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JavaScript Form Question
Old 07-13-2009, 02:09 PM JavaScript Form Question
ADeacon's Avatar
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Posts: 32
Name: Andrew
Location: Texas
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Hello,

I'm working with a form at the moment and I have a JavaScript question. I have a field that when one of the first five options is selected, the two fields below them are selectable as well. The values of the options are all numbers, but I would like to be able to make the values the field names so they can be useful for data in their database. How can I manipulate the JS and the form data to make this work. My strength is not in JS so please forgive my ignorance.

I'll leave a link and code below.

Thanks in advance,

-Deacon-

Link:

http://drawninwardmedia.com/apply_test.html

Code:


<html>
<head>
<script type="text/javascript" language="javascript">

function update_specialty() {
var prof = document.register.profession.selectedIndex;
var matched = 0; // try to indicate match so we can turn ps off or on
// alert(prof);

if (document.register.profession.options[prof].value == "1") {
document.register.primary1.style.display = 'inline';
document.register.secondary1.style.display = 'inline';
document.register.selectedPS.value = 1;
matched = 1;
} else {
document.register.primary1.style.display = 'none';
document.register.secondary1.style.display = 'none';
}


if (document.register.profession.options[prof].value == "2") {
document.register.primary2.style.display = 'inline';
document.register.secondary2.style.display = 'inline';
document.register.selectedPS.value = 2;
matched = 1;
} else {
document.register.primary2.style.display = 'none';
document.register.secondary2.style.display = 'none';
}


if (document.register.profession.options[prof].value == "53") {
document.register.primary53.style.display = 'inline';
document.register.secondary53.style.display = 'inline';
document.register.selectedPS.value = 53;
matched = 1;
} else {
document.register.primary53.style.display = 'none';
document.register.secondary53.style.display = 'none';
}


if (document.register.profession.options[prof].value == "55") {
document.register.primary55.style.display = 'inline';
document.register.secondary55.style.display = 'inline';
document.register.selectedPS.value = 55;
matched = 1;
} else {
document.register.primary55.style.display = 'none';
document.register.secondary55.style.display = 'none';
}


if (document.register.profession.options[prof].value == "64") {
document.register.primary64.style.display = 'inline';
document.register.secondary64.style.display = 'inline';
document.register.selectedPS.value = 64;
matched = 1;
} else {
document.register.primary64.style.display = 'none';
document.register.secondary64.style.display = 'none';
}


if (document.register.profession.options[prof].value == "65") {
document.register.primary65.style.display = 'inline';
document.register.secondary65.style.display = 'inline';
document.register.selectedPS.value = 65;
matched = 1;
} else {
document.register.primary65.style.display = 'none';
document.register.secondary65.style.display = 'none';
}


if (document.register.profession.options[prof].value == "69") {
document.register.primary69.style.display = 'inline';
document.register.secondary69.style.display = 'inline';
document.register.selectedPS.value = 69;
matched = 1;
} else {
document.register.primary69.style.display = 'none';
document.register.secondary69.style.display = 'none';
}


if (document.register.profession.options[prof].value == "78") {
document.register.primary78.style.display = 'inline';
document.register.secondary78.style.display = 'inline';
document.register.selectedPS.value = 78;
matched = 1;
} else {
document.register.primary78.style.display = 'none';
document.register.secondary78.style.display = 'none';
}

if (matched == 1) {
document.register.primary_specialty.style.display = 'none';
document.register.secondary_specialty.style.displa y = 'none';
} else {
document.register.primary_specialty.style.display = 'inline';
document.register.secondary_specialty.style.displa y = 'inline';
}
}

</script>
</head>

<body>

<form enctype="multipart/form-data" action="apply_send.php" method="POST" name="register" onsubmit="return check_form();">
<br/>

