()\[\]\\.,;:\s@"]+)*)|(".+"))@((\[[0-9]{1,3}\.[0-9]{1,3}\.[0-9]{1,3}\.[0-9]{1,3}\])|(([a-zA-Z\-0-9]+\.)+[a-zA-Z]{2,}))$/;var returnValue = true;var fieldname=document.forms['wodifyLeadForm']['name'].value; if(fieldname==null||fieldname=='') {document.getElementById('errorname').style.display='inline';returnValue=false;} else {document.getElementById('errorname').style.display='none';}var fieldemail=document.forms['wodifyLeadForm']['email'].value; if(fieldemail==null||fieldemail==''||!reEmail.test(fieldemail)) {document.getElementById('warningemail').style.display='inline';returnValue=false;} else {document.getElementById('warningemail').style.display='none';}var fieldgender=document.forms['wodifyLeadForm']['gender'].options[document.forms['wodifyLeadForm']['gender'].selectedIndex].value;if(fieldgender==null||fieldgender=='') {document.getElementById('errorgender').style.display='inline';returnValue=false;} else {document.getElementById('errorgender').style.display='none';}var fieldcity=document.forms['wodifyLeadForm']['city'].value; if(fieldcity==null||fieldcity=='') {document.getElementById('errorcity').style.display='inline';returnValue=false;} else {document.getElementById('errorcity').style.display='none';}var fieldstate=document.forms['wodifyLeadForm']['state'].options[document.forms['wodifyLeadForm']['state'].selectedIndex].value;if(fieldstate==null||fieldstate=='') {document.getElementById('errorstate').style.display='inline';returnValue=false;} else {document.getElementById('errorstate').style.display='none';}var fielddateofbirth=document.forms['wodifyLeadForm']['dateofbirth'].value;if(fielddateofbirth==null||fielddateofbirth=='') {document.getElementById('errordateofbirth').style.display='inline';returnValue=false;} else {document.getElementById('errordateofbirth').style.display='none';}var fieldleadsource=document.forms['wodifyLeadForm']['leadsource'].options[document.forms['wodifyLeadForm']['leadsource'].selectedIndex].value;if(fieldleadsource==null||fieldleadsource=='') {document.getElementById('errorleadsource').style.display='inline';returnValue=false;} else {document.getElementById('errorleadsource').style.display='none';} return returnValue; }; function onChangePhoneValidation(phoneId){ var fieldphone=phoneId.value.replace(/[^0-9]/g, ""); var fieldPhoneLenght=fieldphone.length; if(fieldPhoneLenght==10||(0==0&&fieldPhoneLenght==0)) {document.getElementById('warningphone').style.display='none';} else {document.getElementById('warningphone').style.display='inline';} } "
class="sqs-block-button-element--large sqs-button-element--secondary sqs-block-button-element"
>
Make It
