var HealthForm = Class.create();
	HealthForm.prototype =
	{
		initialize: function(form_id){
			this.initializeDisplay();
			this.initializeRequiredFields();
			this.initializeEvents();
			this.lockReturnKey			= false;
			this.form_elements			= this.getErrorElements();
			this.step		=	1;
			this.is_valid						= true;
		},
	
		/***************************************************************************************************
		 *initialize the elements of the form, hide and show as directed
		 */
		initializeDisplay : function(){
			showChildren($("number_of_children"));
			showSpouse();
	    	this.previousStep();
	    	//$("").show();
			$("additional-family").show();
			this.showExistingCarrier();
			this.showTakesMedications();
			this.showPreExisting();
		},
	
		/*************************************************
		 *initialize the validations for required elements
		 */
		initializeRequiredFields : function(){
			//coverage section (applicant)
			$("gender1_error").addClassName("required");
			$("dob1_on_error").addClassName("validate-dob");
			$("insured1_height_error").addClassName("validate-height");
			$("insured1_weight_error").addClassName("validate-weight");
			//health info section
			$("reqdate_begin_error").addClassName("validate-request-date");
			//contact info section
			$("first_name_error").addClassName("validate-alpha");
			$("last_name_error").addClassName("validate-alpha");
			$("address1_street1_error").addClassName("required");
			$("address1_city_error").addClassName("validate-alpha");
			
      if($("address1_state_error") != null){
      	$("address1_state_error").addClassName("validate-state");
      }
      
      if($("address1_zip_error") != null){
      	$("address1_zip_error").addClassName("validate-zip");
      }
      
			$("phone1_error").addClassName("validate-phone");
			$("phone2_error").addClassName("validate-phone");
			$("email1_error").addClassName("validate-email");
			$("privacy_policy_error").addClassName("validate-privacy");
		},
	
		/***************************************************************************************************
		 *add event listeners for submit button, return key and custom onclick/onchange
		 */
		initializeEvents : function(){
			Event.observe(document, "keypress", this.validateOnReturnKey.bindAsEventListener(this));
			Event.observe("submit", "click", this.validateFields.bindAsEventListener(this));
			//forward back
			Event.observe("continue", 'click', this.nextStep.bindAsEventListener(this));
			Event.observe("back", 'click', this.previousStep.bindAsEventListener(this));
			
			Event.observe("takes_medications_1", "click", this.showTakesMedications.bindAsEventListener(this));
			Event.observe("takes_medications_0", "click", this.showTakesMedications.bindAsEventListener(this));
	
			Event.observe("pre_existing_1", "click", this.showPreExisting.bindAsEventListener(this));
			Event.observe("pre_existing_0", "click", this.showPreExisting.bindAsEventListener(this));
	
			Event.observe("has_existing_carrier_1", "click", this.showExistingCarrier.bindAsEventListener(this));
			Event.observe("has_existing_carrier_0", "click", this.showExistingCarrier.bindAsEventListener(this));
			
			Event.observe("add-spouse", "click", function(e){
				$("has_spouse").value	=	1;
				showSpouse();
				spouseValidation(true);
				Event.stop(e);
			});
			
			Event.observe("remove-spouse", "click", function(e){
				$("has_spouse").value	=	0;
				showSpouse();
				spouseValidation(false);
				Event.stop(e);
			});
			
			Event.observe("add-child", "click", function(e){
				var children	=	$F("number_of_children");
				if(children < 5){
					$("number_of_children").value =	parseInt($F("number_of_children")) + 1;
					showChildren($("number_of_children"));
				}
				Event.stop(e);
			});
			
			Event.observe("remove-child1", "click", function(e){
				$("child_option1").hide();
				toggleAddChild();
				changeValidationForInsured(3, false);
				shiftChildren(3);
				Event.stop(e);
			});
			
			Event.observe("remove-child2", "click", function(e){
				$("child_option2").hide();
				toggleAddChild();
				changeValidationForInsured(4, false);
				shiftChildren(4);
				Event.stop(e);
			});
			
			Event.observe("remove-child3", "click", function(e){
				$("child_option3").hide();
				toggleAddChild();
				changeValidationForInsured(5, false);
				shiftChildren(5);
				Event.stop(e);
			});
			
