File name as variable PHP
I have an existing form that I am modifying for another use. I want to be able to name the file to lastname.firstname.txt, eg: Lewis.Charles.txt.
My question is the code below correct for doing that.
I am rusty on my quote usage for PHP.
My question is the code below correct for doing that.
I am rusty on my quote usage for PHP.
$filename = "apps/'$lname'.'$fname'.txt"; //File to be written toSOLUTION
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ASKER CERTIFIED SOLUTION
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Dave Baldwin
And file names with spaces in them are often a problem. You also need to filter out special characters in that operating system like '\', '/', and others. Because someone will try to use them. Like "John/Becky Morgan".
ASKER
Below is the complete code.
<?php
/* |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||||||| Variables ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||*/
$today = date("DATE_RFC2822"); // sets $today to today's date from client device
$fname = $_POST['fname'];
$lname = $_POST['lname'];
$phone = $_POST['phone'];
$addr = $_POST['addr'];
$city = $_POST['city'];
$state = $_POST['state'];
$zip = $_POST['zip'];
$email = $_POST['email'];
$besttime = $_POST['besttime'];
$contactmethod = $_POST['contactmethod'];
$dob = $_POST['dob'];
$howhear = $_POST['howhear'];
if(isset($_POST['cardiosurgery'])) { $cardiosurgery = "YES"; }
if(isset($_POST['schdocvisits'])) { $schdocvisits = "YES"; }
if(isset($_POST['homecare'])) { $homecare = "YES"; }
if(isset($_POST['ekgtesting'])) { $ekgtesting = "YES"; }
if(isset($_POST['other'])) { $other = "YES"; }
$othermsg = $_POST['othermsg'];
/* ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||||||| Validation ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||*/
switch (@$_GET['do'])
{
case "send":
if (!preg_match("/\S+/",$fname))
{
unset($_GET['do']);
$message = "First Name required. Please try again.";
break;
}
if (!preg_match("/\S+/",$lname))
{
unset($_GET['do']);
$message = "Last Name required. Please try again.";
break;
}
if (!preg_match("/^\S+@[A-Za-z0-9_.-]+\.[A-Za-z]{2,6}$/",$email))
{
unset($_GET['do']);
$message = "Proper Email Address format: example@website.net Please try again.";
break;
}
if (!preg_match("/^[0-9 #\-\*\.\(\)]+$/",$phone))
{
unset($_GET['do']);
$message = "Phone Number required. No letters, please.";
break;
}
/* |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||| Set message to null if no error ||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||*/
$message = '';
unset($_GET['do']);
break;
default: break;
}
/* |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||||| Write Variables to File ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||*/
if(isset($_POST['submit'])){
if ($message == "") {
$filename = "files/$lname.$fname.txt";
$fhandle = fopen($filename, 'w'); // variable to hold file name
fwrite($fhandle,'Date: '.$today."\n"); //Writes $today to textfile
fwrite($fhandle,'Best Time to Call: '.$besttime."\n"); //Writes $besttime to textfile
fwrite($fhandle,'ContactMethod: '.$contactmethod."\n"); //Writes $contactmethod to textfile
fwrite($fhandle,'First Name: '.$fname."\n"); //Writes $today to textfile
fwrite($fhandle,'Last Name:~ '.$lname."\n"); //Writes $today to textfile
fwrite($fhandle,'Phone Number: '.$phone."\n"); //Writes $today to textfile
fwrite($fhandle,'Address: '.$addr."\n"); //Writes $today to textfile
fwrite($fhandle,'City: '.$city."\n"); //Writes $today to textfile
fwrite($fhandle,'State: '.$state."\n"); //Writes $today to textfile
fwrite($fhandle,'Zip: '.$zip."\n"); //Writes $today to textfile
fwrite($fhandle,'Email: '.$email."\n"); //Writes $today to textfile
fwrite($fhandle,'Date of Birth: '.$dob."\n"); //Writes $today to textfile
fwrite($fhandle,'Cardiovascular Surgery: '.$nursesvc."\n"); //Writes $today to textfile
fwrite($fhandle,'Schedule Dr. Visits: '.$pcare."\n"); //Writes $today to textfile
fwrite($fhandle,'Home Care: '.$homecare."\n"); //Writes $today to textfile
fwrite($fhandle,'EKG Testing: '.$ekgtesting."\n"); //Writes $today to textfile
fwrite($fhandle,'Other_Message~ '.$othermsg."\n"); //Writes $today to textfile
fwrite($fhandle,'How did you hear about us: '.$howhear."\n"); //Writes $today to textfile
fclose($fhandle);
/*||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||| phpmailer sends file as attachment |||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||*/
