Ask a Question · Community Portal

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['ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$captcha$CaptchaLinkButton',''], [], 90, 'ctl00$ctl00'); //]]> </script> <div class="page-heading"> <div class="container"> <ul class="breadcrumb"><li><a href="/">Home</a></li> <li class="active">Ask a Question</li> </ul> <div class="page-header"> <h1> <span class="xrm-attribute xrm-editable-text"><span class="xrm-attribute-value">Ask a Question</span></span> </h1> </div> <div class="notifications"></div> </div> </div> <div class="container"> <div id="mainContent"> <div class="xrm-editable-html xrm-attribute no-value page-copy"><div class="xrm-attribute-value"></div></div> <script type="text/javascript"> function entityFormClientValidate() { // Custom client side validation. 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Returning false will prevent the form from submitting. return true; } </script> <div id="WebFormControl"> </div> <div id="EntityFormControl"> <span><script type="text/javascript">$(document).ready(function() { console.log('custom javascript load') $(".page-header").hide(); //$("#cr047_typeofrequest").prop("disabled", true); $.getJSON("https://jsonip.com?callback=?", function (data) { $("#cr047_createdbyipaddress").val(data.ip); $("#cr047_createdbyipaddress").parents("tr").hide(); }); $("#cr047_hhsopdiv").parents("tr").hide(); $("#cr047_nihic").parents("tr").hide(); $("#cr047_customerdivision input[type='radio']").closest("div").append('<div id="dvPublicLink">For the public: <a title="" href="https://www.nihlibrary.nih.gov/public" target="_blank">https://www.nihlibrary.nih.gov/public</a></div>'); $("#dvPublicLink").hide(); $("#cr047_email").closest("div").append('<div id="divEmailInfo">Provide your government (nih.gov or hhs.gov) or IHS tribal email address</div>'); $("#cr047_customerdivision input[type='radio']").change(function() { if (this.value == '928710000') { $("#cr047_hhsopdiv").val(""); $("#cr047_nihic").val(""); $("#cr047_nihic").parents("tr").hide(); $("#cr047_hhsopdiv").parents("tr").show(); $("#dvPublicLink").hide(); } else if (this.value == '928710001') { $("#cr047_hhsopdiv").val(""); $("#cr047_nihic").val(""); $("#cr047_nihic").parents("tr").show(); $("#cr047_hhsopdiv").parents("tr").hide(); $("#dvPublicLink").hide(); } else if (this.value == '928710002') { $("#cr047_hhsopdiv").val(""); $("#cr047_nihic").val(""); $("#cr047_nihic").parents("tr").hide(); $("#cr047_hhsopdiv").parents("tr").hide(); $("#dvPublicLink").show(); } }); if (window.location.href.toLowerCase().indexOf("bmj-request") > -1) { $("#cr047_description").val("BMJ request"); } $("#cr047_typeofrequest").change(function() { if (this.value == '928710000') { window.location.href = "/ask-a-question/"; } else if (this.value == '928710001') { window.location.href = "/Editing/"; } else if (this.value == '928710002') { window.location.href = "/literature-search/"; } else if (this.value == '928710003') { window.location.href = "/report-a-problem/"; } else if (this.value == '928710004') { window.location.href = "/software-registration/"; } else if (this.value == '928710005') { window.location.href = "/SuggestResource/"; } else if (this.value == '928710006') { window.location.href = "/Suggest-a-training/"; } else if (this.value == '928710007') { window.location.href = "/Translations/"; } else if (this.value == '928710008') { window.location.href = "/consultation/"; } else if (this.value == '928710009') { window.location.href = "/mediregs-account/"; } else if (this.value == '928710010') { window.location.href = "/library-provided-account/"; } else if (this.value == '928710011') { window.location.href = "/Evidence-Synthesis/"; } }); }); if (window.jQuery) { (function ($) { if (typeof (entityFormClientValidate) != 'undefined') { var originalValidationFunction = entityFormClientValidate; if (originalValidationFunction && typeof (originalValidationFunction) == "function") { entityFormClientValidate = function () { if ($("#cr047_customerdivision input[type='radio']:checked").val() == '928710000' && $("#cr047_hhsopdiv").val() == '') { $('#ValidationSummaryEntityFormControl_EntityFormView').empty(); $('#ValidationSummaryEntityFormControl_EntityFormView').append($("<div class='notification alert alert-danger' role='alert'>IC\agency is a required field.</div>")); $("#ValidationSummaryEntityFormControl_EntityFormView").show(); $(window).scrollTop(0); return false; // return false mean apply validation } else if ($("#cr047_customerdivision input[type='radio']:checked").val() == '928710001' && $("#cr047_nihic").val() == '') { $('#ValidationSummaryEntityFormControl_EntityFormView').empty(); $('#ValidationSummaryEntityFormControl_EntityFormView').append($("<div class='notification alert alert-danger' role='alert'>IC\agency is a required field.</div>")); $("#ValidationSummaryEntityFormControl_EntityFormView").show(); $(window).scrollTop(0); return false; // return false mean apply validation } if ($("#cr047_email").val()){ if ($("#cr047_email").val() != $("#emailaddress").val()) { $('#ValidationSummaryEntityFormControl_EntityFormView').empty(); $('#ValidationSummaryEntityFormControl_EntityFormView').append($("<div class='notification alert alert-danger' role='alert'>email address not match.