{"id":43,"date":"2025-11-10T07:10:04","date_gmt":"2025-11-10T07:10:04","guid":{"rendered":"https:\/\/staging.ccomdigital.in\/client\/mitoswab\/website\/contact\/"},"modified":"2026-05-07T06:31:14","modified_gmt":"2026-05-07T06:31:14","slug":"request-a-test-kit","status":"publish","type":"page","link":"https:\/\/www.mitoswab.com\/staging\/request-a-test-kit\/","title":{"rendered":"Request a Test Kit"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"43\" class=\"elementor elementor-43\">\n\t\t\t\t<div class=\"elementor-element elementor-element-874df62 e-con-full page-banner page-top-banner-section e-flex e-con e-parent\" data-id=\"874df62\" data-element_type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-36e0095 e-con-full internal-page-banner e-flex e-con e-child\" data-id=\"36e0095\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-22a220e elementor-widget__width-inherit elementor-widget elementor-widget-cta\" data-id=\"22a220e\" data-element_type=\"widget\" data-settings=\"{&quot;layout_preset&quot;:&quot;focus&quot;,&quot;cta_vertical_position&quot;:&quot;start&quot;,&quot;primary_button_shape&quot;:&quot;default&quot;,&quot;box_shape&quot;:&quot;sharp&quot;}\" data-widget_type=\"cta.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"has-shape-sharp shape-type-box ehp-cta has-preset-focus\">\n\t\t\t<div class=\"ehp-cta__overlay\"><\/div>\n\t\t\t<div class=\"ehp-cta__elements-container\">\n\t\t\t\t\t\t<div class=\"ehp-cta__text-container\">\n\t\t\t<h1 class=\"ehp-cta__heading\">Request a Test Kit<\/h1>\t\t<\/div>\n\t\t\t\t\t<div class=\"ehp-cta__ctas-container\">\n\t\t\t\t<div class=\"ehp-cta__buttons-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-431d568a internal-container-section e-flex e-con-boxed e-con e-parent\" data-id=\"431d568a\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-7f84906a e-con-full e-flex e-con e-child\" data-id=\"7f84906a\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-15c09ad elementor-widget elementor-widget-shortcode\" data-id=\"15c09ad\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\">  <!--<title>FRATNOW - Request Test Kit For Adults & Kids<\/title>-->\n  <!--<meta content=\"Get the FRAT\u00ae kit for sample collection at no cost. Prescriptions required from medical professionals, and results are sent exclusively to your prescribing physician.\" name=\"description\">-->\n  <!--<meta content=\"\" name=\"keywords\">-->\n <!-- Canonical Tag -->\n\t\n\t<!-- End Canonical Tag -->\n  \n  <!-- <script type=\"text\/javascript\" src=\".\/js\/jquery-1.10.2.min.js\"><\/script>\n    -->\n  <script src=\"https:\/\/code.jquery.com\/jquery-3.7.1.min.js\"><\/script>\n  \n  <style>\n.form-side-image {\n  float: left;\n    width: 32%;\n    margin-left: 3%;\n    }\n\n    .form-side-image img {\n      width: 100%;\n      max-width: 500px;\n      border-radius: 20px;\n      transition: transform 0.4s ease, box-shadow 0.4s ease;\n      box-shadow: 0 4px 15px rgba(0,0,0,0.1);     border: 1px solid #ccc;\n    padding: 25px;\n    background: #f3f3f3;\n      object-fit: cover;    transform-origin: top right;\n    }\n\n    .form-side-image img:hover {\n      transform: scale(2);\n      box-shadow: 0 8px 25px rgba(0,0,0,0.2);\n    }\n    \n    #frat-test-kit-info, .banner-contact-us.order-a-test-kit .container {\n    max-width: 1600px !important;\n    width: 90%;\n}\n    \n    \n@media screen and (max-width: 768px) {\n   .form-side-image {\n        float: left;\n        width: 100%;\n        margin-left: 0%;\n        margin: 0 auto;\n        margin-top: 5% !important;\n        clear: both;\n        text-align: center;\n} \n\n.form-side-image img {\n   transform-origin: bottom center;\n    }\n\n\n .form-side-image img:hover {\n      transform: scale(1.3);\n \n    }\n\n}\n.req-flow-row {\n    display: flex;\n    justify-content: space-between;\n    align-items: center;\n    margin-bottom:30px;\n}\n\n.req-flow-row p {\n    margin: 0;\n}\n\n.process-title {\n    font-weight: 600;\n}\n\n\nlabel {\n    font-weight: 700;\n    margin-top: 20px !important;\n    margin-bottom: 10px;\n}\n@media (min-width: 940px) {\n    .input-col-left {\n        width: 47%;\n        display: inline-block;\n    }\n        .input-col-right {\n        width: 47%;\n        display: inline-block;\n        float: right;\n    }\n   \n}\n   input[type=text]{\n    border:1px solid rgba(0,0,0,.1);\n        \n    }\n    label span {\n    color: #f47040;\n}\np.submit-info.form-heading {font-size: 21px;\nfont-weight: bold;\n    width: 100%;\n    margin-bottom: 20px;\n}\n.form-heading {\n    border-top: 1px solid #d8dddd;\n    padding-top: 40px;\n    margin-top: 40px;\n}#challenge-container {\n    margin-bottom: 20px;\n}\n.captcha-t6 div#challenge-container {\n        width: 100%;\n    float: left;\n    \/* margin-left: 5%; *\/\n    background: url(https:\/\/www.fratnow.com\/assets\/img\/captcha-bg.jpg);\n    text-align: center;\n    line-height: 35px;\n    border: 1px solid #e5e5e5;\n    border-radius: 5px;\n    color: #000;\n    font-weight: 500;\n    margin-top: 20px;\n    \n }\n\n.form-control {\n    margin-bottom: 10px;\n}\n.captcha-t6 {\n    display: block;\n    margin-bottom: 30px;\n}\n\n .red-text-3452 {\n    font-size: 14px;\n}\n.red-text-3452 {\n    color: red;\n}\n.form-floating-1 select {\n    padding: 8px !important;\n    border: none !important;\n    border: 1px solid rgba(0, 0, 0, .1) !important;\n        border-radius: 5px;\n}\nselect#am:focus {\n    outline: none;\n    outline-width: 0 !important;\n    box-shadow: none;\n}\n\ninput::placeholder {\n  color: #333; \/* your color *\/\n}\n\ntextarea::placeholder {\n  color: #333;\n}\n\n input:focus,select:focus {\n  border: 1px solid #f47040 !important; outline: 0;\n \n}\n\n.form-select {\n    margin-bottom: 10px;\n    display: block;\n    width: 100%;\n    padding: .375rem 2.25rem .375rem .75rem;\n    -moz-padding-start: calc(0.75rem - 3px);\n    font-size: 1rem;\n    font-weight: 400;\n    line-height: 1.5;\n    color: #212529;\n    background-color: #fff;\n    background-image: url(\"data:image\/svg+xml,%3csvg xmlns='http:\/\/www.w3.org\/2000\/svg' viewBox='0 0 16 16'%3e%3cpath fill='none' stroke='%23343a40' stroke-linecap='round' stroke-linejoin='round' stroke-width='2' d='m2 5 6 6 6-6'\/%3e%3c\/svg%3e\");\n    background-repeat: no-repeat;\n    background-position: right .75rem center;\n    background-size: 16px 12px;\n    border: 1px solid #ced4da;\n    border-radius: .375rem;\n    transition: border-color .15s ease-in-out, box-shadow .15s ease-in-out;\n    -webkit-appearance: none;\n    -moz-appearance: none;\n    appearance: none;\n}\nbutton.btn.sub-btn:hover, input.btn.sub-btn:hover {\n    background: #fff;\n    color: #f47040 !important;\n    border: 1px solid #f47040;\n    \n}\n.btn.sub-btn, #frat-test-kit-info input.btn.sub-btn {\n    margin: 0px;\n    margin-left: 0px;\n    width: 100%;\n    margin-top: 20px;\ncolor: #fff !important;\n    background: #f47040;\n    border-radius: 5px; border: 1px solid #f47040;font-weight: 500;padding: 10px;}\n    \n  #loading {\n    position: absolute;\n    margin: 0px;\n    margin-left: 0px;\n    width: 100%;\n        top: 0;\n    margin-top: 20px;\n    text-align: center;\n    color: #fff !important;\n    background: #f47040;\n    border-radius: 5px;\n    border: 1px solid #f47040;\n    font-weight: 500;\n    padding: 10px;\n    font-size: 8px;\n}\n.ld-sub{position: relative;}\n\n\n <\/style>\n<div style=\"clear:both;\"><\/div>\n<br>\n  <main id=\"main\">\n       <section id=\"frat-contact-us\" class=\"frat-contact-us pb-0 pt-5\">      \n               <p class=\"mt-5\">Required fields are marked with an asterisk (*).