require_once('class.phpmailer.php'); //File must be located in same directory
$mail = new PHPMailer(); // defaults to using php "mail()"
$body = file_get_contents('contents.html'); // File with message for email
$body = eregi_replace("[\]",'',$body);
$mail->SetFrom('questioner@douglasmedical.com', 'Questioner Answers'); // Sent from Email Address/Name
$mail->AddReplyTo("questioner@douglasmedical.com","Questioner Answers"); // Reply to email address
$address = "questioner@douglasmedical.com"; // Email of Recipient
$mail->AddAddress($address, "Questioner Answers"); // Name of Recipient
$mail->Subject = "DMS Patient Questioner from: For $plname, $pfname"; // Subject Line of Email
$mail->AltBody = "To view the message, please use an HTML compatible email viewer!"; // optional, comment out and test
$mail->MsgHTML($body);
$mail->AddAttachment("apps/referral.txt"); // attachment
if(!$mail->Send()) {
echo "Mailer Error: " . $mail->ErrorInfo;
} else {
echo '<META HTTP-EQUIV="refresh" content="0;URL=thank_you.htm">'; // Redirect to thank you page
} } }
?>
<!-- ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|||||||||||||||||||||||||||||||||||||||||||||||| Start HTML CODE ||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||| -->
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<title>Douglas Medical Specialists | Questioner Form</title>
<link rel="stylesheet" href="questioner.css" type="text/css" >
<meta http-equiv="Content-Type" content="text/html;charset=utf-8" >
<!-- JS to limit number of characters in text fields -->
<script language="javascript" type="text/javascript">
function limitText(limitField, limitCount, limitNum) {
if (limitField.value.length > limitNum) {
limitField.value = limitField.value.substring(0, limitNum);
} else {
limitCount.value = limitNum - limitField.value.length;
}
}
</script>
<script type="text/javascript">
/***********************************************
* Disable "Enter" key in Form script- By Nurul Fadilah(nurul@REMOVETHISvolmedia.com)
* This notice must stay intact for use
* Visit http://www.dynamicdrive.com/ for full source code
***********************************************/
function handleEnter (field, event) {
var keyCode = event.keyCode ? event.keyCode : event.which ? event.which : event.charCode;
if (keyCode == 13) {
var i;
for (i = 0; i < field.form.elements.length; i++)
if (field == field.form.elements[i])
break;
i = (i + 1) % field.form.elements.length;
field.form.elements[i].focus();
return false;
}
else
return true;
}
</script>
</head>
<body>
<center>
<form action="index.php?do=send" method="POST">
<p><a href="index.html">
<img alt="" src="images/doctors.png"></a></p>
<h1>Patient Referrals</h1>
<p>Please fill in the Referral Form Below.</p>
<p><font color="red">*</font> Required Fields</p> <span style="color:red;">
<?php
if ($message)
echo "$message";
?>
</span>
<table border="1" width="500">
<TR bgcolor="#B2C6DE">
<TD align="center" colSpan=6>Patient Information</TD>
</TR>
<tr><td width="150px">
<font color="red">*</font> First Name: </td><td><input type="text" name="fname" size="20" value="<?php echo @$fname ?>"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.fname,this.form.countdown9,45);"
onKeyUp="limitText(this.form.fname,this.form.countdown9,45);">
</td></tr>
<tr><td>
<font color="red">*</font> Last Name: </td><td><input type="text" name="lname" size="20" value="<?php echo @$lname ?>"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.lname,this.form.countdown10,45);"
onKeyUp="limitText(this.form.lname,this.form.countdown10,45);">
</td></tr>
<tr><td>
Phone Number: </td><td><input type="text" name="phone" size="20" value="<?php echo @$phone ?>"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.phone,this.form.countdown11,12);"
onKeyUp="limitText(this.form.phone,this.form.countdown11,12);">
</td></tr>
<tr><td>
Address: </td><td><input type="text" name="addr" size="20" value="<?php echo @$addr ?>"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.addr,this.form.countdown12,80);"
onKeyUp="limitText(this.form.addr,this.form.countdown12,80);">
</td></tr>
<tr><td>
City: </td><td><input type="text" name="city" size="20" value="<?php echo @$city ?>"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.city,this.form.countdown13,20);"
onKeyUp="limitText(this.form.city,this.form.countdown13,20);">
</td></tr>
<tr><td>
State: </td><td><input type="text" name="state" size="20" value="<?php echo @$state ?>"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.state,this.form.countdown14,2);"