</div>")); $("#ValidationSummaryEntityFormControl_EntityFormView").show(); $(window).scrollTop(0); return false; // return false mean apply validation } else { return true; // return true mean successful } } else{ return true; } }; } } }(window.jQuery)); } // Apply Client Side Validation on FieldName /*if (window.jQuery) { (function ($) { $(document).ready(function () { if (typeof (Page_Validators) == 'undefined') return; // Create new validator var newValidator = document.createElement('span'); newValidator.style.display = "none"; newValidator.id = "FieldNameValidator"; newValidator.controltovalidate = "FieldName"; newValidator.errormessage = "<a href='#FieldName_label'>FieldName is required field.</a>"; newValidator.validationGroup = ""; // Set this if you have set ValidationGroup on the form newValidator.initialvalue = ""; newValidator.evaluationfunction = function () { var FieldName = $("#FieldName").val(); if (FieldName == "") return false; // return false mean apply validation else return true; // return true mean successful }; // Add the new validator to the page validators array: Page_Validators.push(newValidator); // Wire-up the click event handler of the validation summary link $("a[href='#FieldName_label']").on("click", function () { scrollToAndFocus('FieldName_label','FieldName'); }); }); }(window.jQuery)); }*/</script></span><div id="EntityFormPanel" class="crmEntityFormView" onkeypress="javascript:return WebForm_FireDefaultButton(event, 'InsertButton')"> <div id="EntityFormControl_EntityFormView" class="entity-form"> <input type="hidden" name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$EntityFormControl_EntityFormView_EntityName" id="EntityFormControl_EntityFormView_EntityName" value="cr047_nihlibraryticketingsystem" /><input type="hidden" name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$EntityFormControl_EntityFormView_EntityID" id="EntityFormControl_EntityFormView_EntityID" /><input type="hidden" name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$EntityFormControl_EntityFormView_EntityState" id="EntityFormControl_EntityFormView_EntityState" /><input type="hidden" name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$EntityFormControl_EntityFormView_EntityStatus" id="EntityFormControl_EntityFormView_EntityStatus" /><span id="EntityFormControl_EntityFormView_EntityLayoutConfig" data-form-layout="{"EntityName":"cr047_nihlibraryticketingsystem","Id":"00000000-0000-0000-0000-000000000000","SubmitActionLink":{"Modal":{},"Type":0,"Enabled":false,"ShowModal":0,"FilterCriteriaId":"9dee3f2d-a922-4f9c-bb3d-6aa152e17fdf"},"PreviousActionLink":{"Type":0,"Enabled":false,"ShowModal":0,"FilterCriteriaId":"8ae1092c-9523-4cab-93b8-d545d3b5a751"},"NextActionLink":{"Type":0,"Enabled":false,"ShowModal":0,"FilterCriteriaId":"d303af74-2c60-4a58-9a93-5a4c06a26fba"},"CreateRelatedRecordActionLink":{"Modal":{},"Type":0,"Enabled":false,"ShowModal":0,"FilterCriteriaId":"85917ba4-a169-4564-a2a5-968d3ff48096"},"EnableEntityPermissions":false,"LanguageCode":0,"EnableActions":false,"ShowActionButtonContainer":0,"AutoGenerateSteps":false}"></span><div id="ValidationSummaryEntityFormControl_EntityFormView" class="validation-summary alert alert-error alert-danger alert-block" role="alert" style="display:none;"> </div><div class="tab clearfix"><div class="tab-column" style="width:33%;"><div><fieldset aria-label="General"><table role="presentation" class="section"><colgroup></colgroup><tr> <td colspan="1" rowspan="1" class="clearfix cell picklist-cell"><div class="info required"><label for="cr047_typeofrequest" id="cr047_typeofrequest_label" class="field-label">Type of request</label><div class="validators"><span id="RequiredFieldValidatorcr047_typeofrequest" style="display:none;">*</span></div></div><div class="control"><select name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_typeofrequest" id="cr047_typeofrequest" class="form-control picklist " onchange="setIsDirty(this.id);" required="" aria-required="true" aria-invalid="false" title="Please select an item in this list"> <option value="" label="Select" aria-label="Select"></option> <option selected="selected" value="928710000">Ask a question</option> <option value="928710001">Editing</option> <option value="928710011">Evidence Synthesis</option> <option value="928710010">Library-provided account</option> <option value="928710002">Literature search</option> <option value="928710009">MediRegs account</option> <option value="928710003">Report a problem</option> <option value="928710004">Software or Database Seat License</option> <option value="928710005">Suggest a resource</option> <option value="928710006">Suggest a training</option> <option value="928710007">Translations</option> <option value="928710008">Tutorial/consultation</option> </select></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell picklist-cell"><div class="info required"><label id="cr047_customerdivision_label" class="field-label">Customer Division</label><div class="validators"><span id="RequiredFieldValidatorcr047_customerdivision" style="display:none;">*</span></div></div><div class="control"><span