<br/>
<table width="530" cellspacing="0" cellpadding="0" border="0" style="font-size: 12px;">
<tbody><tr>
<td valign="top"><div style="float: left;">Professional Information</div> <div style="float: right;"> <sup class="asterisc">*</sup>Required Field</div></td><td style="width: 6px;"></td>
</tr>
</tbody></table>
<br/>
<table width="538" cellspacing="0" cellpadding="1" border="0" style="font-size: 12px;">
<tbody><tr><td width="205" class="cellright">Profession<sup class="asterisc">*</sup></td>
<td width="333" colspan="2" class="cellleft"><select name="profession" style="width: 315px;" onchange="update_specialty()">
<option selected="selected" value="">Click to Select</option>
<option value="2">Licensed Practical Nurse (LPN)</option><option value="53">Licensed Vocational Nurse (LVN)</option><option value="1">Registered Nurse (RN)</option><option value="4">Certified Nurse Assistant (CNA)</option><option value="44">Admin/Office</option><option value="45">Anesthesiologist Assistant</option><option value="46">Audiologist</option><option value="47">Behavioral Health Technician (BHT)</option><option value="94">Cardiac Monitor / EKG Technician</option><option value="48">Certified Occupational Therapy Assistant (COTA)</option><option value="49">Certified Registered Nurse Anesthetist (CRNA)</option><option value="96">Dental Assistant</option><option value="95">Dental Hygienist</option><option value="50">EEG Technician</option><option value="51">Emergency Medical Technician (EMT)</option><option value="89">Home Health Aide (HHA)</option><option value="54">Medical Assistant (MA)</option><option value="90">Medical Coder</option><option value="55">Medical Lab</option><option value="92">Medical Records Clerk</option><option value="93">Medication Aide</option><option value="56">Mental Health Technician (MHT)</option><option value="3">Nurse Practitioner</option><option value="57">Occupational Therapist</option><option value="58">Operating Room Technician (ORT)</option><option value="91">Pharmacist</option><option value="59">Pharmacy Technician</option><option value="61">Phlebotomist</option><option value="62">Physical Therapist</option><option value="63">Physical Therapist Assistant</option><option value="64">Physician</option><option value="65">Physician Assistant</option><option value="66">Polysomnographic Tech</option><option value="68">Radiation Therapist/Dosimetrist</option><option value="69">Radiological Tech</option><option value="70">Registered Polysomnographic Tech</option><option value="71">Respiratory Therapist</option><option value="80">Scrub Technician</option><option value="73">Speech/Language Therapist Assistant</option><option value="74">Speech/Language Therapist/Pathologist</option><option value="75">Sterile Processing Tech</option><option value="76">Surgical Assistant</option><option value="78">Surgical Technologist</option><option value="79">Unit Clerk</option>
</select></td></tr>
<tr><td>&nbsp;</td></tr>
<tr><td class="cellright">Primary Specialty<sup class="asterisc">*</sup></td>
<td colspan="2" class="cellleft">
<input type="hidden" name="selectedPS" value="">
<select name="primary_specialty" disabled style="width:315px;">
<option value="">Click to Select</option>
</select>

