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.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("required");
    	$("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");
    	$("address1_state_error").addClassName("validate-state");
    	$("address1_zip_error").addClassName("validate-zip");
    	$("phone1_error").addClassName("validate-phone");
    	$("email1_error").addClassName("validate-email");
    	$("privacy_policy_error").addClassName("validate-checked");
    },

    /***************************************************************************************************
     *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));
      
      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("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-spouse", "click", function(e){
			$("has_spouse").value	=	0;
			showSpouse();
			spouseValidation(false);
			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
     */

    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");
    }
  }

function spouseValidation(validate){
	if(validate){
		$("gender2_error").addClassName("required");
		$("dob2_on_error").addClassName("validate-dob");
		$("insured2_height_error").addClassName("validate-number");
		$("insured2_weight_error").addClassName("validate-weight");
	}else{
		$("gender2_error").removeClassName("required");
		$("dob2_on_error").removeClassName("validate-dob");
		$("insured2_height_error").removeClassName("validate-number");
		$("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_mm_on").value = $("dob2_mm_on").title;
		$("dob2_mm_on").addClassName("default-text");
		$("dob2_dd_on").clear();
		$("dob2_dd_on").value = $("dob2_dd_on").title;
		$("dob2_dd_on").addClassName("default-text");
		$("dob2_yyyy_on").clear();
		$("dob2_yyyy_on").value = $("dob2_yyyy_on").title;
		$("dob2_yyyy_on").addClassName("default-text");
		$("insured2_height").clear();
		$("insured2_weight").clear();
		$("gender2").clear();
	}
}

function showSpouse(){
   switchChildStripes();
   if($F("has_spouse") == 1){
      $("add-spouse").hide();
      $("disabled-spouse").show();
      $("spouse-row").show();
      spouseValidation(true);
   }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") != "" &&
					$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"]		=	$F("insured" +  i + "_height");
					packed_children["insured" + insured_kid + "_weight"]				=	$F("insured" +  i + "_weight");
					packed_children["is_smoker" + insured_kid]						=	$("is_smoker" +  i).checked;
					packed_children["is_student" + insured_kid]					=	$("is_student" +  i).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"]		=	$F("insured" +  i + "_height");
						packed_children["insured" + insured_kid + "_weight"]				=	$F("insured" +  i + "_weight");
						packed_children["is_smoker" + insured_kid]						=	$("is_smoker" +  i).checked;
						packed_children["is_student" + insured_kid]					=	$("is_student" +  i).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").value	 									= packed_children["insured" +  i + "_height"];
				$("insured" +  i + "_weight").value													= packed_children["insured" +  i + "_weight"];
				$("gender" +  i + "").value																	= packed_children["gender" +  i + ""];
				$("is_smoker" +  i).checked						 							= packed_children["is_smoker" +  i];
				$("is_student" +  i).checked													= packed_children["is_student" +  i];
				$("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-number");
		$("insured" + insured + "_weight_error").addClassName("validate-weight");
		$("dob" + insured + "_on_error").addClassName("validate-child-dob");
	} else {
		$(id).clear();
		$("insured" + insured + "_height").clear();
		$("insured" + insured + "_weight").value	=	"";
		$("dob" + insured + "_mm_on").clear();
		$("dob" + insured + "_dd_on").clear();
		$("dob" + insured + "_yyyy_on").clear();
		$(id + "_error").removeClassName("required");
		$("insured" + insured + "_height_error").removeClassName("validate-number");
		$("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 switchChildStripes() {
  $$('.child').each(function(e){
    $(e).toggleClassName('even');
  });
}
  function isAnyChecked(parent_id){
    var is_valid  = true;
    is_valid      =  Form.getElements($(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();
		});
  }