id="cr047_customerdivision" class="picklist horizontal " role="presentation" onchange="setIsDirty(this.id);" data-required="true" aria-invalid="false" title="Please select an item in this list"><input id="cr047_customerdivision_0" type="radio" name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_customerdivision" value="928710001" /><label for="cr047_customerdivision_0"><span class='sr-only'>Customer Division </span>NIH</label><input id="cr047_customerdivision_1" type="radio" name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_customerdivision" value="928710000" /><label for="cr047_customerdivision_1"><span class='sr-only'>Customer Division </span>HHS</label><input id="cr047_customerdivision_2" type="radio" name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_customerdivision" value="928710002" /><label for="cr047_customerdivision_2"><span class='sr-only'>Customer Division </span>Public</label></span></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell picklist-cell"><div class="info"><label for="cr047_nihic" id="cr047_nihic_label" class="field-label">IC/agency</label><div class="validators"></div></div><div class="control"><select name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_nihic" id="cr047_nihic" class="form-control picklist " onchange="setIsDirty(this.id);"> <option selected="selected" value="" label="Select" aria-label="Select"></option> <option value="100000000">ARPA-H</option> <option value="928710000">CC</option> <option value="928710001">CIT</option> <option value="928710002">CSR</option> <option value="928710003">FIC</option> <option value="928710004">NCATS</option> <option value="928710005">NCCIH</option> <option value="928710106">NCI</option> <option value="928710007">NEI</option> <option value="928710008">NHGRI</option> <option value="928710009">NHLBI</option> <option value="928710010">NIA</option> <option value="928710011">NIAAA</option> <option value="928710012">NIAID</option> <option value="928710013">NIAMS</option> <option value="928710014">NIBIB</option> <option value="928710015">NICHD</option> <option value="928710116">NIDA</option> <option value="928710017">NIDCD</option> <option value="928710018">NIDCR</option> <option value="928710019">NIDDK</option> <option value="928710020">NIEHS</option> <option value="928710021">NIGMS</option> <option value="928710022">NIMH</option> <option value="928710023">NIMHD</option> <option value="928710024">NINDS</option> <option value="928710025">NINR</option> <option value="928710026">NLM</option> <option value="928710027">OD</option> </select></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell picklist-cell"><div class="info"><label for="cr047_hhsopdiv" id="cr047_hhsopdiv_label" class="field-label">IC/agency</label><div class="validators"></div></div><div class="control"><select name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_hhsopdiv" id="cr047_hhsopdiv" class="form-control picklist " onchange="setIsDirty(this.id);"> <option selected="selected" value="" label="Select" aria-label="Select"></option> <option value="1928710000">ACF</option> <option value="1928710001">ACL</option> <option value="1928710002">AHRQ</option> <option value="1928710003">CMS</option> <option value="1928710004">HRSA</option> <option value="1928710005">IHS/Headquarters</option> <option value="1928710006">IHS/Alaska</option> <option value="1928710007">IHS/Albuquerque</option> <option value="1928710008">IHS/Bemidji</option> <option value="1928710009">IHS/Billings</option> <option value="1928710010">IHS/California</option> <option value="1928710011">IHS/Great Plains</option> <option value="1928710012">IHS/Nashville</option> <option value="1928710013">IHS/Navajo</option> <option value="1928710014">IHS/Oklahoma</option> <option value="1928710015">IHS/Phoenix</option> <option value="1928710016">IHS/Portland</option> <option value="1928710017">IHS/Tucson</option> <option value="1928710018">IOS</option> <option value="969400000">OS/ASFR</option> <option value="1928710019">OS/ASPE</option> <option value="1928710020">OS/ASPR</option> <option value="1928710021">OS/DAB</option> <option value="1928710022">OS/OASH</option> <option value="1928710023">OS/OCR</option> <option value="1928710024">OS/OGA</option> <option value="1928710025">OS/OGC</option> <option value="1928710026">OS/OIG</option> <option value="1928710027">OS/OMH</option> <option value="1928710028">OS/OMHA</option> <option value="1928710029">OS/ONC</option> <option value="1928710030">PSC</option> <option value="928710031">SAMHSA</option> </select></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell text form-control-cell"><div class="info required"><label for="cr047_firstname" id="cr047_firstname_label" class="field-label">First Name </label><div class="validators"><span id="RequiredFieldValidatorcr047_firstname" style="display:none;">*</span><span id="MaximumLengthValidatorcr047_firstname" style="visibility:hidden;">*</span></div></div><div class="control"><input name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_firstname" type="text" maxlength="100" id="cr047_firstname" class="text form-control " onchange="setIsDirty(this.id);" aria-required="true" title="First Name  is a required field." aria-label="First