Hanibal Posted November 23, 2012 Share Posted November 23, 2012 (edited) I'm a novice html user and I have an html page I'm trying to perform actions on. Specifically determining which value(?) acts on the html to emulate a mouse click (or performs a mouse click). Here are a couple screenshots . When the page opens there are 2 fields which don't display ("agent name" and "agency name") unless the link "Not on this list?" is left-mouse-clicked. I'm populating all the fields on the form with data from another program using GetElementById and that is working everywhere except on hidden fields. I can't figure out which part of the html needs to be acted upon to show those fields (or if they even need to be visible) so I can auto-populate them as well. Here's the section of html I think it's in and thanks in advance for any help. </div> <div class="MyOrders-BodyContainer"><div class="MyOrders-Header-Content"><div class="MyOrders-Header-Menu"><a href="/MyOrders">Home</a> | <a href="/SearchOrders#adv=1">Search Orders</a> | <a href="/Logout">Logout</a> </div><div class="MyOrders-Header-Menu-Right"><a href="/">SMM</a> | <a href="/About">About Us</a> | <a href="/Divisions">Divisions</a> | <a href="/News">News</a> | <a href="/Contact">Contact Us</a></div></div> <div class="Content-Container"> <fieldset class="inputform" style="margin-left: 10px; width: 600px; border: none;"><input type="hidden" name="ctl00$ctl00$body$body$hfOrderForID" id="hfOrderForID" /> <div id="ctl00_ctl00_body_body_pnlMainSection"> <h1>Direct Orders</h1> <h2>Order Details</h2><ul class="Errors" style="display: none;"></ul> <p id="pBehalfOf"><label id="lblBehalfof">Order On Behalf Of</label><select name="ctl00$ctl00$body$body$ddlOrderFor" id="ddlOrderFor"><option value="-1">Please Select a Party to Order For</option><option value="b8ed661f-16ab-4710-83dd-2a326723482e" Packet="3" pk="225079" ar="False" xar="10" cr="False">Bresnahan, Dan</option><option value="04a43a93-3cf5-43e4-8663-a14ba47810d8" Packet="3" pk="225094" ar="False" xar="10" cr="False">O'Leary, R</option> </select> <a href="#" id="aOrderBehalfNotOnList">Not on this list?</a></p><p id="pAgentNotOnList" style="display: none;"><label id="lblAgentNotOnList">Agent Name</label><input name="ctl00$ctl00$body$body$txtAgentNotOnList" type="text" id="txtAgentNotOnList" /><input type="hidden" name="ctl00$ctl00$body$body$hfOrderForDisabled" id="hfOrderForDisabled" value="0" /> Edited November 23, 2012 by Hanibal Link to comment Share on other sites More sharing options...
Hanibal Posted November 27, 2012 Author Share Posted November 27, 2012 I noticed my post got a fair number of views but no responses.Is what I asked not possible?Poorly worded?Or did I unknowingly violate some board etiquette?Any response appreciated. Link to comment Share on other sites More sharing options...
Ingolme Posted November 27, 2012 Share Posted November 27, 2012 I don't usually reply to threads I have troble understanding. This is just a hobby of mine and I do have other things in my life to deal with. You say that a field should become visible when something is clicked on. That requires Javascript and you haven't shown any Javascript code. If I read correctly, you want to populate certain fields with a value, but I can't see the Javascript code that is supposed to do that either. Link to comment Share on other sites More sharing options...
Hanibal Posted November 27, 2012 Author Share Posted November 27, 2012 Thanks. At least I now know it was poorly presented. I hope this one will be better.I have been able to get the fields to fill-in, it's the mouse click I haven't been able to conquer. I've been using the following after the page loads:myurl.object.document.getElementById("Tried many things between these quotes")=and many values but I'm not finding the right combination. There's a link called "Not on this list?" that I need to click on to reveal the hidden fields. Here's the entire html for the page (I've colored the text red in the area I think the parts I need are in, but I could be completely wrong)Thanks again <!