<\/p>\n            \n            <div class=\"row gy-4 \">\n             <form class=\"c-form\" id=\"enquiry-form\" action=\"\"  method=\"POST\">\n            <!--<p class=\"submit-info\">To Request a FRAT<sup>\u00ae<\/sup> kit, please submit the following information:<\/p>-->\n\n            <div class=\"row\">\n    <div class=\"col-sm-4 col-width-100 sel-option-div\" >\n        <div class=\"form-floating-1 after-arr-select\">\n            <label for=\"am\">I am a <span>*<\/span><\/label>\n            <select class=\"form-select\" aria-label=\"I am a\" id=\"am\" name=\"am\" onchange=\"validateOccupation()\">\n                <option value=\"\" selected>Select<\/option>\n                <option value=\"Provider (Ship to Office)\">Provider (Ship to Office)<\/option>\n                <option value=\"Provider (Ship to Patient)\">Provider (Ship to Patient)<\/option>\n                <option value=\"Parent\">Parent<\/option>\n                <option value=\"Patient\">Patient<\/option>\n                <!--<option value=\"Provider for Patient\">Provider for Patient<\/option>-->\n                <!-- <option value=\"Other\">Other<\/option> -->\n            <\/select>\n        <\/div>\n    <\/div>\n    <div id=\"option-error\"><\/div>\n    <span id=\"errorOccupation\" class=\"red-text-3452\"><\/span>\n    <p class=\"choose-physician-only\">Choose Provider only if you are the prescribing Provider.<\/p>\n<\/div>\n\n                  \n                  <!-- New Physician Details Section -->\n    <p class=\"submit-info form-heading\">Provider Details<\/p>\n    <div class=\"row\">\n        <div class=\"col-sm-4 col-width-100\">\n           <div class=\"form-floating-1\">\n             <label for=\"company\">Provider's Office\/Organization <span>*<\/span><\/label>\n             <input type=\"text\" class=\"form-control\" id=\"organization\" name=\"organization\" placeholder=\"Your Provider's Office\/Organization\" oninput=\"validateOrganization()\">\n             <span id=\"errorPhysicionOffice\" class=\"red-text-3452\"><\/span>\n           <\/div>\n        <\/div>\n    <\/div>\n\n    <!-- Provider's First Name and Last Name Fields -->\n    <div class=\"row\">\n        <div class=\"col-sm-4 input-col-left\">\n            <div class=\"form-floating-1\">\n                <label for=\"pname\">Provider's First Name <span>*<\/span><\/label>\n                <input type=\"text\" class=\"form-control\" id=\"pname\" name=\"pname\" placeholder=\"Provider's First Name\" oninput=\"validateNameField('pname', 'errorPName', 'Physician name')\">\n                <span id=\"errorPName\" class=\"red-text-3452\"><\/span>\n           <\/div>\n        <\/div>\n        <div class=\"col-sm-4 input-col-right\">\n                <div class=\"form-floating-1\">\n                <label for=\"plname\">Provider's Last Name <span>*<\/span><\/label>\n                <input type=\"text\" class=\"form-control\" id=\"plname\" name=\"plname\" placeholder=\"Provider's Last Name\" oninput=\"validateNameField('plname', 'errorPLastName', 'Physician last name')\">\n                <span id=\"errorPLastName\" class=\"red-text-3452\"><\/span>\n            <\/div>\n        <\/div>\n    <\/div>\n\n    <div class=\"row\">\n        <div class=\"col-sm-4 col-width-100\">\n           <div class=\"form-floating-1\">\n             <label for=\"provideremail\">Provider's Email <span id=\"mandatoryProviderEmail\">*<\/span><\/label>\n             <input type=\"text\" class=\"form-control\" id=\"provideremail\" name=\"provideremail\" placeholder=\"Provider's Email\" oninput=\"validateProviderEmail()\">\n             <span id=\"errorProviderEmail\" class=\"red-text-3452\"><\/span>\n           <\/div>\n        <\/div>\n    <\/div>\n    \n<p class=\"submit-info form-heading\">Shipping Details (Kits will be Delivered Here)<\/p>\n    <div class=\"row\">\n        <div class=\"col-sm-4 input-col-left\">\n            <div class=\"form-floating-1\">\n                <label for=\"name\">Receiver's First Name <span>*<\/span><\/label>                    \n                <input type=\"text\" class=\"form-control\" id=\"firstname\" name=\"first_name\" placeholder=\"Receiver's First Name\" oninput=\"validateNameField('firstname', 'errorFirstName', 'Receiver first name')\">\n                <span id=\"errorFirstName\" class=\"red-text-3452\"> <\/span>\n            <\/div>\n        <\/div>\n       <div class=\"col-sm-4 input-col-right\">\n    <div class=\"form-floating-1\">\n        <label for=\"lname\">Receiver's Last Name <span>*<\/span><\/label>\n        <input type=\"text\" class=\"form-control\" id=\"lastname\" name=\"last_name\" placeholder=\"Receiver's Last Name\" oninput=\"validateLastName()\">\n        <span id=\"errorLastName\" class=\"red-text-3452\"><\/span>\n    <\/div>\n<\/div>\n<\/div>\n                <div class=\"row\">\n                  <div class=\"col-sm-6 col-width-100\">\n                <div class=\"form-floating-1\">\n                    <label for=\"address\">Address <span>*<\/span><\/label>\n                    <input type=\"text\" class=\"form-control\" id=\"address\" name=\"address\" rows=\"4\" cols=\"50\" style=\"resize: none;\" placeholder=\"Your Address\"  oninput=\"validateAddress()\">\n                    <span id=\"errorAddress\" class=\"red-text-3452\"> <\/span>\n                  <\/div>\n                 <\/div>\n                <\/div>\n                <div class=\"row\">\n                    <div class=\"col-sm-4 input-col-right\">\n                        <div class=\"form-floating-1\">\n                            <label for=\"country\">Country <span>*<\/span><\/label>\n                            <select