Name " onkeypress="javascript:return LengthError(this, event);" /></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell text form-control-cell"><div class="info required"><label for="cr047_lastname" id="cr047_lastname_label" class="field-label">Last Name</label><div class="validators"><span id="RequiredFieldValidatorcr047_lastname" style="display:none;">*</span><span id="MaximumLengthValidatorcr047_lastname" style="visibility:hidden;">*</span></div></div><div class="control"><input name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_lastname" type="text" maxlength="100" id="cr047_lastname" class="text form-control " onchange="setIsDirty(this.id);" aria-required="true" title="Last Name is a required field." aria-label="Last Name" onkeypress="javascript:return LengthError(this, event);" /></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell text form-control-cell"><div class="info required"><label for="cr047_email" id="cr047_email_label" class="field-label">Email</label><div class="validators"><span id="EmailFormatValidatorcr047_email" style="visibility:hidden;">*</span><span id="RequiredFieldValidatorcr047_email" style="display:none;">*</span><span id="MaximumLengthValidatorcr047_email" style="visibility:hidden;">*</span></div></div><div class="control"><input name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_email" maxlength="100" id="cr047_email" class="text form-control " type="email" ondblclick="launchEmail(this.value);" onchange="setIsDirty(this.id);" required="" onkeypress="javascript:return LengthError(this, event);" style="text-decoration:underline;" /></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell text form-control-cell"><div class="info"><label for="emailaddress" id="emailaddress_label" class="field-label">Confirm Email</label><div class="validators"><span id="EmailFormatValidatoremailaddress" style="visibility:hidden;">*</span><span id="MaximumLengthValidatoremailaddress" style="visibility:hidden;">*</span></div></div><div class="control"><input name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$emailaddress" maxlength="100" id="emailaddress" class="text form-control " type="email" ondblclick="launchEmail(this.value);" onchange="setIsDirty(this.id);" onkeypress="javascript:return LengthError(this, event);" style="text-decoration:underline;" /></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell text form-control-cell"><div class="info"><label for="cr047_phone" id="cr047_phone_label" class="field-label">Phone</label><div class="validators"><span id="MaximumLengthValidatorcr047_phone" style="visibility:hidden;">*</span></div></div><div class="control"><input name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_phone" type="text" maxlength="100" id="cr047_phone" class="text form-control " onchange="setIsDirty(this.id);" placeholder="Provide a telephone number" onkeypress="javascript:return LengthError(this, event);" /></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell textarea form-control-cell"><div class="info required"><label for="cr047_description" id="cr047_description_label" class="field-label">Question/Comments</label><div class="validators"><span id="RequiredFieldValidatorcr047_description" style="display:none;">*</span><span id="MaximumLengthValidatorcr047_description" style="visibility:hidden;">*</span></div></div><div class="control"><textarea name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_description" rows="4" cols="20" maxlength="4000" id="cr047_description" class="textarea form-control " onchange="setIsDirty(this.id);" aria-required="true" aria-label="Question/Comments" title="Question/Comments is a required field." onkeydown="javascript:return LimitInput(this, event);" oninput="javascript:return LimitInput(this, event);" onpaste="javascript:return LimitPaste(this, event);"> </textarea></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell text form-control-cell"><div class="info"><div class="validators"><span id="MaximumLengthValidatorcr047_createdbyipaddress" style="visibility:hidden;">*</span></div></div><div class="control"><input name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_createdbyipaddress" type="text" maxlength="100" id="cr047_createdbyipaddress" class="text form-control " onchange="setIsDirty(this.id);" onkeypress="javascript:return LengthError(this, event);" /></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell"></td> <td class="cell zero-cell"></td> </tr> </table></fieldset></div></div><div class="tab-column" style="width:66%;"><div><fieldset aria-label="Notes"><table role="presentation" class="section"><colgroup></colgroup><tr> <td colspan="1" rowspan="15" class="clearfix cell"></td> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> </table></fieldset></div></div></div><div class="tr"><div class="captcha-cell"><div id="ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha" class="RadCaptcha RadCaptcha_Default"> <span id="ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ctl00" style="display:none;"></span><div id="ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_SpamProtectorPanel"> <div id="ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ctl01"> <img