onKeyUp="limitText(this.form.state,this.form.countdown14,2);">
</td></tr>
<tr><td>
Zip: </td><td><input type="text" name="zip" size="20" value="<?php echo @$zip ?>"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.zip,this.form.countdown15,5);"
onKeyUp="limitText(this.form.zip,this.form.countdown15,5);">
</td></tr>
<tr><td>
Email: </td><td><input type="text" name="email" size="20" value="<?php echo @$email ?>"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.email,this.form.countdown16,50);"
onKeyUp="limitText(this.form.email,this.form.countdown16,50);">
</td></tr>
<tr><td>
Date of Birth: </td><td><input type="text" name="dob" size="20" value="<?php echo @$dob ?>"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.dob,this.form.countdown17,10);"
onKeyUp="limitText(this.form.dob,this.form.countdown17,10);">
</td></tr>
</table>
<table border="1" width="500">
<TR bgcolor="#B2C6DE">
<TD align="center" colSpan=6>Questioner</TD>
</TR>
<tr><td>
Are you interested in the following services?<br>
<input type="checkbox" name="cardiosurgery" value="YES"> Cardiovascular Surgery<br>
<input type="checkbox" name="schdocvisits" value="YES"> Scheduling Regular Doctor Visits<br>
<input type="checkbox" name="homecare" value="YES"> Home Care (Housekeeping, Laundry, Meal Prep, etc.)<br>
<input type="checkbox" name="ekgtesting" value="YES"> EKG Testing<br>
<input type="checkbox" name="bloodwork" value="YES"> Blood Work<br>
<input type="checkbox" name="other" > Other - Please Specify:<br>
Other Information:<br>
<textarea rows="5" cols="40" name="othermsg"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.othermsg,this.form.countdown18,240);"
onKeyUp="limitText(this.form.othermsg,this.form.countdown18,240);"
><?php echo @$othermsg ?></textarea>
</td></tr>
<tr><td>How did you hear about Douglas Medical Specialists?<br>
<textarea rows="5" cols="40" name="howhear"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.howhear,this.form.countdown19,240);"
onKeyUp="limitText(this.form.howhear,this.form.countdown19,240);"
><?php echo @$howhear ?></textarea></td></tr>
</table>
<br>
<input type="submit" name="submit" value="Click Here to Submit" style="height: 75px; width: 400px; font-size: 24px;">
</form>
</center>
</body>
</html>
<!-- ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||||||||| End HTML CODE |||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||| -->ASKER
I've made several modifications trying to get it to work again but it seems like I broke something along the way.
<?php
// Report all PHP errors
error_reporting(-1);
/* |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||||||| Variables ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||*/
$today = date("DATE_RFC2822"); // sets $today to today's date from client device
$fname = $_POST['fname'];
$lname = $_POST['lname'];
$phone = $_POST['phone'];
$addr = $_POST['addr'];
$city = $_POST['city'];
$state = $_POST['state'];
$zip = $_POST['zip'];
$email = $_POST['email'];
$besttime = $_POST['besttime'];
$contactmethod = $_POST['contactmethod'];
$dob = $_POST['dob'];
$howhear = $_POST['howhear'];
if(isset($_POST['cardiosurgery'])) { $cardiosurgery = "YES"; }
if(isset($_POST['schdocvisits'])) { $schdocvisits = "YES"; }
if(isset($_POST['homecare'])) { $homecare = "YES"; }
if(isset($_POST['ekgtesting'])) { $ekgtesting = "YES"; }
if(isset($_POST['other'])) { $other = "YES"; }
$othermsg = $_POST['othermsg'];
/* ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||||||| Validation ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||*/
switch (@$_GET['do'])
{
case "send":
if (!preg_match("/\S+/",$fname))
{
unset($_GET['do']);
$message = "First Name required. Please try again.";
break;
}
if (!preg_match("/\S+/",$lname))
{
unset($_GET['do']);
$message = "Last Name required. Please try again.";
break;
}
if (!preg_match("/^\S+@[A-Za-z0-9_.-]+\.[A-Za-z]{2,6}$/",$email))
{
unset($_GET['do']);
$message = "Proper Email Address format: example@website.net Please try again.";
break;
}
if (!preg_match("/^[0-9 #\-\*\.\(\)]+$/",$phone))
{
unset($_GET['do']);
$message = "Phone Number required. No letters, please.";
break;
}
/* |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||| Set message to null if no error ||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||*/
$message = '';
unset($_GET['do']);
break;
default: break;
}