<select name="primary2" style="width:315px;display:none;"><option value="">Click to Select</option><option value="106">Burns ICU</option><option value="107">Cardiac Cath</option><option value="108">Cardiac ICU</option><option value="80">Cardiovascular ICU</option><option value="15">Critical Care</option><option value="21">Dialysis</option><option value="18">Emergency Room</option><option value="124">Geriatrics/Long Term Care</option><option value="126">Homecare</option><option value="14">ICU</option><option value="26">Labor and Delivery</option><option value="139">Medical ICU</option><option value="12">Medical/Surgical</option><option value="142">Medical/Surgical - Neurology</option><option value="143">Medical/Surgical - Orthopedic</option><option value="23">Neonatal Intensive Care Unit</option><option value="147">Neuro ICU</option><option value="73">Newborn Nursery</option><option value="151">OB/GYN</option><option value="152">Occupational Medicine</option><option value="153">Office Nurse</option><option value="22">Oncology</option><option value="154">Oncology/Chemo</option><option value="155">Oncology/Non-Chemo</option><option value="38">Operating Room</option><option value="160">PACU/Recovery Room</option><option value="19">Pediatric Non-ICU</option><option value="24">Peds Intensive Care Unit</option><option value="77">Post Partum</option><option value="171">Progressive Care Unit</option><option value="17">Psychiatry</option><option value="20">Rehab</option><option value="174">School Setting</option><option value="76">Step Down ICU</option><option value="177">Surgical ICU</option><option value="16">Telemetry</option><option value=64>Other</option></select><select name="primary53" style="width:315px;display:none;"><option value="">Click to Select</option><option value="106">Burns ICU</option><option value="107">Cardiac Cath</option><option value="108">Cardiac ICU</option><option value="80">Cardiovascular ICU</option><option value="15">Critical Care</option><option value="21">Dialysis</option><option value="18">Emergency Room</option><option value="124">Geriatrics/Long Term Care</option><option value="126">Homecare</option><option value="14">ICU</option><option value="26">Labor and Delivery</option><option value="139">Medical ICU</option><option value="12">Medical/Surgical</option><option value="142">Medical/Surgical - Neurology</option><option value="143">Medical/Surgical - Orthopedic</option><option value="23">Neonatal Intensive Care Unit</option><option value="147">Neuro ICU</option><option value="73">Newborn Nursery</option><option value="151">OB/GYN</option><option value="153">Office Nurse</option><option value="22">Oncology</option><option value="154">Oncology/Chemo</option><option value="155">Oncology/Non-Chemo</option><option value="38">Operating Room</option><option value="160">PACU/Recovery Room</option><option value="19">Pediatric Non-ICU</option><option value="24">Peds Intensive Care Unit</option><option value="77">Post Partum</option><option value="171">Progressive Care Unit</option><option value="17">Psychiatry</option><option value="20">Rehab</option><option value="174">School Setting</option><option value="76">Step Down ICU</option><option value="177">Surgical ICU</option><option value="16">Telemetry</option><option value=64>Other</option></select><select name="primary55" style="width:315px;display:none;"><option value="">Click to Select</option><option value="105">Blood Bank</option><option value="113">Cytologist</option><option value="125">Histologist</option><option value="140">Medical Technician</option><option value="141">Medical Technologist</option><option value=64>Other</option></select><select name="primary64" style="width:315px;display:none;"><option value="">Click to Select</option><option value="102">Administrators</option><option value="103">Allergy and Immunology</option><option value="104">Anesthesiology</option><option value="112">Colon and Rectal Surgery</option><option value="114">Dermatology</option><option value="116">Emergency Medicine</option><option value="117">Epidemiology</option><option value="118">Epileptology</option><option value="119">Family Practice</option><option value="121">General Preventative Medicine</option><option value="122">General Surgery</option><option value="127">Hospitalist</option><option value="128">IM/Dermatology</option><option value="129">IM/Emergency Med</option><option value="130">IM/Emergency/Critical Care</option><option value="132">IM/Neurology</option><option value="133">IM/PMR</option><option value="134">IM/Preventative Medicine</option><option value="135">IM/Psychiatry</option><option value="136">Internal Medicine</option><option value="144">Med-Peds</option><option value="145">Molecular Genetic Pathology</option><option