id="ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_CaptchaImageUP" alt="This is a CAPTCHA image, use shortcut Ctrl + Alt + P to play the alphabet audio for this image" src="../Telerik.Web.UI.WebResource.axd?type=rca&isc=false&guid=06087c23-f3b7-4698-a47d-d0d0c68f2d18" style="height:50px;width:180px;display:block;" /><a id="ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_CaptchaLinkButton" class="rcRefreshImage" title="Generate a new image" href="javascript:__doPostBack('ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$captcha$CaptchaLinkButton','')" style="display:block;">Generate a new image</a><a href="../Telerik.Web.UI.WebResource.axd?type=cah&isc=false&guid=06087c23-f3b7-4698-a47d-d0d0c68f2d18" id="ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_CaptchaAudioCodeUP" title="Play the audio code" class="rcCaptchaAudioLink" style="display:block;">Play the audio code</a> </div><p><input name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$captcha$CaptchaTextBox" type="text" maxlength="7" id="ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_CaptchaTextBox" /><label for="ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_CaptchaTextBox" id="ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_CaptchaTextBoxLabel">Enter the code from the image</label></p> </div><input id="ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ClientState" name="ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ClientState" type="hidden" /> </div></div></div> </div><div class="actions"><input type="button" name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$InsertButton" value="Submit" onclick="javascript:if(typeof entityFormClientValidate === 'function'){if(entityFormClientValidate()){if(typeof Page_ClientValidate === 'function'){if(Page_ClientValidate('')){clearIsDirty();disableButtons();this.value = 'Processing...';}}else{clearIsDirty();disableButtons();this.value = 'Processing...';}}else{return false;}}else{if(typeof Page_ClientValidate === 'function'){if(Page_ClientValidate('')){clearIsDirty();disableButtons();this.value = 'Processing...';}}else{clearIsDirty();disableButtons();this.value = 'Processing...';}};WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$InsertButton", "", true, "", "", false, true))" id="InsertButton" class="submit-btn btn btn-primary form-action-container-left" /></div> </div> </div> </div> <div class="page-metadata clearfix"> <div class="xrm-attribute xrm-editable-text"> <div class="xrm-attribute-value"><script> </script></div> </div> </div> <link href="https://gov.content.powerapps.us/resource/powerappsportal/dist/editor.bundle-a512fd8d1f.css" onerror="javascript: var target = event.target; var link = document.createElement('link'); link.crossOrigin = target.crossOrigin; link.href = '/dist/editor.bundle-a512fd8d1f.css'; link.rel = 'stylesheet'; target.insertAdjacentElement('afterend',link);" rel="stylesheet" /> <script onerror="javascript: var target = event.target; var script = document.createElement('script'); script.crossOrigin = target.crossOrigin; script.src = '/dist/editor.bundle-90ea956569.js'; script.type = 'text/javascript'; target.insertAdjacentElement('afterend',script);" src="https://gov.content.powerapps.us/resource/powerappsportal/dist/editor.bundle-90ea956569.js" type="text/javascript"></script> </div> <script type="text/javascript"> //<![CDATA[ var Page_ValidationSummaries = new Array(document.getElementById("ValidationSummaryEntityFormControl_EntityFormView")); var Page_Validators = new Array(document.getElementById("RequiredFieldValidatorcr047_typeofrequest"), document.getElementById("RequiredFieldValidatorcr047_customerdivision"), document.getElementById("RequiredFieldValidatorcr047_firstname"), document.getElementById("MaximumLengthValidatorcr047_firstname"), document.getElementById("RequiredFieldValidatorcr047_lastname"), document.getElementById("MaximumLengthValidatorcr047_lastname"), document.getElementById("EmailFormatValidatorcr047_email"), document.getElementById("RequiredFieldValidatorcr047_email"), document.getElementById("MaximumLengthValidatorcr047_email"), document.getElementById("EmailFormatValidatoremailaddress"), document.getElementById("MaximumLengthValidatoremailaddress"), document.getElementById("MaximumLengthValidatorcr047_phone"), document.getElementById("RequiredFieldValidatorcr047_description"), document.getElementById("MaximumLengthValidatorcr047_description"), document.getElementById("MaximumLengthValidatorcr047_createdbyipaddress"), document.getElementById("ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ctl00")); //]]> </script> <script type="text/javascript"> //<![CDATA[ var cr047_description = document.all ? document.all["cr047_description"] : document.getElementById("cr047_description"); cr047_description.exMaxLen = "4000"; var ValidationSummaryEntityFormControl_EntityFormView = document.all ? document.all["ValidationSummaryEntityFormControl_EntityFormView"] : document.getElementById("ValidationSummaryEntityFormControl_EntityFormView"); ValidationSummaryEntityFormControl_EntityFormView.headertext = "<h2 class=\'validation-header\'><span role=\'presentation\' class=\'fa fa-info-circle\'></span> The form could not be submitted for the following reasons:</h2>"; var RequiredFieldValidatorcr047_typeofrequest = document.all ? document.all["RequiredFieldValidatorcr047_typeofrequest"] : document.getElementById("RequiredFieldValidatorcr047_typeofrequest"); RequiredFieldValidatorcr047_typeofrequest.controltovalidate = "cr047_typeofrequest"; RequiredFieldValidatorcr047_typeofrequest.errormessage = "<a href=\'#cr047_typeofrequest_label\' onclick=\'javascript:scrollToAndFocus(\"cr047_typeofrequest_label\",\"cr047_typeofrequest\");return false;\' referenceControlId=cr047_typeofrequest>Type of request is a required field. </a>"; RequiredFieldValidatorcr047_typeofrequest.display = "Dynamic"; RequiredFieldValidatorcr047_typeofrequest.