/* |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||||| Write Variables to File ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||*/
if(isset($_POST['submit'])){
if ($message == "") {
$filename = 'files/questions.txt'; //File to be written to
$fhandle = fopen($filename, 'w'); // variable to hold file name
fwrite($fhandle,'Date- '.$today."\n"); //Writes $today to textfile
fwrite($fhandle,'Best Time to Call- '.$besttime."\n"); //Writes $besttime to textfile
fwrite($fhandle,'ContactMethod- '.$contactmethod."\n"); //Writes $contactmethod to textfile
fwrite($fhandle,'First Name- '.$fname."\n"); //Writes $today to textfile
fwrite($fhandle,'Last Name- '.$lname."\n"); //Writes $today to textfile
fwrite($fhandle,'Phone Number- '.$phone."\n"); //Writes $today to textfile
fwrite($fhandle,'Address- '.$addr."\n"); //Writes $today to textfile
fwrite($fhandle,'City- '.$city."\n"); //Writes $today to textfile
fwrite($fhandle,'State- '.$state."\n"); //Writes $today to textfile
fwrite($fhandle,'Zip- '.$zip."\n"); //Writes $today to textfile
fwrite($fhandle,'Email- '.$email."\n"); //Writes $today to textfile
fwrite($fhandle,'Date of Birth- '.$dob."\n"); //Writes $today to textfile
fwrite($fhandle,'Cardiovascular Surgery- '.$nursesvc."\n"); //Writes $today to textfile
fwrite($fhandle,'Schedule Dr. Visits- '.$pcare."\n"); //Writes $today to textfile
fwrite($fhandle,'Home Care- '.$homecare."\n"); //Writes $today to textfile
fwrite($fhandle,'EKG Testin- '.$ekgtesting."\n"); //Writes $today to textfile
fwrite($fhandle,'Other_Message~ '.$othermsg."\n"); //Writes $today to textfile
fwrite($fhandle,'How did you hear about us: '.$howhear."\n"); //Writes $today to textfile
fclose($fhandle);
/*||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||| phpmailer sends file as attachment |||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||*/
require_once('class.phpmailer.php'); //File must be located in same directory
$mail = new PHPMailer(); // defaults to using php "mail()"
$body = file_get_contents('contents.html'); // File with message for email
$body = eregi_replace("[\]",'',$body);
$mail->SetFrom('office@graycomputer.net', 'Questioner Answers'); // Sent from Email Address/Name
$mail->AddReplyTo("office@graycomputer.net","Questioner Answers"); // Reply to email address
$address = "office@graycomputer.net"; // Email of Recipient
$mail->AddAddress($address, "Questioner Answers"); // Name of Recipient
$mail->Subject = "DMS Patient Questioner from: For $plname, $pfname"; // Subject Line of Email
$mail->AltBody = "To view the message, please use an HTML compatible email viewer!"; // optional, comment out and test
$mail->MsgHTML($body);
$mail->AddAttachment("files/questions.txt"); // attachment
if(!$mail->Send()) {
echo "Mailer Error: " . $mail->ErrorInfo;
} else {
echo '<META HTTP-EQUIV="refresh" content="0;URL=thank_you.htm">'; // Redirect to thank you page
} } }
?>
<!-- ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|||||||||||||||||||||||||||||||||||||||||||||||| Start HTML CODE ||||||||||||||||||||||||||||||||||||||||||||||||||||||
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||| -->
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<title>Douglas Medical Specialists | Questioner Form</title>
<link rel="stylesheet" href="questioner.css" type="text/css" >
<meta http-equiv="Content-Type" content="text/html;charset=utf-8" >
<!-- JS to limit number of characters in text fields -->
<script language="javascript" type="text/javascript">
function limitText(limitField, limitCount, limitNum) {
if (limitField.value.length > limitNum) {
limitField.value = limitField.value.substring(0, limitNum);
} else {
limitCount.value = limitNum - limitField.value.length;
}
}
</script>
<script type="text/javascript">
/***********************************************
* Disable "Enter" key in Form script- By Nurul Fadilah(nurul@REMOVETHISvolmedia.com)
* This notice must stay intact for use
* Visit http://www.dynamicdrive.com/ for full source code
***********************************************/
function handleEnter (field, event) {
var keyCode = event.keyCode ? event.keyCode : event.which ? event.which : event.charCode;
if (keyCode == 13) {
var i;
for (i = 0; i < field.form.elements.length; i++)
if (field == field.form.elements[i])
break;
i = (i + 1) % field.form.elements.length;
field.form.elements[i].focus();
return false;
}
else
return true;
}
</script>
</head>
<body>
<center>
<form action="index.php?do=send" method="POST">
<p><a href="index.html">