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd"><html xmlns="http://www.w3.org/1999/xhtml"><head id="ctl00_ctl00_Head1"><title></title><meta name="description" content="Superior Mobile Medics (SMM) is a mobile medical exam company providing a variety of services across the United States." /><meta name="keywords" content="mobile medical exam, health and wellness, clinical research, paramedical exam, life insurance" /><meta http-equiv="content-type" content="text/html;charset=UTF-8" /><link rel="icon" href="/favicon.ico" type="image/x-icon" /><script type="text/javascript" src="ScriptCombiner.axd?s=Default&v=9&t=js"></script><link type="text/css" rel="stylesheet" href="ScriptCombiner.axd?s=Default&v=9&t=css" /><script type="text/javascript" src="ScriptCombiner.axd?s=NewOrder&v=8&t=js"></script><link type="text/css" rel="stylesheet" href="ScriptCombiner.axd?s=NewOrder&v=8&t=css" /><style type="text/css"> div.FormContent-Container { height: 3000px; } div.FooterContent-Container { height: 2240px; } .rbl { padding-top: 14px; } .il .small { width: 50px; } .alertAgeTrue { color: #AF2626; } .alertAgeFalse { color: #00AFDB; }</style></head><body id="bBody"> <form name="aspnetForm" method="post" action="NewOrder" onsubmit="javascript:return WebForm_OnSubmit();" id="aspnetForm" onreset="if (window.setTimeout) window.setTimeout('DES_OnReset(false);', 100);"><div><input type="hidden" name="DES_Group" id="DES_Group" value="" /><input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE" 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/></div> <div class="MyOrders-BodyContainer"> <div class="MyOrders-Header-Content"> <div class="MyOrders-Header-Menu"> <a href="/MyOrders">Home</a> | <a href="/SearchOrders#adv=1">Search Orders</a> | <a href="/Logout">Logout</a> </div> <div class="MyOrders-Header-Menu-Right"> <a href="/">SMM</a> | <a href="/About">About Us</a> | <a href="/Divisions">Divisions</a> | <a href="/News">News</a> | <a href="/Contact">Contact Us</a> </div> </div> <div class="Content-Container"> <fieldset class="inputform" style="margin-left: 10px; width: 600px; border: none;"> <input type="hidden" name="ctl00$ctl00$body$body$hfOrderForID" id="hfOrderForID" /> <div id="ctl00_ctl00_body_body_pnlMainSection"> <h1> Direct Orders </h1> <h2> Order Details </h2> <ul class="Errors" style="display: none;"> </ul> <p id="pBehalfOf"> <label id="lblBehalfof"> Order On Behalf Of </label> <select name="ctl00$ctl00$body$body$ddlOrderFor" id="ddlOrderFor"> <option value="-1">Please Select a Party to Order For</option> <option value="b8ed661f-16ab-4710-83dd-2a326723482e" Packet="3" pk="225079" ar="False" xar="10" cr="False">Bresnahan, Dan</option> <option value="ccf4c4d7-0476-492f-b05a-4d9688e95c14" Packet="3" pk="225081" ar="False" xar="10" cr="False">Bresnahan, Dan </option> <option value="e1ad1320-8808-4bff-bd8c-8ff78c56bda1" Packet="3" pk="138055" ar="False" xar="10" cr="False">Doherty, S</option> <option value="be45fb2e-7cbd-4f29-adcb-2200b6d840f5" Packet="3" pk="190771" ar="False" xar="10" cr="False">Donerty, S</option> <option value="9ff5888a-3fec-4f94-b88d-a010043573ca" Packet="3" pk="185116" ar="False" xar="10" cr="False">Gruenberg, S</option> <option value="ac659049-ccf0-4442-ac18-b7054695e5fa" Packet="3" pk="187487" ar="False" xar="10" cr="False">Lewis, J</option> <option value="405368f9-d8fa-4407-866c-8e64079f24be" Packet="3" pk="225095" ar="False" xar="10" cr="False">O'Leary, R</option> <option value="04a43a93-3cf5-43e4-8663-a14ba47810d8" Packet="3" pk="225094" ar="False" xar="10" cr="False">O'Leary, R</option> <option value="992f0c10-b1cc-4163-b516-37d51164d72f" Packet="3" pk="138053" ar="False" xar="10" cr="False">Omid, Hamid</option> <option value="ff98bf8a-c043-4812-989e-f70332a95dbb" Packet="3" pk="131146" ar="False" xar="10" cr="False">Provencher, F</option> <option value="706e906e-c03c-4949-8e3e-68a8281de3d9" Packet="3" pk="213484" ar="False" xar="10" cr="False">Randone, B</option> <option value="c9973033-2d8a-4ecd-b0cb-9bb3f09be71a" Packet="3" pk="158721" ar="False" xar="10" cr="False">Samel, J</option> <option value="048d071b-e62a-403c-9486-764784581157" Packet="3" pk="166542" ar="False" xar="10" cr="False">Schemack, Don</option> <option