class=\"form-select\" aria-label=\"Country\" id=\"Country\" name=\"country\" onchange=\"validateCountry()\">\n                                <option value=\"\" selected>Select Country<\/option>\n                                <option value=\"United States\">United States<\/option>\n                                <option value=\"Canada\">Canada<\/option>\n                                <option value=\"United Kingdom\">United Kingdom<\/option>\n                                <option value=\"Ukraine\">Ukraine<\/option>\n                                <option value=\"Belgium\">Belgium<\/option>\n                                <option value=\"Georgia\">Georgia<\/option>\n                                <option value=\"United Arab Emirates\">UAE<\/option>\n                                <option value=\"Philippines\">Philippines<\/option>\n                                <option value=\"Spain\">Spain<\/option>\n                                <option value=\"South Korea\">South Korea<\/option>\n                                <option value=\"Other\">Other<\/option>\n                            <\/select>\n                            <span id=\"errorCountry\" class=\"red-text-3452\"><\/span>\n                        <\/div>\n                    <\/div>\n                    <div class=\"col-sm-4 input-col-left\">\n                        <div class=\"form-floating-1\">  \n                            <label for=\"zip\">Postal Code <span>*<\/span><\/label>\n                            <input type=\"text\" class=\"form-control\" id=\"zipcode\" name=\"zip_code\" placeholder=\"Enter Postal Code\" \n                                maxlength=\"10\" onblur=\"validatePostalCodeAndFetchLocation()\" \n                                oninput=\"this.value = this.value.toUpperCase()\">\n                            <span id=\"errorZip\" class=\"red-text-3452\"> <\/span>\n                        <\/div>\n                    <\/div>\n                <\/div>\n                <div class=\"row\">\n                    <div class=\"col-sm-4 input-col-left\">\n                        <div class=\"form-floating-1\">\n                            <label for=\"city\">City <span>*<\/span><\/label>\n                            <input type=\"text\" class=\"form-control\" id=\"city\" name=\"city\" placeholder=\"City\">\n                            <span id=\"errorCity\" class=\"red-text-3452\"> <\/span>\n                        <\/div>\n                    <\/div>\n                    <div class=\"col-sm-4 input-col-right\">\n                        <div class=\"form-floating-1\">\n                            <label for=\"state\">State\/Province <span>*<\/span><\/label>\n                            <input type=\"text\" class=\"form-control\" id=\"state\" name=\"state\" placeholder=\"State\/Province\">\n                            <span id=\"errorState\" class=\"red-text-3452\"> <\/span>\n                        <\/div>\n                    <\/div>\n                <\/div>\n     \n                <div class=\"row\">\n                 <div class=\"col-sm-4 input-col-left\">\n                <div class=\"form-floating-1\"> \n\t\t\t\t\t<label for=\"phone\">Telephone <span>*<\/span><\/label>\n                    <input type=\"text\" class=\"form-control\" id=\"telephone\" name=\"telephone\" placeholder=\"Your Telephone Number\" onkeypress=\"validateTelephone(event)\">\n                    <span id=\"errorTelephone\" class=\"red-text-3452\"> <\/span>\n                  <\/div>\n                  <\/div>\n                 <div class=\"col-sm-4 input-col-right\">\n                <div class=\"form-floating-1\">\n\t\t\t\t\t<label for=\"email\">Email Address <span>*<\/span><\/label>\n                    <input type=\"text\" class=\"form-control\" id=\"email\" name=\"email\" placeholder=\"Your Email Address\" oninput=\"validateEmail()\" >\n                    <span id=\"errorEmail\" class=\"red-text-3452\"> <\/span>\n                  <\/div>\n                  <\/div>\n                <\/div>\n                <div class=\"row\">\n                <div class=\"col-sm-4 input-col-left\">\n                <div class=\"form-floating-1\">  \n\t\t\t\t\t<label for=\"kit\"># of Test Kits <span>*<\/span><\/label>\n                    <input type=\"text\" class=\"form-control\" id=\"testkits\" name=\"kits\" placeholder=\"# of Test Kits\" oninput=\"return validateQuantity(event)\">\n                    <span id=\"errorNoOfKits\" class=\"red-text-3452\"> <\/span>\n                <\/div>\n                 <\/div>\n                <\/div>\n                <div class=\"row\">\n                <div class=\"col-sm-6 captcha-t6\">\n                    <div class=\"form-floating-1\">  \n                    <label for=\"user_input\">Captcha Code <span>*<\/span><\/label>\n                        <input type=\"text\" class=\"form-control\" id=\"user-input\" name=\"user_input\" placeholder=\"Enter Captcha Code\" autocomplete=\"off\" \/>\n                        <div id=\"challenge-container\"class=\"challenge-container\"><\/div>\n                        <span id=\"captcha-error\" class=\"red-text-3452\"><\/span>\n                        <input type=\"hidden\" class=\"form-control\" name=\"challenge\" id=\"challenge\" value=\"\" \/>\n                    <\/div>\n                    <\/div>\n                <\/div>\n\t\t\t\t\n                <div class=\"row\">\n                  <!--<div class=\"col\">\n                    <input type=\"text\" class=\"form-control\" placeholder=\"Message\" name=\"msg\" fdprocessedid=\"sgkaa8\">\n                    <div id=\"message-error\"><\/div>\n                  <\/div>-->\n                <\/div>\n                <div class=\"row\">\n\t\t\t\t<div>\n  <p>\n    Patient\/Parent\/Provider will receive a confirmation email from our support staff. Your order IS NOT complete until you respond to the email and submit a completed Test Requisition Form signed by both the provider and patient.\n  <\/p>\n  <p>If you don't receive our response in 48 hrs, please contact us on<br> +1 484-534-9311 or email us directly at <a href=\"mailto:support@mitoswab.com\">support@mitoswab.com<\/a><\/p>\n<\/div>\n              <div class=\"ld-sub\">\n                <input type=\"button\" onclick=\"kitFormValidation()\" id=\"submit\" class=\"btn btn-default sub-btn\" name=\"submit\" value=\"Submit\"><\/input>\n                <div class=\"load\" id=\"loading\" style=\"display: none;\"><i  class=\"fa fa-circle-notch fa-spin fa-3x fa-fw loding-icon-153\"><\/i>\n                <!--<button type=\"submit\" onclick=\"kitFormValidation()\" id=\"submit\" class=\"btn btn-default sub-btn\" name=\"submit\" value=\"Submit\">Submit<\/button>-->\n              <\/div>\n              <\/div>\n            <\/form>\n          <\/div><!