value="148">Neuro/Diag. Rad/Neuro Rad</option><option value="149">Neurological Surgery</option><option value="25">Neurology</option><option value="292">Nuclear Medicine</option><option value="151">OB/GYN</option><option value="152">Occupational Medicine</option><option value="156">Ophthalmology</option><option value="158">Orthopedic Surgery</option><option value="159">Otolaryngology</option><option value="161">Pathology</option><option value="162">Pediatrics</option><option value="163">Pediatrics Bariatric</option><option value="164">Peds/EM</option><option value="165">Peds/EMR</option><option value="166">Peds/Psych/C&amp;A</option><option value="167">Physical Medicine &amp; Rehab</option><option value="168">Physician Assistant</option><option value="169">Plastic Surgery</option><option value="170">Preventative Medicine</option><option value="172">Psych/FP</option><option value="17">Psychiatry</option><option value="173">Radiation Oncology</option><option value="58">Radiology</option><option value="176">Sports Medicine</option><option value="185">Thoracic Surgery</option><option value="56">Urology</option><option value=64>Other</option></select><select name="primary65" style="width:315px;display:none;"><option value="">Click to Select</option><option value="109">Cardiothoracic</option><option value="189">PA - General</option><option value="190">PA - Neuro</option><option value="191">PA - Ortho</option><option value=64>Other</option></select><select name="primary69" style="width:315px;display:none;"><option value="">Click to Select</option><option value="107">Cardiac Cath</option><option value="110">Cardiovascular Technologist</option><option value="111">CAT Scan Technologist</option><option value="115">Diagnostic Medical Sonographer</option><option value="188">Echocardiography</option><option value="120">Fluoroscopy</option><option value="123">General X-Ray</option><option value="137">Mammography</option><option value="146">MRI Technologist</option><option value="150">Nuclear Medicine Technology</option><option value="175">Special Procedures</option><option value="186">Ultrasound Sonographer</option><option value="187">Vascular Technologist</option><option value=64>Other</option></select><select name="primary1" style="width:315px;display:none;"><option value="">Click to Select</option><option value="106">Burns ICU</option><option value="107">Cardiac Cath</option><option value="108">Cardiac ICU</option><option value="80">Cardiovascular ICU</option><option value="15">Critical Care</option><option value="21">Dialysis</option><option value="18">Emergency Room</option><option value="124">Geriatrics/Long Term Care</option><option value="126">Homecare</option><option value="14">ICU</option><option value="26">Labor and Delivery</option><option value="138">Management</option><option value="139">Medical ICU</option><option value="12">Medical/Surgical</option><option value="142">Medical/Surgical - Neurology</option><option value="143">Medical/Surgical - Orthopedic</option><option value="23">Neonatal Intensive Care Unit</option><option value="147">Neuro ICU</option><option value="73">Newborn Nursery</option><option value="151">OB/GYN</option><option value="153">Office Nurse</option><option value="22">Oncology</option><option value="154">Oncology/Chemo</option><option value="155">Oncology/Non-Chemo</option><option value="38">Operating Room</option><option value="157">OR First Assistant</option><option value="160">PACU/Recovery Room</option><option value="19">Pediatric Non-ICU</option><option value="24">Peds Intensive Care Unit</option><option value="77">Post Partum</option><option value="171">Progressive Care Unit</option><option value="17">Psychiatry</option><option value="20">Rehab</option><option value="174">School Setting</option><option value="76">Step Down ICU</option><option value="177">Surgical ICU</option><option value="16">Telemetry</option><option value=64>Other</option></select><select name="primary78" style="width:315px;display:none;"><option value="">Click to Select</option><option value="178">Surgical Tech - General Surgery</option><option value="179">Surgical Tech - Neuro</option><option value="180">Surgical Tech - OBGYN</option><option value="181">Surgical Tech - Open Heart</option><option value="182">Surgical Tech - Orthopedic</option><option value="183">Surgical Tech - Plastics</option><option value="184">Surgical Tech - Vascular</option><option value=64>Other</option></select> </td></tr>
<tr><td>&nbsp;</td></tr>
<tr><td class="cellright">Secondary Specialty<sup class="asterisc"> </sup></td>
<td colspan="2" class="cellleft"><input type="hidden" value="" name="Selected SS"/><select style="width: 315px;" disabled="" name="secondary_specialty">
<option value="">Click to Select</option>
</select>