value="6134e7f3-f3fb-4453-8e78-e3f29aeefa20" Packet="3" pk="187773" ar="False" xar="10" cr="False">Shemack, D</option> <option value="a0b17256-81fd-4d23-accf-76f8c2567c82" Packet="3" pk="187772" ar="False" xar="10" cr="False">Shikrallah, D</option> <option value="c1948c56-52ac-44d6-a4c1-346ee4a90bc8" Packet="3" pk="187486" ar="False" xar="10" cr="False">Vaillancourt, D</option> <option value="5fb3520e-c48f-4dd5-bd02-c291bd897c52" Packet="3" pk="192687" ar="False" xar="10" cr="False">Vaillancourt, Daniel</option>[color=#ff0000]</select> <a href="#" id="aOrderBehalfNotOnList">Not on this list?</a> </p> <p id="pAgentNotOnList" style="display: none;"> <label id="lblAgentNotOnList">Agent Name</label> <input name="ctl00$ctl00$body$body$txtAgentNotOnList" type="text" id="txtAgentNotOnList" /> <input type="hidden" name="ctl00$ctl00$body$body$hfOrderForDisabled" id="hfOrderForDisabled" value="0" /> </p> <input type="hidden" name="ctl00$ctl00$body$body$hfShowPacket" id="hfShowPacket" /> <input type="hidden" name="ctl00$ctl00$body$body$hfPullBy" id="hfPullBy" value="0" /> <p id="pAgent" style="display: none;"> <label id="lblAccessSub"> And </label> <select id="ddlAgent"> </select> <a href="MyOrders/#" id="aNotOnList">Not on this list?</a> </p> <input type="hidden" name="ctl00$ctl00$body$body$hfAgentID" id="hfAgentID" /> <input type="hidden" name="ctl00$ctl00$body$body$hfAgentName" id="hfAgentName" /> <p id="pAgencyNotOnList" style="display: none;"> <label id="lblAgencyNotOnList">Agency Name</label> <input name="ctl00$ctl00$body$body$txtAgencyNotOnList" type="text" id="txtAgencyNotOnList" />[/color] </p> <p id="pReferenceNumber"> <label> Your Reference # </label> <input name="ctl00$ctl00$body$body$txtReference" type="text" maxlength="30" id="txtReference" helptext="If you would like to track this order with your own order ID, please enter it here for future searching." /> </p> <p> <label> Bar Code </label> <input name="ctl00$ctl00$body$body$txtBarCode" type="text" maxlength="30" id="txtBarCode" /> </p> <p id="pFollowUpEmail" style="display: none;"> <label> 3rd Party Status Email </label> <input name="ctl00$ctl00$body$body$txtFollowUpEmail" type="text" id="txtFollowUpEmail" helptext="Enter the email address of a 3rd party you wish to provide notifications of exam progress." /> <span id='ctl00_ctl00_body_body_revEmail' style='visibility:hidden;display:none;' class='DESVALErrorText'><img id='ctl00_ctl00_body_body_revEmail_Img' src='' alt=''></img></span> </p> <div id="ctl00_ctl00_body_body_dSubContractors"> <h3> Subcontractors </h3> <p> Your account currently has subcontactors assigned to it. Would you like to assign one now? If you are not sure yet, leave the default "I am not sure" option selected. You can always change your subcontractor later via the orders editor. </p> <p> <label>Subcontractor</label> <select name="ctl00$ctl00$body$body$ddlSubcontractor" id="ddlSubcontractor"> <option value="">I am not sure</option> <option value="20453">Frances La Chance</option> <option value="20457">Jeanine Rolli</option></select> </p> </div> <h2> Carrier Information </h2> <p class="il"> <label> Insurance Carrier </label> <select name="ctl00$ctl00$body$body$ddlCarrier" id="ddlCarrier"> <option selected="selected" value="9501">Please Select an Insurance Carrier</option> <option value="9502">AAA Life Insurance</option> <option value="9504">Acacia Mutual</option> <option value="9911">Alfa Life Insurance</option> <option value="9796">Allianz Life Insurance</option> <option value="10128">Allstate</option> <option value="10812">Allstate Life Of NY</option> <option value="10822">American Amicable</option> <option value="10610">American Family</option> <option value="10063">American Fidelity Assurance</option> <option value="10714">American General Life - Houston</option> <option value="10725">American General Life & Accident</option> <option value="10115">American Heritage Life</option> <option value="10113">American Home Life Insurance Company</option> <option value="11204">American Income (ALTIG)</option> <option value="10623">American Income