-- End post list item -->\n        <\/div>\n   \n      <\/section><!-- End Recent Blog Posts Section -->\n      \n<\/main><!-- End #main -->\n\n<script>\nfunction initializeValidation() {\n    \/\/ Apply input restrictions and validation\n    $('#pname, #plname, #firstname, #lastname, #city, #state').on('input keyup', function() {\n        var fieldId = $(this).attr('id');\n        var value = $(this).val();\n        \n        \/\/ Check the id for the relevant fields\n        if (\n    fieldId === 'pname' || \n    fieldId === 'plname' || \n    fieldId === 'firstname' || \n    fieldId === 'lastname' ||\n    fieldId === 'city' ||\n    fieldId === 'state'\n) {\n            \/\/ Replace any character that is not a letter (a-z, A-Z) or space\n            value = value.replace(\/[^a-zA-Z\\s]\/g, '');\n            if (value.length > 35) {\n                value = value.slice(0, 35); \/\/ Limit input to 35 characters\n            }\n            $(this).val(value); \/\/ Set the modified value back into the field\n        }\n    });\n}\nfunction validateQuantity(event) {\n        const key = event.key;\n        const quantityInput = document.getElementById('testkits');\n        const quantityError = document.getElementById('errorNoOfKits');\n        const currentValue = quantityInput.value.trim(); \/\/ Trim whitespace from the input value\n\n        \/\/ Allow control keys (e.g., Backspace, Delete, Arrow keys)\n        if (event.ctrlKey || event.metaKey || event.altKey || key === 'ArrowLeft' || key === 'ArrowRight' || key === 'Backspace' || key === 'Delete') {\n            return true; \/\/ Allow the keypress\n        }\n\n        \/\/ Check if the entered key would result in a valid quantity\n        const newValue = currentValue + key; \/\/ Concatenate the current value with the pressed key\n        const parsedValue = parseInt(newValue, 10); \/\/ Parse the concatenated value as an integer\n\n        if (isNaN(parsedValue) || parsedValue < 1) {\n            \/\/ Display error message and prevent default action if the value is invalid\n            quantityError.textContent = 'Please enter a number greater than zero.';\n            event.preventDefault(); \/\/ Prevent the keypress\n            return false;\n        } else {\n            \/\/ Clear error message if the value is valid\n            quantityError.textContent = '';\n            return true; \/\/ Allow the keypress\n        }\n    }\n    \n   function validateOrganization() {\n    const organizationInput = document.getElementById('organization');\n    const organizationValue = organizationInput.value.trim();\n    const errorElement = document.getElementById('errorPhysicionOffice');\n\n    \/\/ Pattern to allow letters, spaces, apostrophes, and hyphens\n    \/\/ const orgPattern = \/^[a-zA-Z\\s'-.]+$\/;\n    const orgPattern = \/^[a-zA-Z\\s'\\-,.&@#!$%^*()_+=[\\]{}|;:\"<>?\/~`]+$\/;\n\n    if (!orgPattern.test(organizationValue)) {\n        \/\/ Display error message if the organization name is invalid\n        errorElement.textContent = 'Organization name can only contain letters, spaces, apostrophes, hyphens, and common special characters.';\n    } else {\n        \/\/ Clear any previous error message\n        errorElement.textContent = '';\n    }\n}\nfunction validateOccupation() {\n    const occupationSelect = document.getElementById('am');\n    const occupationValue = occupationSelect.value;\n    const errorElement = document.getElementById('errorOccupation');\n\n    if (occupationValue === '') {\n        \/\/ Display error message if no valid option is selected\n        errorElement.textContent = 'Please select an occupation.';\n    } else {\n        \/\/ Clear any previous error message\n        errorElement.textContent = '';\n    }\n}\n\nfunction validateLastName() {\n    const lastname = document.getElementById('lastname').value.trim();\n    const errorElement = document.getElementById('errorLastName');\n    let validLastName = true;\n\n    \/\/ Check if last name is empty\n    if (lastname === \"\") {\n        errorElement.textContent = \"Last name cannot be empty.\";\n        validLastName = false;\n    } \n    \/\/ Check if last name exceeds 50 characters\n    else if (lastname.length > 50) {\n        errorElement.textContent = \"Last name should be within 50 characters.\";\n        validLastName = false;\n    } \n    \/\/ Clear error if input is valid\n    else {\n        errorElement.textContent = \"\";\n        validLastName = true;\n    }\n    \n    return validLastName;\n}\n\n    $('#am').on('change', function() {\n        \/\/ This will show\/hide the asterisk and re-validate the email field\n        toggleProviderEmailAsterisk(); \n    });\n    \n    \/\/ Call it on page load to set the initial state\n    toggleProviderEmailAsterisk();\n        \n    function validateEmail() {\n        const emailInput = document.getElementById('email');\n        const email = emailInput.value.trim();\n\n        const emailPattern = \/^[^\\s@]+@[^\\s@]+\\.[^\\s@]+$\/;\n\n        if (!emailPattern.test(email)) {\n            \/\/ Display error message if the email format is invalid\n            $('#errorEmail').text('Please enter a valid email address.');\n        } else {\n            \/\/ Clear any previous error message\n            \/\/ emailInput.setCustomValidity('');\n            $('#errorEmail').text('');\n        }\n    }\n\n    function isProviderEmailMandatory() {\n        const occupationValue = $('#am').val();\n        const nonMandatoryOccupations = ['Patient', 'Parent'];\n        \n        return !nonMandatoryOccupations.includes(occupationValue);\n    }\n\n    function toggleProviderEmailAsterisk() {\n        const isRequired = isProviderEmailMandatory();\n        const mandatorySpan = document.getElementById('mandatoryProviderEmail');\n        \n        if (mandatorySpan) {\n            if (isRequired) {\n                mandatorySpan.style.display = 'inline'; \n            } else {\n                mandatorySpan.style.display = 'none';\n                $('#errorProviderEmail').text(''); \n            }\n        }\n        \n        \/\/ validateProviderEmail(); \n    }\n\n    function validateProviderEmail() {\n        const emailInput = document.getElementById('provideremail');\n        const email = emailInput.value.trim();\n        const isRequired = isProviderEmailMandatory();\n\n        const emailPattern = \/^[^\\s@]+@[^\\s@]+\\.