Im doing a Contact form for a client and my php is limited. I need to make everything in this required. Here is the code:
<?php
ob_start();
if(empty($_POST)) {
$status = '';
$display_form = true;
} else {
$fname = $_POST['fname'];
$lname = $_POST['lname'];
$pname = $_POST['pname'];
$email = $_POST['email'];
$phone = $_POST['phone'];
$prescrip = $_POST['prescrip'];
$payment = $_POST['payment'];
$card = $_POST['card'];
$shipping = $_POST['shipping'];
$error_list = array();
if(empty($fname)) {
$error_list[] = 'You did not supply your first name';
}
if(empty($lname)) {
$error_list[] = 'You did not supply your last name';
}
if(empty($pname)) {
$error_list[] = 'You did not supply your patient name';
}
if(empty($email)) {
$error_list[] = 'You did not supply your email address';
}
if(empty($phone)) {
$error_list[] = 'You did not supply a phone number';
}
if(empty($prescrip)) {
$error_list[] = 'You did not supply a prescription number';
}
if(empty($payment)) {
$error_list[] = 'You did not supply a payment method';
}
if(empty($shipping)) {
$error_list[] = 'You did not select a shipping method';
}
if(empty($error_list)) {
$email_contents = "The following message was sent to you from your website:\n";
$email_contents .= "First Name: $fname\n";
$email_contents .= "Last Name: $lname\n";
$email_contents .= "Patient Name: $pname\n";
$email_contents .= "Email: $email\n";
$email_contents .= "Phone Number: $phone\n";
$email_contents .= "Prescription Number: $prescrip\n";
$email_contents .= "Payment Type: $payment\n";
$email_contents .= "Payment Card On File: $card\n";
$email_contents .= "Shipping Method: $shipping\n";
$extra_headers = "From: $fname <$email>\n";
$extra_headers .= "Reply-To: $email";
mail('scripts@sbhmed.com','Refill Form Submission', $email_contents, $extra_headers );
header('Location: http://www.sbhmed.com/refill_request_confirm.php');
$status = "Thank you $fname. We will be sure to get back to you as soon as possible!";
$display_form = false;
} else {
$status = '<ul>';
foreach($error_list as $error_message) {
$status .= "<li>$error_message</li>";
}
$status .= '</ul>';
$display_form = true;
}
}
ob_flush();
?>
Thanks for your help