Life</option> <option value="10776">American National</option> <option value="10791">American Republic</option> <option value="10740">American United</option> <option value="10693">Americo</option> <option value="9522">Ameritas</option> <option value="10937">Ameritas Life of NY</option> <option value="10144">Amica Life Insurance</option> <option value="11178">Anthem:Blue Cross of CA</option> <option value="11166">Anthem:Blue Cross of Georgia</option> <option value="10545">Army Air Force Mutual Aid</option> <option value="10932">Ash Brokerage</option> <option value="10751">ASPC Study</option> <option value="10472">Assurant Health Medical</option> <option value="9526">Assurity Life</option> <option value="10207">Atlantic Coast Life</option> <option value="9788">Auto Owners Life</option> <option value="9924">Aviva Life & Annuity of NY</option> <option value="9524">Aviva Life & Annuity</option> <option value="10201">AXA Equitable- Brokerage</option> <option value="10151">AXA Equitable- Career (RETAIL)</option> <option value="10198">Baltimore Life</option> <option value="10119">Bankers Fidelity Life</option> <option value="10210">Bankers L&C</option> <option value="11216">Banner Life - Permanent Products</option> <option value="11217">Banner Life - Permanent Products (ASH Brokerage)</option> <option value="11219">Banner Life - Permanent Products (PKT IN CRL KIT)</option> <option value="11214">Banner Life - Term Products</option> <option value="11215">Banner Life - Term Products (ASH Brokerage)</option> <option value="11218">Banner Life - Term Products (PKT IN CRL KIT)</option> <option value="9532">Beneficial Life</option> <option value="10864">Beneficial Life (APS)</option> <option value="9768">Berkshire DI</option> <option value="10433">Boston Mutual</option> <option value="9830">Catholic Financial Life</option> <option value="11064">Catholic Life</option> <option value="10645">Central United Life</option> <option value="10497">Centrian Life Insurance</option> <option value="10815">Cigna Life Insurace</option> <option value="9901">Cincinnati Life</option> <option value="10758">CMFG Life</option> <option value="10737">Colonial Life & Accident</option> <option value="10462">Colorado Bankers</option> <option value="10223">Columbian Mutual Life Insurance Co.</option> <option value="10190">Columbus Life</option> <option value="10090">Companion Life of New York</option> <option value="11224">Consumers Life</option> <option value="10701">Cotton States</option> <option value="10417">Country Companies</option> <option value="10769">Country Investors Life</option> <option value="10865">Dearborn National (Group)</option> <option value="10866">Dearborn National (Individual)</option> <option value="10099">Degree of Honor Protective</option> <option value="10134">EMC National Life</option> <option value="10221">Equitrust Life</option> <option value="10594">Erie Family Life</option> <option value="10789">Exceptional Risk Advisors</option> <option value="9921">Family Life</option> <option value="10181">Farm Bureau of Iowa</option> <option value="10908">Farm Bureau of MI</option> <option value="10793">Farm Bureau of MO</option> <option value="10506">Farm Family</option> <option value="10692">Farmers and Traders Ins Co</option> <option value="9814">Farmers New World (Midwest)</option> <option value="10795">Farmers New World (Pacific)</option> <option value="11086">Fasano Associates - Union Labor Life</option> <option value="9562">Federal Life</option> <option value="10094">Federated Life</option> <option value="9564">Fidelity & Guaranty Life Insurance Co</option> <option value="10508">Fidelity Life Association</option> <option value="10133">First Investors Life</option> <option value="10512">Gen Study High/Low Depression</option> <option value="9566">Genworth L & A Insurance Co.