<img alt="" src="images/doctors.png"></a></p>
<h1>Welcome to Douglas Medical Specialists!</h1>
<p>Please fill in the questioner below.</p>
<p><font color="red">*</font> Required Fields</p> <span style="color:red;">
<?php
if ($message)
echo "$message";
?>
</span>
<table border="1" width="500">
<TR bgcolor="#B2C6DE">
<TD align="center" colSpan=6>Patient Information</TD>
</TR>
<tr><td width="150px">
<font color="red">*</font> First Name: </td><td><input type="text" name="fname" size="20" value="<?php echo @$fname ?>"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.fname,this.form.countdown9,45);"
onKeyUp="limitText(this.form.fname,this.form.countdown9,45);">
</td></tr>
<tr><td>
<font color="red">*</font> Last Name: </td><td><input type="text" name="lname" size="20" value="<?php echo @$lname ?>"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.lname,this.form.countdown10,45);"
onKeyUp="limitText(this.form.lname,this.form.countdown10,45);">
</td></tr>
<tr><td>
Phone Number: </td><td><input type="text" name="phone" size="20" value="<?php echo @$phone ?>"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.phone,this.form.countdown11,12);"
onKeyUp="limitText(this.form.phone,this.form.countdown11,12);">
</td></tr>
<tr><td>
Address: </td><td><input type="text" name="addr" size="20" value="<?php echo @$addr ?>"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.addr,this.form.countdown12,80);"
onKeyUp="limitText(this.form.addr,this.form.countdown12,80);">
</td></tr>
<tr><td>
City: </td><td><input type="text" name="city" size="20" value="<?php echo @$city ?>"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.city,this.form.countdown13,20);"
onKeyUp="limitText(this.form.city,this.form.countdown13,20);">
</td></tr>
<tr><td>
State: </td><td><input type="text" name="state" size="20" value="<?php echo @$state ?>"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.state,this.form.countdown14,2);"
onKeyUp="limitText(this.form.state,this.form.countdown14,2);">
</td></tr>
<tr><td>
Zip: </td><td><input type="text" name="zip" size="20" value="<?php echo @$zip ?>"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.zip,this.form.countdown15,5);"
onKeyUp="limitText(this.form.zip,this.form.countdown15,5);">
</td></tr>
<tr><td>
Email: </td><td><input type="text" name="email" size="20" value="<?php echo @$email ?>"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.email,this.form.countdown16,50);"
onKeyUp="limitText(this.form.email,this.form.countdown16,50);">
</td></tr>
<tr><td>
Date of Birth: </td><td><input type="text" name="dob" size="20" value="<?php echo @$dob ?>"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.dob,this.form.countdown17,10);"
onKeyUp="limitText(this.form.dob,this.form.countdown17,10);">
</td></tr>
</table>
<table border="1" width="500">
<TR bgcolor="#B2C6DE">
<TD align="center" colSpan=6>Questioner</TD>
</TR>
<tr><td>
Are you interested in the following services?<br>
<input type="checkbox" name="cardiosurgery" value="YES"> Cardiovascular Surgery<br>
<input type="checkbox" name="schdocvisits" value="YES"> Scheduling Regular Doctor Visits<br>
<input type="checkbox" name="homecare" value="YES"> Home Care (Housekeeping, Laundry, Meal Prep, etc.)<br>
<input type="checkbox" name="ekgtesting" value="YES"> EKG Testing<br>
<input type="checkbox" name="bloodwork" value="YES"> Blood Work<br>
<input type="checkbox" name="other" > Other - Please Specify:<br>
Other Information:<br>
<textarea rows="5" cols="40" name="othermsg"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.othermsg,this.form.countdown18,240);"
onKeyUp="limitText(this.form.othermsg,this.form.countdown18,240);"
><?php echo @$othermsg ?></textarea>
</td></tr>
<tr><td>How did you hear about Douglas Medical Specialists?<br>
<textarea rows="5" cols="40" name="howhear"
onkeypress="return handleEnter(this, event);"
onKeyDown="limitText(this.form.howhear,this.form.countdown19,240);"
onKeyUp="limitText(this.form.howhear,this.form.countdown19,240);"
><?php echo @$howhear ?></textarea></td></tr>
</table>
<br>
<input type="submit" name="submit" value="Click Here to Submit" style="height: 75px; width: 400px; font-size: 24px;">
</form>
</center>
</body>
</html>
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ASKER
Actually the 337 lines are the full project, started to go off topic with this one. Thanks for the heads up about GIT, I have been looking for a version control software for awhile.
Thanks for the points, ~Ray