
<!--Written for the following forms:  consumers_info.php, pharm_info.php, and health_info.php.  This file must be placed in the same directory as these files.-->


function verify() {
var themessage = "You are required to complete the following fields: ";
if (document.form.first.value=="") {
themessage = themessage + " - First Name";
}
if (document.form.last.value=="") {
themessage = themessage + " -  Last Name";
}
if (document.form.addr1.value=="") {
themessage = themessage + " -  Address 1";
}
if (document.form.city.value=="") {
themessage = themessage + " -  City";
}
if (document.form.state.value=="") {
themessage = themessage + " -  State";
}
if (document.form.zip.value=="") {
themessage = themessage + " -  Zip";
}
if (document.form.email.value=="") {
themessage = themessage + " -  Email Address";
}
if (document.form.security_code.value=="") {
themessage = themessage + " -  Security Code";
}
//alert if fields are empty and cancel form submit
if (themessage == "You are required to complete the following fields: ") {
document.form.submit();
}
else {
alert(themessage);
return false;
   }
}