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; RequiredFieldValidatorcr047_typeofrequest.initialvalue = ""; var RequiredFieldValidatorcr047_customerdivision = document.all ? document.all["RequiredFieldValidatorcr047_customerdivision"] : document.getElementById("RequiredFieldValidatorcr047_customerdivision"); RequiredFieldValidatorcr047_customerdivision.controltovalidate = "cr047_customerdivision"; RequiredFieldValidatorcr047_customerdivision.errormessage = "<a href=\'#cr047_customerdivision_label\' onclick=\'javascript:scrollToAndFocus(\"cr047_customerdivision_label\",\"cr047_customerdivision\");return false;\' referenceControlId=cr047_customerdivision>Customer Division is a required field. </a>"; RequiredFieldValidatorcr047_customerdivision.display = "Dynamic"; RequiredFieldValidatorcr047_customerdivision.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; RequiredFieldValidatorcr047_customerdivision.initialvalue = ""; var RequiredFieldValidatorcr047_firstname = document.all ? document.all["RequiredFieldValidatorcr047_firstname"] : document.getElementById("RequiredFieldValidatorcr047_firstname"); RequiredFieldValidatorcr047_firstname.controltovalidate = "cr047_firstname"; RequiredFieldValidatorcr047_firstname.errormessage = "<a href=\'#cr047_firstname_label\' onclick=\'javascript:scrollToAndFocus(\"cr047_firstname_label\",\"cr047_firstname\");return false;\' referenceControlId=cr047_firstname>First Name is a required field. </a>"; RequiredFieldValidatorcr047_firstname.display = "Dynamic"; RequiredFieldValidatorcr047_firstname.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; RequiredFieldValidatorcr047_firstname.initialvalue = ""; var MaximumLengthValidatorcr047_firstname = document.all ? document.all["MaximumLengthValidatorcr047_firstname"] : document.getElementById("MaximumLengthValidatorcr047_firstname"); MaximumLengthValidatorcr047_firstname.controltovalidate = "cr047_firstname"; MaximumLengthValidatorcr047_firstname.errormessage = "<a href=\'#cr047_firstname_label\' onclick=\'javascript:scrollToAndFocus(\"cr047_firstname_label\",\"cr047_firstname\");return false;\' referenceControlId=cr047_firstname>First Name exceeds the maximum length of 100 characters. </a>"; MaximumLengthValidatorcr047_firstname.evaluationfunction = "CustomValidatorEvaluateIsValid"; var RequiredFieldValidatorcr047_lastname = document.all ? document.all["RequiredFieldValidatorcr047_lastname"] : document.getElementById("RequiredFieldValidatorcr047_lastname"); RequiredFieldValidatorcr047_lastname.controltovalidate = "cr047_lastname"; RequiredFieldValidatorcr047_lastname.errormessage = "<a href=\'#cr047_lastname_label\' onclick=\'javascript:scrollToAndFocus(\"cr047_lastname_label\",\"cr047_lastname\");return false;\' referenceControlId=cr047_lastname>Last Name is a required field. </a>"; RequiredFieldValidatorcr047_lastname.display = "Dynamic"; RequiredFieldValidatorcr047_lastname.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; RequiredFieldValidatorcr047_lastname.initialvalue = ""; var MaximumLengthValidatorcr047_lastname = document.all ? document.all["MaximumLengthValidatorcr047_lastname"] : document.getElementById("MaximumLengthValidatorcr047_lastname"); MaximumLengthValidatorcr047_lastname.controltovalidate = "cr047_lastname"; MaximumLengthValidatorcr047_lastname.errormessage = "<a href=\'#cr047_lastname_label\' onclick=\'javascript:scrollToAndFocus(\"cr047_lastname_label\",\"cr047_lastname\");return false;\' referenceControlId=cr047_lastname>Last Name exceeds the maximum length of 100 characters. </a>"; MaximumLengthValidatorcr047_lastname.evaluationfunction = "CustomValidatorEvaluateIsValid"; var EmailFormatValidatorcr047_email = document.all ? document.all["EmailFormatValidatorcr047_email"] : document.getElementById("EmailFormatValidatorcr047_email"); EmailFormatValidatorcr047_email.controltovalidate = "cr047_email"; EmailFormatValidatorcr047_email.errormessage = "<a href=\'#cr047_email_label\' onclick=\'javascript:scrollToAndFocus(\"cr047_email_label\",\"cr047_email\");return false;\' referenceControlId=cr047_email>Email must be a valid email address. </a>"; EmailFormatValidatorcr047_email.evaluationfunction = "CustomValidatorEvaluateIsValid"; var RequiredFieldValidatorcr047_email = document.all ? document.all["RequiredFieldValidatorcr047_email"] : document.getElementById("RequiredFieldValidatorcr047_email"); RequiredFieldValidatorcr047_email.controltovalidate = "cr047_email"; RequiredFieldValidatorcr047_email.errormessage = "<a href=\'#cr047_email_label\' onclick=\'javascript:scrollToAndFocus(\"cr047_email_label\",\"cr047_email\");return false;\' referenceControlId=cr047_email>Email is a required field. </a>"; RequiredFieldValidatorcr047_email.display = "Dynamic"; RequiredFieldValidatorcr047_email.