Success!";
if (!$_POST['homecare'] || !$_POST['primary'] || !$_POST['full_name'] || !$_POST['email'] || !$_POST['comments']) {
$status = "FAILURE";
$message = "You have missed a required field, please
click here and complete the form.";
}
if ($status != "FAILURE") {
$content="";
$c_to = $_POST['email']." (".$_POST['full_name'].")";
$subject = "Get Started with Paradigm HomeCare";
$contentS = "Dear ".$_POST['full_name'].",
This email is to confirm the successful submission of the following contact information:
";
$contentL = "Dear ".$this_company.",
".$_POST['full_name']." has submitted the following information:
";
$content.="----------------------------------------------------------------
CONTACT INFORMATION
Homecare is for: ". trim(htmlspecialchars($_POST['homecare'])) ."
Primary Need: ". trim(htmlspecialchars($_POST['primary'])) ."
Secondary Need: ". trim(htmlspecialchars($_POST['secondary'])) ."
Full Name: ". trim(htmlspecialchars($_POST['full_name'])) ."
Email: ". trim(htmlspecialchars($_POST['email'])) ."
Phone: ". trim(htmlspecialchars($_POST['phone'])) ."
Comments: ". trim(htmlspecialchars($_POST['comments'])) ."
Thank you,
".$this_company."
".$this_url."";
//finish content vars
$contentS.=$content; $contentL.=$content;
//email recipient
$mailit = @mail($this_company_from, $subject, $contentL, "From: $this_company_from\nMime-Version: 1.0\nContent-Type: text/html; charset=ISO-8859-1\nContent-Transfer-Encoding: 7bit");
//email the sender
$mailit2 = @mail($c_to, $subject, $contentS, "From: $this_company_from\nMime-Version: 1.0\nContent-Type: text/html; charset=ISO-8859-1\nContent-Transfer-Encoding: 7bit");
$message = "Thank you for your interest in
".$this_company.".
We will contact you shortly.
";
}
?>
Tell your medical provder, "I want Paradigm Homecare's, Proactive Plan for Healing."