[^\\s@]+$\/;\n\n        if (email === \"\" && !isRequired) {\n            $('#errorProviderEmail').text('');\n            return;\n        }\n\n        if (!emailPattern.test(email)) {\n            $('#errorProviderEmail').text('Please enter a valid email address.');\n        } else {\n            $('#errorProviderEmail').text('');\n        }\n    }\n\nfunction validateTelephone(event) {\n    const key = event.key;\n    const phoneInput = document.getElementById('telephone');\n    const phoneValue = phoneInput.value; \/\/ Remove trim() here to check exact position\n    const errorElement = document.getElementById('errorTelephone');\n\n    if (event.ctrlKey || event.metaKey || key === 'Backspace' || key === 'Delete' || key === 'ArrowLeft' || key === 'ArrowRight') {\n        return true;\n    }\n\n    if (phoneValue.length >= 20) {\n        errorElement.textContent = 'Telephone must be less than 20 characters.';\n        event.preventDefault();\n        return false;\n    }\n\n    if (key === '+' && phoneValue.length === 0) {\n        errorElement.textContent = '';\n        return true;\n    }\n\n    if (\/\\d\/.test(key)) {\n        errorElement.textContent = ''; \n        return true;\n    }\n\n    errorElement.textContent = 'Telephone can only contain numbers (and + at the start).';\n    event.preventDefault();\n    return false;\n}\n\n\/\/ Clear error message on valid input\ndocument.getElementById('telephone').addEventListener('input', function () {\n    const phoneInput = document.getElementById('telephone');\n    const errorElement = document.getElementById('errorTelephone');\n    \n    if (phoneInput.value.length <= 20) {\n        errorElement.textContent = '';\n    }\n});\n\n    function validateCountry() {\n        const countryInput = document.getElementById('Country');\n        const countryValue = countryInput.value;\n        const errorElement = document.getElementById('errorCountry');\n    \n        if (countryValue === '' || countryValue === null) {\n            errorElement.textContent = 'Please select a country.';\n        } else {\n            errorElement.textContent = '';\n        }\n    }\n\n    function validateState() {\n        const stateInput = document.getElementById('state');\n        const stateValue = stateInput.value.trim();\n        const errorElement = document.getElementById('errorState');\n    \n        if (stateValue === '' || stateValue === null) {\n            errorElement.textContent = 'State\/Province cannot be empty.';\n        } else if (stateValue.length > 50) {\n            errorElement.textContent = 'State\/Province should be within 50 characters.';\n        } else {\n            errorElement.textContent = '';\n        }\n    }\n\n\n   function validateCity() {\n        const cityInput = document.getElementById('city');\n        const cityValue = cityInput.value.trim();\n        const errorElement = document.getElementById('errorCity');\n    \n        if (cityValue === '' || cityValue === null) {\n            errorElement.textContent = 'City cannot be empty.';\n        } else if (cityValue.length > 50) {\n            errorElement.textContent = 'City should be within 50 characters.';\n        } else {\n            errorElement.textContent = '';\n        }\n    }\n\n\n    \n    function validateNameField(inputId, errorId, fieldName) {\n    const inputElement = document.getElementById(inputId);\n    const inputValue = inputElement.value.trim();\n    const errorElement = document.getElementById(errorId);\n    const pattern = \/^[a-zA-Z]*$\/; \/\/ Only letters allowed\n\n    \/\/ Validate if input is empty or contains invalid characters\n    if (inputValue === '') {\n        errorElement.textContent = `${fieldName} cannot be empty.`;\n    } else if (!pattern.test(inputValue)) {\n        errorElement.textContent = `${fieldName} can only contain letters.`;\n    } else if (inputValue.length > 50) {\n        errorElement.textContent = `${fieldName} should be within 50 characters.`;\n    } else {\n        errorElement.textContent = ''; \/\/ Clear error if valid\n    }\n\n    \/\/ Hide error when user starts typing\n    inputElement.addEventListener('input', function() {\n        errorElement.textContent = '';\n    });\n}\n\n    function validateAddress() {\n    const addressInput = document.getElementById('address');\n    const addressValue = addressInput.value.trim();\n    const errorElement = document.getElementById('errorAddress');\n\n    \/\/ Validate length and presence\n    if (addressValue === '') {\n        errorElement.textContent = 'Address cannot be empty.';\n    } else if (addressValue.length >= 250) {\n        errorElement.textContent = 'Address must be less than 25 characters.';\n    } else {\n        errorElement.textContent = ''; \/\/ Clear error if valid\n    }\n\n    \/\/ Clear error when the user starts typing\n    addressInput.addEventListener('input', function() {\n        errorElement.textContent = '';\n    });\n}\n\n\n    \n    $(function() {\n    $(\".holder + input\").keyup(function() {\n        if($(this).val().length) {\n            $(this).prev('.holder').hide();\n        } else {\n            $(this).prev('.holder').show();\n        }\n    });\n    $(\".holder + select\").change(function() {\n        if($(this).val() != '') {\n            $(this).prev('.holder').hide();\n        } else {\n            $(this).prev('.holder').show();\n        }\n    });\n    $(\".holder\").click(function() {\n        $(this).next().focus();\n    });\n    \n    \/\/ Add real-time validation for city and state\n$('#city').on('input', function() {\n    validateCity();\n});\n\n$('#state').on('input', function() {\n    validateState();\n});\n\n\/\/ Add country change listener to handle different postal code formats\n$('#Country').on('change', function() {\n    var country = $(this).val();\n    var zipInput = $('#zipcode');\n    \n    \/\/ Update placeholder based on country\n    if (country === 'United States') {\n        zipInput.attr('placeholder', 'Enter ZIP Code (5 digits)');\n        zipInput.attr('maxlength', '5');\n        zipInput.attr('pattern', '[0-9]{5}');\n    } else if (country === 'Canada') {\n        zipInput.attr('placeholder', 'Enter Postal Code (A1A 1A1)');\n        zipInput.attr('maxlength', '7');\n        zipInput.attr('pattern', '[A-Za-z][0-9][A-Za-z] [0-9][A-Za-z][0-9]');\n    } else if (country === 'United Kingdom') {\n        zipInput.attr('placeholder', 'Enter Postcode (e.g., SW1A 1AA)');\n        zipInput.attr('maxlength', '8');\n    } else {\n        zipInput.attr('placeholder', 'Enter Postal Code');\n        zipInput.attr('maxlength', '10');\n        zipInput.removeAttr('pattern');\n    }\n    \n    \/\/ Clear any previous location data when country changes\n    $('#city').val('');\n    $('#state').val('');\n    $('#errorZip').text('');\n});\n    \n    \/\/ Initialize validation\n    initializeValidation();\n    \n    \/\/ Generate CAPTCHA challenge when the page loads\n        generateChallenge();\n});\n\n\/\/ Function to generate CAPTCHA challenge\n    function generateChallenge() {\n        var characters = 'ABCDEFGHJKLMNOPQRSTUVWXYZ023456789abcdefghjkmnopqrstuvwxyz!