include("../includes/config.php"); $title = "NEUROLOGY/SLEEP SUPPLIES CATALOG"; $link = 'supplies/neuro-sup.php'; $aField_names = array('name' => 'Name','company' => 'Institution or Company', 'departament' => 'Department', 'addr_1' => 'Address 1', 'addr_2' => 'Address 2', 'city' => 'City', 'state' => 'State', 'zip' => 'Zip'); $aRequired_fields=array('name','company','addr_1','city','state','zip'); $form_type="supplies"; include("$doc_root$base_path/includes/functions.php"); if ($HTTP_POST_VARS) { ValidateForm(); } ?>