			Event.observe("remove-child4", "click", function(e){
				$("child_option4").hide();
				toggleAddChild();
				changeValidationForInsured(6, false);
				shiftChildren(6);
				Event.stop(e);
			});
			
			Event.observe("remove-child5", "click", function(e){
				$("child_option5").hide();
				toggleAddChild();
				changeValidationForInsured(7, false);
				shiftChildren(7);
				Event.stop(e);
			});
		},
	
		/***************************************************************************************************
		 *show/add functions
		 *takes hidden row, element and validation to apply/remove
		 */
		showAddValidations: function(name, element, validation_name){
			var name = String(name);
			$$(name).each(function(element){ element.show(); });
			$(element.id).addClassName(validation_name);
		},
	
		hideRemoveValidations: function(name, element, validation_name){
			var name = String(name);
			$$(name).each(function(element){ element.hide(); });
			$(element.id).hide();
			$(element.id).removeClassName(validation_name);
		},
		
		validateFields: function(e){
			this.form_elements	= $$(".error");
			var form						= new Validator(this.form_elements);
			this.is_valid 			= form.isFormValid();
	
			if($("pre_existing_1").checked){
				if(!isAnyChecked("pre_existing_conditions_row")){
					this.is_valid	= false;
				}
			}
			
			if(!this.is_valid) Event.stop(e);
		},
	
		validateOnReturnKey: function(e){
			if(e.keyCode == Event.KEY_RETURN){
				this.validateFields(e);
				Event.stop(e);
			}
		},
		
		getErrorElements: function(){
			return $$("error");
		},
	
		/***************************************************************************************************
		*Custom functions
		*/
	
		//next/previous steps.
		nextStep : function(id) {
		    if(this.step_1_validate_fields(id)){		    	
		      $("HealthInformation").hide();
		      $("CoverageInformation").hide();
		      $("right_btn").hide();
		      
		      $("ContactInformation").show();
		      $("submit").show();
		      $("left_btn").show();
		    }
		},
		  
		previousStep: function(){
		    $("ContactInformation").hide();
		    $("submit").hide();
		    $("left_btn").hide();
		    $("HealthInformation").show();
		    $("CoverageInformation").show();
		    $("right_btn").show();
		},    
		showTakesMedications : function(){
			if($("takes_medications_1").checked){
				this.showAddValidations("#insured1_current_medications_detail_row",$("insured1_current_medications_detail_error"),"required");
			}else{
				this.hideRemoveValidations("#insured1_current_medications_detail_row",$("insured1_current_medications_detail_error"),"required");
				$("insured1_current_medications_detail").clear();
			}
		},
	
		showPreExisting : function(){
			if($("pre_existing_1").checked){
				$("pre_existing_conditions_row").show();
			}else{
				$("pre_existing_conditions_row").hide();
				var PECs = Form.getElements($("pre_existing_conditions_row"));
				PECs.each(function(e){ return (e.checked = false); });
			}
		},
	
		showExistingCarrier : function(){
			($("has_existing_carrier_1").checked) ? this.showAddValidations("#existing_carrier_row",$("existing_carrier_error"),"required") : this.hideRemoveValidations("#existing_carrier_row",$("existing_carrier_error"),"required");
		},
		validate_fields: function(e){
			this.form_elements	= $$(".error");
			var form = new Validator(this.form_elements);
			this.is_valid = form.isFormValid();

			if($("pre_existing_1").checked){
				if(!isAnyChecked("pre_existing_conditions_row")){
					this.is_valid	= false;
				}
			}
			if(!this.is_valid){
				Event.stop(e);
			}
		},
		step_1_validate_fields: function(e){
			this.form_elements	= $$(".error");
			var form = new Validator($("HealthInformation").descendants().concat($("CoverageInformation").descendants()) );
			this.is_valid = form.isFormValid();

			if($("pre_existing_1").checked){
				if(!isAnyChecked("pre_existing_conditions_row")){
					this.is_valid	= false;
				}
			}
			return this.is_valid;
		}