@#$%&*()';\n        var challengeLength = 8;\n        var challenge = '';\n        for (var i = 0; i < challengeLength; i++) {\n            challenge += characters.charAt(Math.floor(Math.random() * characters.length));\n        }\n        $('#challenge-container').text(challenge); \/\/ Display the CAPTCHA challenge\n        $('#challenge').val(challenge); \/\/ Store the CAPTCHA challenge in the hidden input\n    }\n\n    \/\/ Regenerate CAPTCHA when the container is clicked\n    $(document).on('click', '#challenge-container', function() {\n        generateChallenge();\n    }).on('copy', '#challenge-container', function(e) {\n        e.preventDefault(); \/\/ Prevent copying the CAPTCHA\n    });\n    \n    function validatePostalCodeAndFetchLocation() {\n        var zipInput = document.getElementById('zipcode');\n        var zipValue = zipInput.value.trim();\n        var errorElement = document.getElementById('errorZip');\n        var cityInput = document.getElementById('city');\n        var stateInput = document.getElementById('state');\n        var countryInput = document.getElementById('Country');\n        var countryValue = countryInput.value;\n\n        \/\/ Basic validation\n        if (zipValue === '') {\n            errorElement.textContent = 'Please enter a postal code.';\n            return;\n        }\n\n        \/\/ Only use API for United States\n        if (countryValue === 'United States' && zipValue.length === 5) {\n            \/\/ Show loading state for US ZIP codes only\n            errorElement.textContent = 'Looking up location...';\n            errorElement.style.color = '#0066cc';\n            zipInput.disabled = true;\n\n            fetch('https:\/\/api.zippopotam.us\/us\/' + zipValue)\n                .then(response => {\n                    if (!response.ok) {\n                        throw new Error('Invalid ZIP code');\n                    }\n                    return response.json();\n                })\n                .then(data => {\n                    if (data.places && data.places.length > 0) {\n                        var place = data.places[0];\n                        cityInput.value = place['place name'];\n                        stateInput.value = place.state;\n                        errorElement.textContent = '';\n                        errorElement.style.color = '';\n                    } else {\n                        throw new Error('No location found');\n                    }\n                })\n                .catch(error => {\n                    errorElement.textContent = 'Invalid ZIP code. Please enter a valid 5-digit US ZIP code.';\n                    errorElement.style.color = '#d32f2f';\n                })\n                .finally(() => {\n                    zipInput.disabled = false;\n                });\n        } else {\n            \/\/ For other countries or invalid US ZIP codes, clear any previous errors\n            errorElement.textContent = '';\n            errorElement.style.color = '';\n        }\n    }\n\n\/\/ Keep the old function name for backward compatibility\nfunction validateZipCodeAndFetchLocation() {\n    validatePostalCodeAndFetchLocation();\n}\n\n\/\/ form validation and data submit start\n    function kitFormValidation() {\n        var submitButton = $('#submit');\n    \n        \/\/ $('#submit').addClass('')\n        var english = \/^[A-Za-z0-9\\s\\.\\,\/\\\/\\#]*$\/;\n        var mail = \/^\\w+([\\.-]?\\w+)*@\\w+([\\.-]?\\w+)*.(\\.\\w{2,3})+$\/;\n        var regNum = \/^[0-9]+$\/;\n\n        var am = $('#am').val();\n        var pname = $('#pname').val();\n        var plname = $('#plname').val();\n        var pemail = $('#provideremail').val();\n        var firstname = $('#firstname').val();\n        var lastname = $('#lastname').val();\n        var organization = $('#organization').val();\n        var address = $('#address').val();\n        var email = $('#email').val();\n        var city = $('#city').val();\n        var state = $('#state').val();\n        var zipcode = $('#zipcode').val();\n        var Country = $('#Country').val();\n        var telephone = $('#telephone').val();\n        var testkits = $('#testkits').val();\n        var actualChallengeValue = $('#challenge').val();\n        var userEnteredValue = $('#user-input').val();\n    \n        var validationFailed = false;\n        var valFirstNameFailed = false;\n        var validAm = true;\n        var validPhysicianName = true;\n        var validPhysicianLname = true;\n        var validPhysianEmail = true;\n        var validFirstName = true;\n        var validLastName = true;\n        var validPhysicianOffice = true;\n        var validAddress = true;\n        var validCity = true;\n        var validState = true;\n        var validZip = true;\n        var validCountry = true;\n        var validTelephone = true;\n        var validEmail = true;\n        var validNoOfkits = true;\n        let validCaptcha = true;\n        let validOption = true;\n    \n    \n    if (am === null || am === \"\" || am === undefined) {\n        validationFailed = true;\n        $('#errorOccupation').text(\"Please select an option\");\n        $('#am').css('border-color', 'red').focus();\n        validOption = false;\n    } else {\n        validationFailed = false;\n        $('#errorOccupation').text(\"\");\n        $('#am').css('border-color', 'green');\n        validOption = true;\n    }\n\n\n    if (firstname == null || firstname === \"\" || firstname === undefined) {\n        validationFailed = true;\n        $('#errorFirstName').text(\"First name cannot be empty.\");\n        $('#firstname').focus();\n        validFirstName = false;\n    } else if (firstname.length > 50) {\n        validationFailed = true;\n        $('#errorFirstName').text(\"First name should be within 50 characters.\");\n        $('#firstname').focus();\n        validFirstName = false;\n    } else {\n        \/\/ If the name passes validation\n        $('#errorFirstName').text(\"\"); \/\/ Clear error message\n        validationFailed = false;\n        validFirstName = true;\n    }\n\n    if (lastname == null || lastname === \"\" || lastname === undefined) {\n        validationFailed = true;\n        $('#errorLastName').text(\"Last name cannot be empty.