</option> <option value="9580">Genworth Life</option> <option value="10854">Genworth Life (Ash Brokerage)</option> <option value="10143">Germania Life</option> <option value="10920">Gleaner Life</option> <option value="10046">Globe L&A / First Command</option> <option value="10027">Golden Rule Life</option> <option value="10438">Government Personnel Mutual</option> <option value="10073">Grange Life</option> <option value="9594">Guarantee Trust Life</option> <option value="10889">Guardian Group (Bethlehem)</option> <option value="10888">Guardian Group (Spokane)</option> <option value="11056">Guardian Medical Logistics</option> <option value="10881">Guardian/Berkshire (Combo)</option> <option value="10887">Guardian/Berkshire- Combo (CA Only)</option> <option value="9596">Guardian-Life</option> <option value="10107">Hanleigh Management, INC</option> <option value="10771">Harleysville Mutual Life Insurance</option> <option value="9907">Hartford (Non-Term)</option> <option value="10977">Hartford Term</option> <option value="10679">HCC Specialty Underwriters</option> <option value="9915">Horace Mann Life</option> <option value="10956">IA American Life</option> <option value="9920">Illinois Mutual Life</option> <option value="10177">Independent Order of Foresters</option> <option value="10918">Informal APS</option> <option value="11046">ING - Med Port (RSA)</option> <option value="9902">ING Reliastar - Term</option> <option value="11157">ING Reliastar - UL</option> <option value="11075">ING Reliastar of NY - Term</option> <option value="10020">ING Reliastar of NY - UL</option> <option value="9790">ING Security Life of Denver</option> <option value="11145">ING Security Life of Denver (PKT IN CRL KIT)</option> <option value="10589">Investors Life of No. America</option> <option value="9604">Jackson National</option> <option value="10834">Jackson National of NY</option> <option value="9632">John Hancock</option> <option value="11045">John Hancock - Med Port (RSA)</option> <option value="11139">John Hancock Of NY (Edward Jones)</option> <option value="10877">Johns Hopkins Genetic Study</option> <option value="10071">Kanawha Life</option> <option value="9612">Kansas City Life</option> <option value="10790">Knights of Columbus</option> <option value="9844">Lafayette Life</option> <option value="10500">Leaders Life Ins</option> <option value="10873">Leonardi Executive Health Institute</option> <option value="9910">Liberty Life Assurance of Boston - Out Of State</option> <option value="10137">Liberty National</option> <option value="10150">Liberty National / First Command</option> <option value="10885">Life Care: Assurity Life LTC</option> <option value="10880">Life Care: Berkshire LTC</option> <option value="11181">Life Care: Mass Mutual LTC</option> <option value="10884">Life Care: Minnesota Life LTC</option> <option value="10800">Life Insurance Co of SW</option> <option value="10126">Lincoln Benefit</option> <option value="11062">Lincoln National Life (COLI)</option> <option value="9628">Lincoln National Life (Field Accounts)</option> <option value="10974">Lincoln National Life LFA -Exam</option> <option value="11003">Lincoln National Life-Edward Jones Term Tele App</option> <option value="11000">Lincoln National Life-IGS</option> <option value="11002">Lincoln National Life-Paper Tele App</option> <option value="11001">Lincoln National Life-Tele App</option> <option value="10727">Mass Mutual (DI)</option> <option value="10153">Mass Mutual (Life)</option> <option value="10576">Met Life - NEF (New England)</option> <option value="10573">Met Life (DI)</option> <option value="10575">Met Life Brokerage-IDG</option> <option value="10733">Met Life Career-MLFS</option> <option value="9638">Midland National</option> <option value="10906">Midland National-First Command</option> <option value="10441">Minnesota Life</option> <option value="10442">Modern Woodmen</option> <option value="10874">Monumental Life</option> <option value="10667">Monumental Life/First Command</option> <option value="10783">Monumental nVision</option> <option value="10419">Motorists Life</option> <option value="10642">Mutual of Omaha (DI) - Non Brokerage</option> <option value="10641">Mutual of Omaha (DI) -Brokerage</option> <option value="10088">Mutual Savings Life </option> <option value="9916">Mutual Trust Life (MTL)</option> <option value="10590">National Farm Life</option> <option value="10917">National Institute