	}
	
	
	function spouseValidation(validate){
		if(validate){
			$("gender2_error").addClassName("required");
			$("dob2_on_error").addClassName("validate-dob");
			$("insured2_height_error").addClassName("validate-height");
			$("insured2_weight_error").addClassName("validate-weight");
		}else{
			$("gender2_error").removeClassName("required");
			$("dob2_on_error").removeClassName("validate-dob");
			$("insured2_height_error").removeClassName("validate-height");
			$("insured2_weight_error").removeClassName("validate-weight");
			clearErrorMessage("gender2_error");
			clearErrorMessage("dob2_on_error");
			clearErrorMessage("insured2_height_error");
			clearErrorMessage("insured2_weight_error");
			$("dob2_mm_on").clear();
			$("dob2_dd_on").clear();
			$("dob2_yyyy_on").clear();
			$("insured2_height_feet").clear();
			$("insured2_height_inches").clear();
			$("insured2_weight").clear();
		}
	}
	
	function isEmptyInsured(insured){
		var gender 	= isEmptyGender(insured);
		var dob 		= isEmptyDob(insured);
		var height 	= isEmptyHeight(insured);
		var weight 	= isEmptyWeight(insured);
		return (gender && dob && height && weight);
	}
	
	function isEmptyGender(insured){
		return (($F("gender" + insured) == ""));
	}
	
	function isEmptyDob(insured){
		return (($F("dob" + insured + "_mm_on") == "") && ($F("dob" + insured + "_dd_on") == "") && ($F("dob" + insured + "_yyyy_on") == ""));
	}
	
	function isEmptyHeight(insured){
		return (($F("insured" + insured + "_height_feet") == ""));
	}
	
	function isEmptyWeight(insured){
		return (($F("insured" + insured + "_weight") == ""));
	}
	
	function showSpouse(){
		if($F("has_spouse") == 1){
			$("add-spouse").hide();
			$("disabled-spouse").show();
			$("spouse-row").show();
			spouseValidation();
		}else{
			$("add-spouse").show();
			$("disabled-spouse").hide();
			$("spouse-row").hide();
			spouseValidation();
		}
	}
	
	function showChildren(el) {
		var num_children = $F(el);
	
		for (var i = 1;i <= 5; i++) {
			var id			= "child_option" + i;
			var insured = i + 2;
	
			if ( i <= num_children ) {
				$(id).show();
				$("child" + i).show();
				changeValidationForInsured(insured, true);
			} else {
				$(id).hide();
				$("gender" + insured).value = "";
				changeValidationForInsured(insured, false);
			}
		}
		toggleAddChild();
	}
	
	function toggleAddChild(){
		var num_children	=	$F("number_of_children");
		if(num_children == 5){
			$("disabled-child").show();
			$("add-child").hide();
		}else{
			$("disabled-child").hide();
			$("add-child").show();
		}
	}
	
	function shiftChildren(child_removed){
		var packed_children	=	new Array();
		var insured_kid			=	3;
		var total_children	=	0;
		var start_total			=	$F("number_of_children");
		
		//Shift children down
		for (i=3; i<=7; i++) {
				if(
						$F("gender" +1) != "" && $F("insured" +  i + "_height_feet") != "" && $F("insured" +  i + "_height_inches") != "" &&
						$F("dob" +  i + "_yyyy_on") != "" && $F("dob" +  i + "_mm_on") != "" && $F("dob" +  i + "_dd_on") != ""
					){						
					if(i < child_removed){
						packed_children["gender" + insured_kid]											=	$F("gender" + i);
						packed_children["insured" + insured_kid + "_height_feet"]		=	$F("insured" +  i + "_height_feet");
						packed_children["insured" + insured_kid + "_height_inches"]	=	$F("insured" +  i + "_height_inches");
						packed_children["insured" + insured_kid + "_weight"]				=	$F("insured" +  i + "_weight");
						packed_children["is_smoker" + insured_kid + "_1"]						=	$("is_smoker" +  i + "_1").checked;
						packed_children["is_student" + insured_kid + "_1"]					=	$("is_student" +  i + "_1").checked;
						packed_children["dob" + insured_kid + "_yyyy_on"]						=	$F("dob" +  i + "_yyyy_on");
						packed_children["dob" + insured_kid + "_mm_on"]							=	$F("dob" +  i + "_mm_on");
						packed_children["dob" + insured_kid + "_dd_on"]							=	$F("dob" +  i + "_dd_on");
						insured_kid++;
					}else if (i > child_removed){
						if($F("gender" + i) != ""){
							packed_children["gender" + insured_kid]											=	$F("gender" + i);
							packed_children["insured" + insured_kid + "_height_feet"]		=	$F("insured" +  i + "_height_feet");
							packed_children["insured" + insured_kid + "_height_inches"]	=	$F("insured" +  i + "_height_inches");
							packed_children["insured" + insured_kid + "_weight"]				=	$F("insured" +  i + "_weight");
							packed_children["is_smoker" + insured_kid + "_1"]						=	$("is_smoker" +  i + "_1").checked;
							packed_children["is_student" + insured_kid + "_1"]					=	$("is_student" +  i + "_1").checked;
							packed_children["dob" + insured_kid + "_yyyy_on"]						=	$F("dob" +  i + "_yyyy_on");
							packed_children["dob" + insured_kid + "_mm_on"]							=	$F("dob" +  i + "_mm_on");
							packed_children["dob" + insured_kid + "_dd_on"]							=	$F("dob" +  i + "_dd_on");
							insured_kid++;
						}
					}
				}
			}
			
