_form) {
//Part 1	
	//check to see if the name field is blank
	if (dental_form.name.value == "") {
        alert("Please enter your name.")
		dental_form.name.focus()
		dental_form.name.select()
		return false
	}
	//check to see if the name field is blank
	if (dental_form.practice_name.value == "") {
        alert("Please enter the Practice's name.")
		dental_form.practice_name.focus()
		dental_form.practice_name.select()
		return false
	}	

	if (dental_form.practice_address.value == "") {
        alert("Please enter the Practice's address.")
		dental_form.practice_address.focus()
		dental_form.practice_address.select()
		return false
	}	
	
	if (dental_form.practice_city.value == "") {
        alert("Please enter the city where the Practice is located.")
		dental_form.practice_city.focus()
		dental_form.practice_city.select()
		return false
	}	
	
	if (dental_form.practice_county.value == "") {
        alert("Please enter county where the Practice is located.")
		dental_form.practice_county.focus()
		dental_form.practice_county.select()
		return false
	}	
	
	if (dental_form.practice_state.value == "select_state") {
        alert("Please enter state where the Practice is located.")
		dental_form.practice_state.focus()
		//dental_form.practice_state.select()
		return false
	}		

	//check the zip code using validZip function
	if (dental_form.practice_zip.value == "") {
        alert("Please enter the Practice's zip code.")
		dental_form.practice_zip.focus()
		dental_form.practice_zip.select()
		return false		
	} else if (!validZip(dental_form.practice_zip.value)) {
		alert("You must enter a valid zip code.")
		dental_form.practice_zip.focus()
		dental_form.practice_zip.select()
		return false
	}		
	
	if (dental_form.phone.value == "") {
        alert("Please enter your phone number.")
		dental_form.phone.focus()
		dental_form.phone.select()
		return false		
	} else if (!validPhone(dental_form.phone.value)) {
		alert("You must enter a valid phone number.")
		dental_form.phone.focus()
		dental_form.phone.select()
		return false
	}	
	//check the email address using validEmail function
	if (dental_form.email.value == "") {
        alert("Please enter your email address.")
		dental_form.email.focus()
		dental_form.email.select()
		return false		
	} else if (!validEmail(dental_form.email.value)) {
		alert("You must enter a valid email address.")
		dental_form.email.focus()
		dental_form.email.select()
		return false
	}	
//Part 2
	if (dental_form.dental_license.value == "") {
        alert("Please enter the Practice dental license(s).")
		dental_form.dental_license.focus()
		dental_form.dental_license.select()
		return false
	}	
//Part 3
	if (dental_form.a[0].checked == false && dental_form.a[1].checked == false) {
        alert("Please fill in the required fields for part 3 portion (A).")
		dental_form.a[0].focus()
		return false
	}
	if (dental_form.a[0].checked == true)	{
		if (dental_form.a_2[0].checked == false && dental_form.a_2[1].checked == false) {
			alert("Please fill in the required fields for part 3 portion (A).")
			dental_form.a_2[0].focus()
			return false		
		}
	}

	if (dental_form.b_month.value == "month" || dental_form.b_day.value == "day" || dental_form.b_year.value == "year") {
        alert("Please fill in the required fields for part 3 portion (B).")
		
		if (dental_form.b_month.value == "month")
			dental_form.b_month.focus()
		else if (dental_form.b_day.value == "day")
			dental_form.b_day.focus()
		else if (dental_form.b_day.value == "year")
			dental_form.b_year.focus()
			
