[IfUrl type=contains "email"][FillField email with url email][/IfUrl] [IfUrl type=contains "fname"][FillField firstname with url fname][/IfUrl] [IfUrl type=contains "lname"][FillField lastname with url lname][/IfUrl] [IfUrl type=contains "sms"][FillField sms_number with url sms][/IfUrl] [IfUrl type=contains "code"][FillField f2594 with url code][/IfUrl] [Validate f2594 allcap "Please write your Coupon Code in capital letters" force=yes prevent=no] [IfField #oeddddcd807ae-f2165 is '1' AND #oe43503187162-f2593 not 'Faxed In'][Redirect https://patients.orderlymeds.com/signup][/IfField] [IfField #oeddddcd807ae-f2165 is '2,3,4,5,6,7,8,9,10,11,12' AND #oe43503187162-f2593 not 'Faxed In'][Redirect https://patients.orderlymeds.com/healthscreening][/IfField] [IfField #oeddddcd807ae-f2165 not '10' AND #oeddddcd807ae-f2165 not '12' AND #oe43503187162-f2593 is 'Faxed In'][Redirect https://patients.orderlysupport.com/faxed_in_new_client][/IfField] [IfField #oeddddcd807ae-f2165 is '10' AND #oe43503187162-f2593 is 'Faxed In'][Redirect https://patients.orderlymeds.com/continue/paynow][/IfField] [IfField #oeddddcd807ae-f2165 is '12' AND #oe43503187162-f2593 is 'Faxed In'][Redirect https://patients.orderlymeds.com/healthscreening-ty][/IfField] [SyncFields f2151] [HideBlock #oeddddcd807ae] [ShowBlock #o6a682b836e46] [HideField f2593,f2225] [HideColumn 73,76 in #o6a682b836e46] [Validate f2145 numeric "You need to input your height with numeric values." force=yes] [Validate f2147 numeric "You need to input your height with numeric values." force=yes] [Validate f2146 numeric "You need to input your weight with numeric values." force=yes] [IfField #o6a682b836e46-f2145 not '' AND #o6a682b836e46-f2147 not '' AND #o6a682b836e46-f2146 not ''] [Calc $feet=#o6a682b836e46-f2145] [Calc $inches=#o6a682b836e46-f2147] [Calc $height=($feet*12)+$inches] [Calc $weight=#o6a682b836e46-f2146] [Calc $bmi=($weight/($height*$height))*703 round=1] [FillField #o6a682b836e46-f2225 with $bmi] [IfVar $bmi <= $bmimin][ShowColumn 76 in #o6a682b836e46][HideColumn 73 in #o6a682b836e46][/IfVar] [IfVar $bmi > $bmimin][HideColumn 76 in #o6a682b836e46][ShowColumn 73 in #o6a682b836e46][/IfVar] [IfVar $bmi <= $bmimin AND $dateofbirth < $eitheenyearsago][Calc f2372,$eligibility='BMI less than 27'][/IfVar] [/IfField] [Calc $dateofbirth=0] [IfField #o6a682b836e46-f2000 not ''][SetVar $dateofbirth=#o6a682b836e46-f2000 type=unix][/IfField] [Calc $eitheenyearsago=$today-568024668] [IfVar $dateofbirth > $eitheenyearsago][ShowColumn 81 in #o6a682b836e46][/IfVar] [IfVar $dateofbirth > $eitheenyearsago AND $bmi > $bmimin][Calc f2372,$eligibility='Age less than 18'][/IfVar] [Calc $bmimin=27] [Calc $started=#o6a682b836e46-f2364] [IfVar $dateofbirth < $eitheenyearsago AND $bmi > $bmimin][ShowElement 43 in #o6a682b836e46][/IfVar] [IfVar $bmi <= $bmimin AND $dateofbirth > $eitheenyearsago][Calc f2372,$eligibility='BMI less than 27 And Age less than 18'][/IfVar] [HideField f2372,f2162,f2662] [IfVar $bmi > $bmimin AND $dateofbirth < $eitheenyearsago][Calc f2372,$eligibility=''][/IfVar] [IfField f2372 not ''][FillField f2162 with 'Not Eligible'][/IfField] [IfField f2372 is ''][FillField f2162 with 'Select...'][/IfField] [IfField f2162 is 'Select...'][FillField f2662 with checked][/IfField] [IfField f2162 is 'Not Eligible'][FillField f2662 with unchecked][/IfField] [IfField #o6a682b836e46-state is 'Puerto Rico'][FillField f2162 with 'Not Eligible'][/IfField] [IfField #o6a682b836e46-state is 'Mississippi'][FillField f2162 with 'Not Eligible'][/IfField] [IfField #o6a682b836e46-state is 'New Mexico'][FillField f2162 with 'Not Eligible'][/IfField] [IfField #o6a682b836e46-state is 'Louisiana'][FillField f2162 with 'Not Eligible'][/IfField] [IfField #o6a682b836e46-state not ''][Calc $state=#o6a682b836e46-state][/IfField] [HideField f2594] [Validate f2594 allcap "Please write your Coupon Code in capital letters" force=yes prevent=no]