\");\n        $('#lastname').focus();\n        validLastName = false;\n    } else if (lastname.length > 50) {\n        validationFailed = true;\n        $('#errorLastName').text(\"Last name should be within 50 characters.\");\n        $('#lastname').focus();\n        validLastName = false;\n    } else {\n        \/\/ If everything is valid, clear the error message\n        $('#errorLastName').text(\"\");\n        validationFailed = false;\n        validLastName = true;\n    }\n\n    if (pname == null || pname.trim() == \"\" || pname == undefined) {\n        validationFailed = true;\n        $('#errorPName').text(\"Provider's first name cannot be empty\");\n        $('#pname').focus();\n        validPhysicianName = false;\n    } else {\n        if (pname.length > 50) {\n            validationFailed = true;\n            $('#errorPName').text(\"Provider's name should be within 50 characters\");\n            $('#pname').focus();\n            validPhysicianName = false;\n        } else {\n            $('#errorPName').text(\"\");\n            validationFailed = false;\n            validPhysicianName = true;\n        }\n    }\n\n    if (plname == null || plname.trim() == \"\" || plname == undefined) {\n        validationFailed = true;\n        $('#errorPLastName').text(\"Provider's last name cannot be empty\");\n        $('#plname').focus();\n        validPhysicianLname = false;\n    } else {\n        if (plname.length > 50) {\n            validationFailed = true;\n            $('#errorPLastName').text(\"Provider's last name should be within 50 characters\");\n            $('#plname').focus();\n            validPhysicianLname = false;\n        } else {\n            $('#errorPLastName').text(\"\");\n            validationFailed = false;\n            validPhysicianLname = true;\n        }\n    }\n\/\/ organization  \n\n    if (organization == null || organization == \"\" || organization == undefined) {\n        \/\/console.log(\"organization name can not be empty\")\n        validationFailed = true;\n        $('#errorPhysicionOffice').text(\"Provider's Office cannot be empty\");\n        $('#organization').focus();\n        validPhysicianOffice = false;\n\n    }\n    else {\n        if (organization.length > 50) {\n            validationFailed = true;\n            $('#errorPhysicionOffice').text(\"Provider's Office should be within 50 chars\");\n            $('#organization').focus();\n            validPhysicianOffice = false\n        }\n        else {\n            validationFailed = false;\n            $('#errorPhysicionOffice').text(\"\");\n            validPhysicianOffice = true;\n        }\n    } \/\/ address\n\n    if (address == null || address == \"\" || address == undefined) {\n        \/\/console.log(\"address name can not be empty\")\n        validationFailed = true\n        $('#errorAddress').text(\"Address cannot be empty\");\n        $('#address').focus();\n        validAddress = false;\n    }\n    else {\n        if (address.length > 300) {\n            validationFailed = true\n            $('#errorAddress').text(\"Address should be within 300 chars\");\n            $('#address').focus();\n            validAddress = false;\n        }\n        else {\n            validationFailed = false;\n            $('#errorAddress').text(\"\")\n            validAddress = true;\n        }\n    }\n    const isProviderEmailRequired = (am !== 'Patient' && am !== 'Parent');\n\n    if (isProviderEmailRequired) {\n        if (pemail == null || pemail.trim() === \"\" || pemail === undefined) {\n            validationFailed = true; \n            $('#errorProviderEmail').text(\"Provider's Email cannot be empty.\");\n            $('#provideremail').focus();\n            validPhysianEmail = false;\n        } \n        else if (!mail.test(pemail)) {\n            validationFailed = true; \n            $('#errorProviderEmail').text(\"Provider's Email not in correct format.\");\n            $('#provideremail').focus();\n            validPhysianEmail = false;\n        } \n        else {\n            $('#errorProviderEmail').text(\"\");\n            validPhysianEmail = true;\n        }\n    } else {\n        if (pemail.trim() !== \"\" && !mail.test(pemail)) {\n            validationFailed = true; \n            $('#errorProviderEmail').text(\"Email format is incorrect.\");\n            $('#provideremail').focus();\n            validPhysianEmail = false;\n        } \n        else {\n            $('#errorProviderEmail').text(\"\");\n            validPhysianEmail = true;\n        }\n    }\n\n    \/\/ email\n\n    if (email == null || email == \"\" || email == undefined) {\n        \/\/console.log(\"email can not be empty\")\n        validationFailed = true\n        $('#errorEmail').text(\"Email cannot be empty\");\n        $('#email').focus();\n        validEmail = false;\n\n    }\n    else {\n        if (!mail.test(email)) {\n            \/\/console.log(\"Inputs should be in mail only\")\n            validationFailed = true;\n            $('#errorEmail').text(\"Email not in correct format\");\n            $('#email').focus();\n            validEmail = false;\n        }\n        else {\n            $('#errorEmail').text(\"\");\n            validationFailed = false;\n            validEmail = true;\n        }\n    }\n    \/\/ city validation\n    if (city == null || city == \"\" || city == undefined) {\n        validationFailed = true;\n        $('#errorCity').text(\"City cannot be empty\");\n        $('#city').focus();\n        validCity = false;\n    } else {\n        if (city.length > 50) {\n            validationFailed = true;\n            $('#errorCity').text(\"City should be within 50 chars \");\n            $('#city').focus();\n            validCity = false;\n        } else {\n            validationFailed = false;\n            $('#errorCity').text(\"\");\n            validCity = true;\n        }\n    }\n\n    \/\/ state validation\nif (state == null || state == \"\" || state == undefined) {\n    validationFailed = true;\n    $('#errorState').text(\"State cannot be empty\");\n    $('#state').focus();\n    validState = false;\n} else {\n    if (state.length > 50) {\n        validationFailed = true;\n        $('#errorState').text(\"State should be within 50 chars \");\n        $('#state').focus();\n        validState = false;\n    } else {\n        validationFailed = false;\n        $('#errorState').text(\"\");\n        validState = true;\n    }\n}\n    \/\/ zipcode validation\n    if (zipcode == null || zipcode == \"\" || zipcode == undefined) {\n        validationFailed = true;\n        $('#errorZip').text(\"Postal code cannot be empty\");\n        $('#zipcode').focus();\n        validZip = false;\n    } else {\n        if (zipcode.length > 10) {\n            validationFailed = true;\n            $('#errorZip').text(\"Postal code should be within 10 characters\");\n            $('#zipcode').focus();\n            validZip = false;\n        } else {\n            validationFailed = false;\n            $('#errorZip').text(\"\");\n            validZip = true;\n        }\n    }\n    \/\/ country validation\n    if (Country == null || Country === \"\" || Country === undefined) {\n        validationFailed = true;\n        $('#errorCountry').text(\"Country is required.