<select style="width: 315px; display: none;" name="secondary2"><option value="">Click to Select</option><option value="106">Burns ICU</option><option value="107">Cardiac Cath</option><option value="108">Cardiac ICU</option><option value="80">Cardiovascular ICU</option><option value="15">Critical Care</option><option value="21">Dialysis</option><option value="18">Emergency Room</option><option value="124">Geriatrics/Long Term Care</option><option value="126">Homecare</option><option value="14">ICU</option><option value="26">Labor and Delivery</option><option value="139">Medical ICU</option><option value="12">Medical/Surgical</option><option value="142">Medical/Surgical - Neurology</option><option value="143">Medical/Surgical - Orthopedic</option><option value="23">Neonatal Intensive Care Unit</option><option value="147">Neuro ICU</option><option value="73">Newborn Nursery</option><option value="151">OB/GYN</option><option value="152">Occupational Medicine</option><option value="153">Office Nurse</option><option value="22">Oncology</option><option value="154">Oncology/Chemo</option><option value="155">Oncology/Non-Chemo</option><option value="38">Operating Room</option><option value="160">PACU/Recovery Room</option><option value="19">Pediatric Non-ICU</option><option value="24">Peds Intensive Care Unit</option><option value="77">Post Partum</option><option value="171">Progressive Care Unit</option><option value="17">Psychiatry</option><option value="20">Rehab</option><option value="174">School Setting</option><option value="76">Step Down ICU</option><option value="177">Surgical ICU</option><option value="16">Telemetry</option><option value="64">Other</option></select><select style="width: 315px; display: none;" name="secondary53"><option value="">Click to Select</option><option value="106">Burns ICU</option><option value="107">Cardiac Cath</option><option value="108">Cardiac ICU</option><option value="80">Cardiovascular ICU</option><option value="15">Critical Care</option><option value="21">Dialysis</option><option value="18">Emergency Room</option><option value="124">Geriatrics/Long Term Care</option><option value="126">Homecare</option><option value="14">ICU</option><option value="26">Labor and Delivery</option><option value="139">Medical ICU</option><option value="12">Medical/Surgical</option><option value="142">Medical/Surgical - Neurology</option><option value="143">Medical/Surgical - Orthopedic</option><option value="23">Neonatal Intensive Care Unit</option><option value="147">Neuro ICU</option><option value="73">Newborn Nursery</option><option value="151">OB/GYN</option><option value="153">Office Nurse</option><option value="22">Oncology</option><option value="154">Oncology/Chemo</option><option value="155">Oncology/Non-Chemo</option><option value="38">Operating Room</option><option value="160">PACU/Recovery Room</option><option value="19">Pediatric Non-ICU</option><option value="24">Peds Intensive Care Unit</option><option value="77">Post Partum</option><option value="171">Progressive Care Unit</option><option value="17">Psychiatry</option><option value="20">Rehab</option><option value="174">School Setting</option><option value="76">Step Down ICU</option><option value="177">Surgical ICU</option><option value="16">Telemetry</option><option value="64">Other</option></select><select style="width: 315px; display: none;" name="secondary55"><option value="">Click to Select</option><option value="105">Blood Bank</option><option value="113">Cytologist</option><option value="125">Histologist</option><option value="140">Medical Technician</option><option value="141">Medical Technologist</option><option value="64">Other</option></select><select style="width: 315px; display: none;" name="secondary64"><option value="">Click to Select</option><option value="102">Administrators</option><option value="103">Allergy and Immunology</option><option value="104">Anesthesiology</option><option value="112">Colon and Rectal Surgery</option><option value="114">Dermatology</option><option value="116">Emergency Medicine</option><option value="117">Epidemiology</option><option value="118">Epileptology</option><option value="119">Family Practice</option><option value="121">General Preventative Medicine</option><option value="122">General Surgery</option><option value="127">Hospitalist</option><option value="128">IM/Dermatology</option><option value="129">IM/Emergency Med</option><option value="130">IM/Emergency/Critical Care</option><option value="132">IM/Neurology</option><option value="133">IM/PMR</option><option value="134">IM/Preventative Medicine</option><option value="135">IM/Psychiatry</option><option value="136">Internal