		//dental_form.practice_state.select()
		return false
	}	
	if (dental_form.c[0].checked == false && dental_form.c[1].checked == false) {
        alert("Please fill in the required fields for part 3 portion (C).")
		dental_form.c[0].focus()
		//dental_form.practice_state.select()
		return false
	}
	if (dental_form.e_1[0].checked == false && dental_form.e_1[1].checked == false) {
        alert("Please fill in the required fields for part 3 portion (E).")
		dental_form.e_1[0].focus()
		//dental_form.practice_state.select()
		return false
	}
	if (dental_form.f_1.checked == false && dental_form.f_2.checked == false && dental_form.f_3.checked == false) {
        alert("Please fill in the required fields for part 3 portion (F).")
		dental_form.f_1.focus()
		//dental_form.practice_state.select()
		return false
	}
	if (dental_form.g_1[0].checked == false && dental_form.g_1[1].checked == false) {
        alert("Please fill in the required fields for part 3 portion (G).")
		dental_form.g_1[0].focus()
		//dental_form.practice_state.select()
		return false
	}
	if (dental_form.h_1[0].checked == false && dental_form.h_1[1].checked == false) {
        alert("Please fill in the required fields for part 3 portion (H).")
		dental_form.h_1[0].focus()
		//dental_form.practice_state.select()
		return false
	}
	if (dental_form.i_1[0].checked == false && dental_form.i_1[1].checked == false) {
        alert("Please fill in the required fields for part 3 portion (I).")
		dental_form.i_1[0].focus()
		//dental_form.practice_state.select()
		return false
	}	
	if (dental_form.j_1[0].checked == false && dental_form.j_1[1].checked == false) {
        alert("Please fill in the required fields for part 3 portion (J).")
		dental_form.j_1[0].focus()
		//dental_form.practice_state.select()
		return false
	}

//Part 5
	if (dental_form.current_professional_liability.value == "") {
        alert("Please enter your current professional liability provider.")
		dental_form.current_professional_liability.focus()
		dental_form.current_professional_liability.select()
		return false
	}	
	if (dental_form.limit_of_liability.value == "select_limit") {
        alert("Please select the limit of liability.")
		dental_form.limit_of_liability.focus()
		//dental_form.practice_state.select()
		return false
	}	
	if (dental_form.liability_expiration_month.value == "month" || dental_form.liability_expiration_day.value == "day" || dental_form.liability_expiration_year.value == "year") {
        alert("Please select a complete date for the professional liability expiration field.")

		if (dental_form.liability_expiration_month.value == "month")
			dental_form.liability_expiration_month.focus()
		else if (dental_form.liability_expiration_day.value == "day")
			dental_form.liability_expiration_day.focus()
		else if (dental_form.liability_expiration_year.value == "year")
			dental_form.liability_expiration_year.focus()
		
		//dental_form.practice_state.select()
		return false
	}	
	if (dental_form.policy[0].checked == false && dental_form.policy[1].checked == false) {
        alert("Please select your current policy.")
		dental_form.policy[0].focus()
		//dental_form.practice_state.select()
		return false
	}	
		
}	



// Check zip
function validZip(zip) {
		invalidChars = ":,;`~!@#$%^&*()_=[]{}\|/<>.+abcdefghigklmnopqrstuvwxyz"
		// check for bad charcters
		for (i=0; i < invalidChars.length; i++) {
		 	// does it contain any invalid characters?
			badChar = invalidChars.charAt(i)
			if (zip.indexOf(badChar,0) > -1) {
				return false
			}
		}
		// at least 5 characters
		if (zip.length < 5)	{
			return false
		}
		return true;
	}
// Check phone
function validPhone(phone) {
		invalidChars = ":,;`~!@#$%^&*_=[]{}\|/<>.+abcdefghigklmnopqrstuvwxyz"
		// check for bad charcters
		for (i=0; i < invalidChars.length; i++) {
		 	// does it contain any invalid characters?
			badChar = invalidChars.charAt(i)
			if (phone.indexOf(badChar,0) > -1) {
				return false
			}
		}
		// at least 9 characters
		if (phone.length < 9)	{
			return false
		}
		return true;
	}
// Check email address
function validEmail(email) {
		invalidChars = " /:,;"

		for (i=0; i < invalidChars.length; i++) {
		 	// does it contain any invalid characters?
			badChar = invalidChars.charAt(i)
			if (email.indexOf(badChar,0) > -1) {
				return false
			}
		}
		atPos = email.indexOf("@",1)
		// there must be one "@" symbol
		if (atPos == -1) {
			return false
		}
		if (email.indexOf("@",atPos+1) != -1) {
			// and only one "@" symbol
			return false
		}
		periodPos = email.indexOf(".",atPos)
		if (periodPos == -1) {
			// and at least one "." after the "@"
			return false
		}
		if (periodPos + 3 > email.length)	{
			// must be at least 2 characters after the "."
			return false
		}
		return true;
	}