function request1()
	{
	 
	if(isBlank(document.req1.name.value))
	{
	alert("Please enter the Name");
	document.req1.name.value="";
	document.req1.name.focus();
	return false;
	}


	if(isBlank(document.req1.provider.value))
	{
	alert("Please enter the Provider");
	document.req1.provider.value="";
	document.req1.provider.focus();
	return false;
	}


	if(isBlank(document.req1.add1.value))
	{
	alert("Please enter the Address");
	document.req1.add1.value="";
	document.req1.add1.focus();
	return false;
	}


	if(isBlank(document.req1.country.value))
	{
	alert("Please enter the Country");
	document.req1.country.value="";
	document.req1.country.focus();
	return false;
	}


	 if(isBlank(document.req1.phone.value))
		{
		alert("Please enter the Phone Number");
		document.req1.phone.value="";
		document.req1.phone.focus();
		return false;
		}



	if(isBlank(document.req1.phone.value)==false)
	{	
	
	
		var y="-";
			for(var j=0; j < document.req1.phone.value.length; j++)
	       		{
                		temp4=  document.req1.phone.value.substring(j,j+1);
				if(y.indexOf(temp4) == -1)
					{
					if(isNaN(temp4))
						{
						alert("Please enter in Numeric only");
						document.req1.phone.value="";
						document.req1.phone.focus();
						return false;
						}
					}	
	       		}
		}


      if(badEmail(document.req1.email.value) || emailName(document.req1.email.value))

		{
		alert("Please enter the Valid email Address")
		document.req1.email.value="";
		document.req1.email.focus();
		return false;	
			}




	if(isBlank(document.req1.special.value))
	{
	alert("Please enter the Special Type");
	document.req1.special.value="";
	document.req1.special.focus();
	return false;
	}


	if(isBlank(document.req1.no_visits.value))
	{
	alert("Please enter the Number of Visits/Day (Outpatient)");
	document.req1.no_visits.value="";
	document.req1.no_visits.focus();
	return false;
	}


	if(isBlank(document.req1.no_inpatients.value))
	{
	alert("Please enter the Number of Inpatients");
	document.req1.no_inpatients.value="";
	document.req1.no_inpatients.focus();
	return false;
	}


	if(isBlank(document.req1.average_billing.value))
	{
	alert("Please enter the Average billing value per week");
	document.req1.average_billing.value="";
	document.req1.average_billing.focus();
	return false;
	}


	if(isBlank(document.req1.insurance.value))
	{
	alert("Please enter the Any capitated agreement with the insurance");
	document.req1.insurance.value="";
	document.req1.insurance.focus();
	return false;
	}


	if(isBlank(document.req1.super_bill.value))
	{
	alert("Please enter the Super bill");
	document.req1.super_bill.value="";
	document.req1.super_bill.focus();
	return false;
	}


	if(isBlank(document.req1.medical_records.value))
	{
	alert("Please enter the Medical records");
	document.req1.medical_records.value="";
	document.req1.medical_records.focus();
	return false;
	}


	if(isBlank(document.req1.practice.value))
	{
	alert("Please enter the Practice Management software");
	document.req1.practice.value="";
	document.req1.practice.focus();
	return false;
	}


	if(isBlank(document.req1.emr.value))
	{
	alert("Please enter the EMR");
	document.req1.emr.value="";
	document.req1.emr.focus();
	return false;
	}


	if(isBlank(document.req1.location.value))
	{
	alert("Please enter the Location");
	document.req1.location.value="";
	document.req1.location.focus();
	return false;
	}



    return true;  

 }

function isBlank(s)
 { 
  var len = s.length;
  var i;
      for(i = 0; i < len ; ++i)
  	  { 
   	if(s.charAt(i) != " ") return false;
  	  }
	return true;
 }

function badEmail(str) 
{
  
  var supported = 0;
  if (window.RegExp) 
     {
    var tempStr = "a";
    var tempReg = new RegExp(tempStr);
    if (tempReg.test(tempStr)) supported = 1;
     }
  if (!supported) 
    return (str.indexOf(".") <= 2) || (str.indexOf("@") < 0);
    var r1 = new RegExp("(@.*@)|(\\.\\.)|(@\\.)|(^\\.)");
    var r2 = new RegExp("^.+\\@(\\[?)[a-zA-Z0-9\\-\\.]+\\.([a-zA-Z]{2,3}|[0-9]{1,3})(\\]?)$");
  return (r1.test(str) || !r2.test(str));
}

function emailName(str)
  {
  if(str != "")
      {
        var chars="0123456789ABCDEFGHIJKLMNOPQRSTUVWXYZabcdefghijklmnopqrstuvwxyz_-@.";
           for(var i=0; i <  str.length; i++)
 	       {
                temp3=  str.substring(i,i+1);
		if((chars.indexOf(temp3) == -1) )
			 {
			  return true;  
			 }
	       }
      }
   }