Medicine</option><option value="144">Med-Peds</option><option value="145">Molecular Genetic Pathology</option><option value="148">Neuro/Diag. Rad/Neuro Rad</option><option value="149">Neurological Surgery</option><option value="25">Neurology</option><option value="292">Nuclear Medicine</option><option value="151">OB/GYN</option><option value="152">Occupational Medicine</option><option value="156">Ophthalmology</option><option value="158">Orthopedic Surgery</option><option value="159">Otolaryngology</option><option value="161">Pathology</option><option value="162">Pediatrics</option><option value="163">Pediatrics Bariatric</option><option value="164">Peds/EM</option><option value="165">Peds/EMR</option><option value="166">Peds/Psych/C&A</option><option value="167">Physical Medicine & Rehab</option><option value="168">Physician Assistant</option><option value="169">Plastic Surgery</option><option value="170">Preventative Medicine</option><option value="172">Psych/FP</option><option value="17">Psychiatry</option><option value="173">Radiation Oncology</option><option value="58">Radiology</option><option value="176">Sports Medicine</option><option value="185">Thoracic Surgery</option><option value="56">Urology</option><option value="64">Other</option></select><select style="width: 315px; display: none;" name="secondary65"><option value="">Click to Select</option><option value="109">Cardiothoracic</option><option value="189">PA - General</option><option value="190">PA - Neuro</option><option value="191">PA - Ortho</option><option value="64">Other</option></select><select style="width: 315px; display: none;" name="secondary69"><option value="">Click to Select</option><option value="107">Cardiac Cath</option><option value="110">Cardiovascular Technologist</option><option value="111">CAT Scan Technologist</option><option value="115">Diagnostic Medical Sonographer</option><option value="188">Echocardiography</option><option value="120">Fluoroscopy</option><option value="123">General X-Ray</option><option value="137">Mammography</option><option value="146">MRI Technologist</option><option value="150">Nuclear Medicine Technology</option><option value="175">Special Procedures</option><option value="186">Ultrasound Sonographer</option><option value="187">Vascular Technologist</option><option value="64">Other</option></select><select style="width: 315px; display: none;" name="secondary1"><option value="">Click to Select</option><option value="106">Burns ICU</option><option value="107">Cardiac Cath</option><option value="108">Cardiac ICU</option><option value="80">Cardiovascular ICU</option><option value="15">Critical Care</option><option value="21">Dialysis</option><option value="18">Emergency Room</option><option value="124">Geriatrics/Long Term Care</option><option value="126">Homecare</option><option value="14">ICU</option><option value="26">Labor and Delivery</option><option value="138">Management</option><option value="139">Medical ICU</option><option value="12">Medical/Surgical</option><option value="142">Medical/Surgical - Neurology</option><option value="143">Medical/Surgical - Orthopedic</option><option value="23">Neonatal Intensive Care Unit</option><option value="147">Neuro ICU</option><option value="73">Newborn Nursery</option><option value="151">OB/GYN</option><option value="153">Office Nurse</option><option value="22">Oncology</option><option value="154">Oncology/Chemo</option><option value="155">Oncology/Non-Chemo</option><option value="38">Operating Room</option><option value="157">OR First Assistant</option><option value="160">PACU/Recovery Room</option><option value="19">Pediatric Non-ICU</option><option value="24">Peds Intensive Care Unit</option><option value="77">Post Partum</option><option value="171">Progressive Care Unit</option><option value="17">Psychiatry</option><option value="20">Rehab</option><option value="174">School Setting</option><option value="76">Step Down ICU</option><option value="177">Surgical ICU</option><option value="16">Telemetry</option><option value="64">Other</option></select><select style="width: 315px; display: none;" name="secondary78"><option value="">Click to Select</option><option value="178">Surgical Tech - General Surgery</option><option value="179">Surgical Tech - Neuro</option><option value="180">Surgical Tech - OBGYN</option><option value="181">Surgical Tech - Open Heart</option><option value="182">Surgical Tech - Orthopedic</option><option value="183">Surgical Tech - Plastics</option><option value="184">Surgical Tech - Vascular</option><option value="64">Other</option></select> </td></tr>

</tbody>
</table>
</form>

</body>
</html>
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