			for (i=3; i<=7; i++) {
				if(i < insured_kid){
					$("insured" +  i + "_height_feet").value	 									= packed_children["insured" +  i + "_height_feet"];
					$("insured" +  i + "_height_inches").value 									= packed_children["insured" +  i + "_height_inches"];
					$("insured" +  i + "_weight").value													= packed_children["insured" +  i + "_weight"];
					$("gender" +  i + "").value																	= packed_children["gender" +  i + ""];
					$("is_smoker" +  i + "_1").checked						 							= packed_children["is_smoker" +  i + "_1"];
					$("is_student" +  i + "_1").checked													= packed_children["is_student" +  i + "_1"];
					$("dob" +  i + "_yyyy_on").value														= packed_children["dob" +  i + "_yyyy_on"];
					$("dob" +  i + "_mm_on").value															= packed_children["dob" +  i + "_mm_on"];
					$("dob" +  i + "_dd_on").value															= packed_children["dob" +  i + "_dd_on"];
				}else{
					if(packed_children["gender" + i] != undefined){
						changeValidationForInsured(i, false);
					}
				}
			}
			
			$("number_of_children").value	=	start_total - 1;
			showChildren($("number_of_children"))
	}
	
	function changeValidationForInsured(insured, add_validations) {
		var id			= "gender" + insured;
		var gender	= $F(id);
	
		if ( add_validations ) {
			$(id + "_error").addClassName("required");
			$("insured" + insured + "_height_error").addClassName("validate-height");
			$("insured" + insured + "_weight_error").addClassName("validate-weight");
			$("dob" + insured + "_on_error").addClassName("validate-child-dob");
		} else {
			$(id).clear();
			$("insured" + insured + "_height_feet").clear();
			$("insured" + insured + "_height_inches").clear();
			$("insured" + insured + "_weight").value	=	"";
			$("dob" + insured + "_mm_on").value	=	"";
			$("dob" + insured + "_dd_on").value	=	"";
			$("dob" + insured + "_yyyy_on").value	=	"";
			$(id + "_error").removeClassName("required");
			$("insured" + insured + "_height_error").removeClassName("validate-height");
			$("insured" + insured + "_weight_error").removeClassName("validate-weight");
			$("dob" + insured + "_on_error").removeClassName("validate-child-dob");
			$(id + "_error").hide();
			$("insured" + insured + "_height_error").hide();
			$("insured" + insured + "_weight_error").hide();
			$("dob" + insured + "_on_error").hide();
		}
	}
	
	function isAnyChecked(parent_id){
		var is_valid	= true;
		is_valid			=	Form.getElements($(parent_id)).any(function(e){ return (e.checked); });
		if(!is_valid){
			$("pre_existing_conditions_error").addClassName("error");
		}else{
			$("pre_existing_conditions_error").removeClassName("error");
		}
		return is_valid
	}
	
	if (!(BrowserDetect.browser == "Explorer" && BrowserDetect.version < 6)) {
		FastInit.addOnLoad(function() {
			var health_form = new HealthForm();
		});
	}