of Health - NIMH</option> <option value="10662">National Life of VT</option> <option value="10111">National Security Life Ins</option> <option value="10101">National Western Life</option> <option value="10215">Nationwide Provident</option> <option value="9652">Nationwide-Brokerage</option> <option value="10650">Navy Mutual Aid Association</option> <option value="10724">New York Life</option> <option value="10787">NIMH Site #242 - OCD Genetic Study</option> <option value="10598">NIMH Site #283</option> <option value="10024">North American L&H</option> <option value="11144">North American L&H (ASA)</option> <option value="10202">North Carolina Mutual </option> <option value="10008">North Coast Life Insurance Company</option> <option value="10447">Northwestern Mutual</option> <option value="9666">Ohio National</option> <option value="10209">Pacific Guardian Life</option> <option value="10578">Pacific L&A of NY</option> <option value="10018">Pacific Life</option> <option value="11005">Pacific Life - Imeriti</option> <option value="9927">Pan American</option> <option value="11226">PEHP</option> <option value="9904">Pekin Life</option> <option value="10122">Penn Mutual</option> <option value="10678">Pennsylvania Life</option> <option value="10227">Petersen International</option> <option value="10100">Phoenix Life</option> <option value="10114">Pioneer Mutual</option> <option value="10222">Police & Fireman's Insurance Co</option> <option value="10517">Principal Financial Life (DI)</option> <option value="10085">Principal Financial-Brokerage</option> <option value="10998">Pro Financial - Medical Professional - Lloyds</option> <option value="10999">Pro Financial - Professional Golfer</option> <option value="9858">Protective L & A of NY</option> <option value="9692">Protective Life</option> <option value="11153">Protective Life (PKT IN CRL KIT)</option> <option value="11060">Protective Life (QuickMed)</option> <option value="10896">Protective Life (TeleLife/PKT Take Out)</option> <option value="9698">Prudential Financial-Brokerage</option> <option value="10726">Reliable </option> <option value="10212">Royal Neighbors of America</option> <option value="10648">Sagicor Life</option> <option value="10797">SBLI - Savings Bank Life of Mass</option> <option value="10840">SBLI USA Mutual</option> <option value="11080">Securian Life of NY</option> <option value="10168">Security Mutual of NY</option> <option value="9712">Sentinel Security</option> <option value="11220">Shelter Insurance</option> <option value="10781">Simon Simplex Autism Collection</option> <option value="11154">Southern Farm Bureau</option> <option value="10749">SPJST</option> <option value="9718">Standard (DI) Individual</option> <option value="10763">Standard Group All - GRP</option> <option value="10821">Standard Group Ins-CTA</option> <option value="10905">Standard Group Insurance - Employee</option> <option value="10471">Stanford Genetics Study</option> <option value="9720">State Life</option> <option value="10690">Stonebridge</option> <option value="9722">Sun Life</option> <option value="10806">Sun Life of Bermuda</option> <option value="11083">Surency Life & Health</option> <option value="10155">Symetra Life</option> <option value="10488">Tennessee Farmers</option> <option value="10082">Texas Life</option> <option value="10862">The Standard of New York - Group</option> <option value="10005">Thrivent Fincl / Lutheran Brthrhd</option> <option value="11213">Transamerica Life - IUL Products</option> <option value="11205">Transamerica Life - Term Products</option> <option value="11206">Transamerica Life - Term Products (ASA Group)</option> <option value="11207">Transamerica Life - Term Products (ASH)</option> <option value="11208">Transamerica Life - Term Products (PKT IN CRL KIT)</option> <option value="11209">Transamerica Life - UL Products</option> <option value="11210">Transamerica Life - UL Products (ASA Group)</option> <option value="11211">Transamerica Life - UL Products (ASH)</option> <option value="11212">Transamerica Life - UL Products (PKT IN CRL KIT)</option> <option value="10914">UCSF - Clinical