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; RequiredFieldValidatorcr047_email.initialvalue = ""; var MaximumLengthValidatorcr047_email = document.all ? document.all["MaximumLengthValidatorcr047_email"] : document.getElementById("MaximumLengthValidatorcr047_email"); MaximumLengthValidatorcr047_email.controltovalidate = "cr047_email"; MaximumLengthValidatorcr047_email.errormessage = "<a href=\'#cr047_email_label\' onclick=\'javascript:scrollToAndFocus(\"cr047_email_label\",\"cr047_email\");return false;\' referenceControlId=cr047_email>Email exceeds the maximum length of 100 characters. </a>"; MaximumLengthValidatorcr047_email.evaluationfunction = "CustomValidatorEvaluateIsValid"; var EmailFormatValidatoremailaddress = document.all ? document.all["EmailFormatValidatoremailaddress"] : document.getElementById("EmailFormatValidatoremailaddress"); EmailFormatValidatoremailaddress.controltovalidate = "emailaddress"; EmailFormatValidatoremailaddress.errormessage = "<a href=\'#emailaddress_label\' onclick=\'javascript:scrollToAndFocus(\"emailaddress_label\",\"emailaddress\");return false;\' referenceControlId=emailaddress>Confirm Email must be a valid email address. </a>"; EmailFormatValidatoremailaddress.evaluationfunction = "CustomValidatorEvaluateIsValid"; var MaximumLengthValidatoremailaddress = document.all ? document.all["MaximumLengthValidatoremailaddress"] : document.getElementById("MaximumLengthValidatoremailaddress"); MaximumLengthValidatoremailaddress.controltovalidate = "emailaddress"; MaximumLengthValidatoremailaddress.errormessage = "<a href=\'#emailaddress_label\' onclick=\'javascript:scrollToAndFocus(\"emailaddress_label\",\"emailaddress\");return false;\' referenceControlId=emailaddress>Confirm Email exceeds the maximum length of 100 characters. </a>"; MaximumLengthValidatoremailaddress.evaluationfunction = "CustomValidatorEvaluateIsValid"; var MaximumLengthValidatorcr047_phone = document.all ? document.all["MaximumLengthValidatorcr047_phone"] : document.getElementById("MaximumLengthValidatorcr047_phone"); MaximumLengthValidatorcr047_phone.controltovalidate = "cr047_phone"; MaximumLengthValidatorcr047_phone.errormessage = "<a href=\'#cr047_phone_label\' onclick=\'javascript:scrollToAndFocus(\"cr047_phone_label\",\"cr047_phone\");return false;\' referenceControlId=cr047_phone>Phone exceeds the maximum length of 100 characters. </a>"; MaximumLengthValidatorcr047_phone.evaluationfunction = "CustomValidatorEvaluateIsValid"; var RequiredFieldValidatorcr047_description = document.all ? document.all["RequiredFieldValidatorcr047_description"] : document.getElementById("RequiredFieldValidatorcr047_description"); RequiredFieldValidatorcr047_description.controltovalidate = "cr047_description"; RequiredFieldValidatorcr047_description.errormessage = "<a href=\'#cr047_description_label\' onclick=\'javascript:scrollToAndFocus(\"cr047_description_label\",\"cr047_description\");return false;\' referenceControlId=cr047_description>Question/Comments is a required field. </a>"; RequiredFieldValidatorcr047_description.display = "Dynamic"; RequiredFieldValidatorcr047_description.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; RequiredFieldValidatorcr047_description.initialvalue = ""; var MaximumLengthValidatorcr047_description = document.all ? document.all["MaximumLengthValidatorcr047_description"] : document.getElementById("MaximumLengthValidatorcr047_description"); MaximumLengthValidatorcr047_description.controltovalidate = "cr047_description"; MaximumLengthValidatorcr047_description.errormessage = "<a href=\'#cr047_description_label\' onclick=\'javascript:scrollToAndFocus(\"cr047_description_label\",\"cr047_description\");return false;\' referenceControlId=cr047_description>Question/Comments exceeds the maximum length of 4000 characters. </a>"; MaximumLengthValidatorcr047_description.evaluationfunction = "CustomValidatorEvaluateIsValid"; var MaximumLengthValidatorcr047_createdbyipaddress = document.all ? document.all["MaximumLengthValidatorcr047_createdbyipaddress"] : document.getElementById("MaximumLengthValidatorcr047_createdbyipaddress"); MaximumLengthValidatorcr047_createdbyipaddress.controltovalidate = "cr047_createdbyipaddress"; MaximumLengthValidatorcr047_createdbyipaddress.errormessage = "<a href=\'#cr047_createdbyipaddress\' onclick=\'javascript:scrollToAndFocus(\"cr047_createdbyipaddress\",\"cr047_createdbyipaddress\");return false;\' referenceControlId=cr047_createdbyipaddress>Created By (IP Address) exceeds the maximum length of 100 characters. </a>"; MaximumLengthValidatorcr047_createdbyipaddress.evaluationfunction = "CustomValidatorEvaluateIsValid"; var ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ctl00 = document.all ? document.all["ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ctl00"] : document.getElementById("ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ctl00"); ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ctl00.errormessage = "<a href=\'#captcha\' onclick=\'javascript:scrollToAndFocusCapatch();return false;\'>Captcha is incorrect, please re-enter captcha.