\");\n        $('#Country').css('border-color', 'red').focus();\n        validCountry = false;\n    } else {\n        validationFailed = false;\n        $('#errorCountry').text(\"\");\n        $('#Country').css('border-color', 'green');\n        validCountry = true;\n    }\n\n\n    \/\/ telephone\n\n    if (telephone == null || telephone == \"\" || telephone == undefined) {\n        validationFailed = true;\n        $('#errorTelephone').text(\"Telephone cannot be empty\");\n        $('#telephone').focus();\n        validTelephone = false;\n\n    }\n    else {\n\n        var phoneRegex = \/^\\+?[0-9]+$\/;\n\n        if (!phoneRegex.test(telephone)) {\n            validationFailed = true;\n            $('#errorTelephone').text(\"Telephone can only contain numbers and a '+' prefix.\");\n            $('#telephone').focus();\n            validTelephone = false;\n        }\n        else if (telephone.length < 5) {\n            validationFailed = true;\n            $('#errorTelephone').text(\"Telephone  number should have at least 5 digits \");\n            $('#telephone').focus();\n            validTelephone = false;\n        }\n        else if (telephone.length > 21) {\n            validationFailed = true;\n            $('#errorTelephone').text(\"Telephone Should be within  20 chars\");\n            $('#telephone').focus();\n            validTelephone = false;\n        }\n\n        else {\n            validationFailed = false;\n            $('#errorTelephone').text(\"\");\n            validTelephone = true;\n        }\n    }\n    \n            if (userEnteredValue === null || userEnteredValue === \"\" || userEnteredValue === undefined) {\n            validationFailed = true;\n            $('#captcha-error').text(\"CAPTCHA cannot be empty\");\n            $('#user-input').css('border-color', 'red').focus();\n            validCaptcha = false;\n            } else if (userEnteredValue !== actualChallengeValue) {\n            validationFailed = true;\n            $('#captcha-error').text(\"Please enter the correct CAPTCHA.\");\n            $('#user-input').css('border-color', 'red').focus();\n            validCaptcha = false;\n            generateChallenge(); \n            } else {\n            validationFailed = false;\n            $('#captcha-error').text(\"\");\n            $('#user-input').css('border-color', 'green');\n            validCaptcha = true;\n            }\n        \n    \/\/ testkit   \n\n    if (testkits == null || testkits == \"\" || testkits == undefined) {\n        \/\/console.log(\"zipcode can not be empty\")\n        validationFailed = true;\n        $('#errorNoOfKits').text(\"No. of kits cannot be empty\");\n        $('#testkits').focus();\n        validNoOfkits = false;\n\n    }\n    else {\n        if (!regNum.test(testkits)) {\n            \/\/console.log(\"Inputs should be in english only\")\n            validationFailed = true;\n            $('#errorNoOfKits').text(\"No. of kits accept only numbers\");\n            $('#testkits').focus();\n            validNoOfkits = false;\n        }\n        else if (testkits == 0) {\n            validationFailed = true;\n            $('#errorNoOfKits').text(\"No. of kits  should have at least 1\");\n            $('#testkits').focus();\n            validNoOfkits = false;\n        }\n        else if (testkits.length > 3) {\n            validationFailed = true;\n            $('#errorNoOfKits').text(\"No. of kits should be in 3 digits\");\n            $('#testkits').focus();\n            validNoOfkits = false;\n        }\n\n        else {\n            validationFailed = false;\n            $('#errorNoOfKits').text(\"\");\n            validNoOfkits = true;\n        }\n    }\n\n    $(document).on('click', '#challenge-container', function() {\n        generateChallenge();\n    }).on('copy', '#challenge-container', function(e) {\n        e.preventDefault();\n        \n    });\n\n    if (!validationFailed && validOption && validPhysicianName && 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$('#telephone').val(),\n            'testkits': $('#testkits').val(),\n        };\n        $.ajax({\n            type: 'POST',\n            url: 'https:\/\/www.mitoswab.com\/staging\/wp-content\/themes\/hello-biz\/order-backend.php',\n            data: OrderkitData,\n            \/\/ dataType  : 'json',\n            success: function (data) {\n                $('#loading').show();\n                if (data == '\"Email is Sent. order process is completed\"') {\n                    \/\/alert(\"Order process is  completed\");\n                    $(location).attr('href', '');\n                    $('#contact-form')[0].reset();\n\n                }\n                else if (data === 'Email is not sent. order process is not completed') {\n                    alert(\"Order process is  not completed.. Try Again\");\n                }\n                $('#submit').removeAttr('disabled');\n            },\n            failure: function (error) {\n                $('#loading').hide();\n                console.log(error)\n            }\n        });\n    }\n    else {\n        \/\/ alert(\"Fill with right data in required fields\")\n    }\n}\n\/\/ form validation and data submit end\n<\/script>\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Request a Test Kit<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-43","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.mitoswab.com\/staging\/wp-json\/wp\/v2\/pages\/43","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.mitoswab.com\/staging\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.mitoswab.com\/staging\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.mitoswab.com\/staging\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.mitoswab.com\/staging\/wp-json\/wp\/v2\/comments?post=43"}],"version-history":[{"count":266,"href":"https:\/\/www.mitoswab.com\/staging\/wp-json\/wp\/v2\/pages\/43\/revisions"}],"predecessor-version":[{"id":4980,"href":"https:\/\/www.mitoswab.com\/staging\/wp-json\/wp\/v2\/pages\/43\/revisions\/4980"}],"wp:attachment":[{"href":"https:\/\/www.mitoswab.com\/staging\/wp-json\/wp\/v2\/media?parent=43"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}