Research Study</option> <option value="9800">Union Central</option> <option value="10226">Union National Life</option> <option value="10550">United Farm Family Life</option> <option value="10116">United Heritage Mutual Life Insurance Co</option> <option value="10044">United Home Life</option> <option value="9905">United Ins Co of America</option> <option value="9742">United Investors</option> <option value="9744">United of Omaha-Brokerage</option> <option value="10058">United of Omaha-Non-Brokerage</option> <option value="10718">United States Life- Houston or NY</option> <option value="10717">United States Life- Neptune</option> <option value="9746">Unum</option> <option value="9748">Unum (DI)</option> <option value="9548">Washington National</option> <option value="11225">Western Catholic Life</option> <option value="9836">Western Fraternal Life</option> <option value="9758">Western Reserve Life - Florida</option> <option value="9756">Western Reserve Life - Iowa</option> <option value="11052">Western Reserve Life- Express (NOT VUL)</option> <option value="11059">Western Reserve Life- VUL Express</option> <option value="9917">Western Southern Life</option> <option value="9760">William Penn</option> <option value="10180">Woodmen Life</option> <option value="10675">Zurich American Life Insurance Company</option></select> </p> <div id="dCarrierDetails" class="QuickLookup" style="margin-left: 145px; display: none;"> <p> <label>Lab:</label> <span id="spCarrierLab"></span> </p> <p> <label>Location:</label> <span id="spCarrierLocation"></span> </p> <div id="divCarrierAlerts" style="display: none; width: 330px;"> <span class="lbl_l" style="background-color: #FF0000; color: #FFF; margin-top: 10px; width: 80px; padding-left: 3px; display: block;">Alert</span> <div class="Status-Red" id="dCarrierAlertsText"></div> </div> </div> <p id="pProductType" style="display: none;"> <label> Product Type </label> <select id="ddlProductType"> </select> <input type="hidden" name="ctl00$ctl00$body$body$hfProdTypeID" id="hfProdTypeID" /> <input type="hidden" name="ctl00$ctl00$body$body$hfProdTypeName" id="hfProdTypeName" /> </p> <div id="dProductAlert" style="display:none; color: #00afdb; text-align: center;"> If a Product Type is not selected here, we may contact you for the details later. </div> <p> <label> Face Amount </label> <input name="ctl00$ctl00$body$body$itbPolicyAmount" type="text" maxlength="15" id="itbPolicyAmount" class="val" helptext="PLEASE NOTE: If the applicant has a current policy in force with this insurance company, please be sure that the policy amount entered reflects the TOTAL AMOUNT to be in place with this specific insurance company." style="width:150px;" /> </p> <p> <label> Policy Number </label> <input name="ctl00$ctl00$body$body$txtPolicyNumber" type="text" maxlength="15" id="txtPolicyNumber" style="width:150px;" /> </p> <p id="pApplicationNumber" style="display: none;"> <label> Application Number </label> <input name="ctl00$ctl00$body$body$txtApplicationNumber" type="text" id="txtApplicationNumber" /> </p> <div id="dManualRequirements"> <p> <label> Requirements </label> <select name="ctl00$ctl00$body$body$ddlReqs" id="ddlReqs"> <option value="">Please Select Requirements</option> <option value="12110">Blood, HOS</option> <option value="10600">Blood, HOS, Vitals on Labslip</option> <option value="12210">DBS, HOS</option> <option value="11300">EKG Only</option> <option value="11310">EKG, Blood, HOS</option> <option value="311755">HOS 1 of 2 (Day 1)</option> <option value="311756">HOS 2 of 2 (Day 2)</option> <option value="11710">MD Only</option> <option value="30463">MD, Blood</option> <option value="30069">MD, Blood, HOS</option> <option value="30076">MD, Blood, HOS, Vitals on Labslip</option> <option value="30068">MD, EKG Only</option> <option value="11730">MD, EKG, Blood, HOS</option> <option value="30042">MD, EKG, Blood, HOS, Vitals on Labslip</option> <option value="30431">MD, Treadmill, Blood, HOS, Vitals on Labslip</option> <option va Link to comment Share on other sites More sharing options...
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