</a>"; ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ctl00.display = "None"; ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ctl00.evaluationfunction = "CustomValidatorEvaluateIsValid"; //]]> </script> <script type="text/javascript"> //<![CDATA[ function loadCaptchaToolTip() {setTimeout(function() {$('a.rcCaptchaAudioLink').first().attr('data-toggle', 'tooltip').attr('role', 'button');$('a.rcRefreshImage').first().attr('data-toggle', 'tooltip').attr('role', 'button');$('[data-toggle="tooltip"]').tooltip();}, 1000);}loadCaptchaToolTip();$('a.rcRefreshImage').parent().append('<div class="alert sr-only" role="alert" aria-label="The new image is ready"><span aria-hidden="true">The new image is ready</span></div>');$(document).keydown(function(event){if(event.altKey && event.ctrlKey &&event.key == 'p'){$('.RadCaptcha').find('audio').first()[0].play();}}); (function(id) { var e = document.getElementById(id); if (e) { e.dispose = function() { Array.remove(Page_ValidationSummaries, document.getElementById(id)); } e = null; } })('ValidationSummaryEntityFormControl_EntityFormView'); var Page_ValidationActive = false; if (typeof(ValidatorOnLoad) == "function") { ValidatorOnLoad(); } function ValidatorOnSubmit() { if (Page_ValidationActive) { return ValidatorCommonOnSubmit(); } else { return true; } } document.getElementById('RequiredFieldValidatorcr047_typeofrequest').dispose = function() { Array.remove(Page_Validators, document.getElementById('RequiredFieldValidatorcr047_typeofrequest')); } document.getElementById('RequiredFieldValidatorcr047_customerdivision').dispose = function() { Array.remove(Page_Validators, document.getElementById('RequiredFieldValidatorcr047_customerdivision')); } document.getElementById('RequiredFieldValidatorcr047_firstname').dispose = function() { Array.remove(Page_Validators, document.getElementById('RequiredFieldValidatorcr047_firstname')); } document.getElementById('MaximumLengthValidatorcr047_firstname').dispose = function() { Array.remove(Page_Validators, document.getElementById('MaximumLengthValidatorcr047_firstname')); } document.getElementById('RequiredFieldValidatorcr047_lastname').dispose = function() { Array.remove(Page_Validators, document.getElementById('RequiredFieldValidatorcr047_lastname')); } document.getElementById('MaximumLengthValidatorcr047_lastname').dispose = function() { Array.remove(Page_Validators, document.getElementById('MaximumLengthValidatorcr047_lastname')); } document.getElementById('EmailFormatValidatorcr047_email').dispose = function() { Array.remove(Page_Validators, document.getElementById('EmailFormatValidatorcr047_email')); } document.getElementById('RequiredFieldValidatorcr047_email').dispose = function() { Array.remove(Page_Validators, document.getElementById('RequiredFieldValidatorcr047_email')); } document.getElementById('MaximumLengthValidatorcr047_email').dispose = function() { Array.remove(Page_Validators, document.getElementById('MaximumLengthValidatorcr047_email')); } document.getElementById('EmailFormatValidatoremailaddress').dispose = function() { Array.remove(Page_Validators, document.getElementById('EmailFormatValidatoremailaddress')); } document.getElementById('MaximumLengthValidatoremailaddress').dispose = function() { Array.remove(Page_Validators, document.getElementById('MaximumLengthValidatoremailaddress')); } document.getElementById('MaximumLengthValidatorcr047_phone').dispose = function() { Array.remove(Page_Validators, document.getElementById('MaximumLengthValidatorcr047_phone')); } document.getElementById('RequiredFieldValidatorcr047_description').dispose = function() { Array.remove(Page_Validators, document.getElementById('RequiredFieldValidatorcr047_description')); } document.getElementById('MaximumLengthValidatorcr047_description').dispose = function() { Array.remove(Page_Validators, document.getElementById('MaximumLengthValidatorcr047_description')); } document.getElementById('MaximumLengthValidatorcr047_createdbyipaddress').dispose = function() { Array.remove(Page_Validators, document.getElementById('MaximumLengthValidatorcr047_createdbyipaddress')); } document.getElementById('ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ctl00').dispose = function() { Array.remove(Page_Validators, document.getElementById('ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ctl00')); } Sys.Application.add_init(function() { $create(Telerik.Web.UI.RadCaptcha, {"_audioUrl":"/Telerik.Web.UI.WebResource.axd?type=cah\u0026isc=false\u0026guid=06087c23-f3b7-4698-a47d-d0d0c68f2d18","_enableAudio":true,"_persistCode":false,"clientStateFieldID":"ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ClientState"}, {"load":radcaptcha.onClientLoad}, null, $get("ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha")); }); //]]> </script> </form> <script onerror="javascript: var target = event.target; var script = document.createElement('script'); script.crossOrigin = target.crossOrigin; script.src = '/dist/pcf-loader.bundle-f4a0e619b8.js'; script.type = 'text/javascript'; 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