{"id":2,"date":"2024-10-24T10:15:41","date_gmt":"2024-10-24T10:15:41","guid":{"rendered":"https:\/\/mbodyhealth.com\/portal\/?page_id=2"},"modified":"2024-12-27T06:30:40","modified_gmt":"2024-12-27T06:30:40","slug":"portal-registration","status":"publish","type":"page","link":"https:\/\/mbodyhealth.com\/portal\/","title":{"rendered":"Register"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"2\" class=\"elementor elementor-2\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1b44042 e-grid e-con-boxed e-con e-parent\" data-id=\"1b44042\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6d2ae32 elementor-widget elementor-widget-shortcode\" data-id=\"6d2ae32\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><form id=\"gym-multistep-form\" action=\"\/portal\/wp-json\/wp\/v2\/pages\/2\" method=\"post\">\n\n    <link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n    <link rel=\"preconnect\" href=\"https:\/\/fonts.gstatic.com\" crossorigin>\n    <link href=\"https:\/\/fonts.googleapis.com\/css2?family=Poppins:ital,wght@0,100;0,200;0,300;0,400;0,500;0,600;0,700;0,800;0,900;1,100;1,200;1,300;1,400;1,500;1,600;1,700;1,800;1,900&family=Roboto:ital,wght@0,100;0,300;0,400;0,500;0,700;0,900;1,100;1,300;1,400;1,500;1,700;1,900&display=swap\" rel=\"stylesheet\">\n    \n    <!-- Step 1: Role Selection -->\n    <div class=\"form-step step-1 active\">\n        <h2>Let's Get Started! Are You A<\/h2>\n\t\t<!--<p>Are You?<\/p>!-->\n        <div class=\"role-selection\">\n            <button type=\"button\" class=\"role-option\" data-role=\"gym_employee\">Gym Employee<\/button>\n            <button type=\"button\" class=\"role-option\" data-role=\"gym_member\">Gym Member<\/button>\n            <button type=\"button\" class=\"role-option\" data-role=\"family_friend\">Family\/Friend<\/button>\n            <input type=\"hidden\" name=\"role\" id=\"selected-role\" required>\n        <\/div>\n        <div class=\"btns-group\">\n            <button type=\"button\" class=\"next-step\">Next<\/button>\n        <\/div>\n        <div class=\"portal-signin\">\n            <h4>Already a User? <a href=\"https:\/\/mbodyhealth.com\/portal\/login\">Sign In<\/a><\/h4>            \n        <\/div>\n    <\/div>\n\n    <!-- Step 2: Personal Information -->\n    <div class=\"form-step step-2\">\n        <h2>Personal Information<\/h2>\n        <div class=\"form-group-wrap\">\n            <div class=\"form-group\">\n                <label for=\"first_name\">First Name <span class=\"required\">*<\/span><\/label>\n                <input type=\"text\" name=\"first_name\" required>\n            <\/div>\n            <div class=\"form-group\">\n                <label for=\"last_name\">Last Name <span class=\"required\">*<\/span><\/label>\n                <input type=\"text\" name=\"last_name\" required>\n            <\/div>\n        <\/div>\n\n\n        <div class=\"form-group\">\n            <label for=\"email\">Email Address <span class=\"required\">*<\/span><\/label>\n            <input type=\"email\" name=\"email\" required>\n        <\/div>\n\n        <div class=\"form-group-wrap\">\n            <div class=\"form-group\">\n                <!--<label for=\"mobile\">Mobile <span class=\"required\">*<\/span><\/label>!-->\n\t\t\t\t<label for=\"mobile\">Mobile <span class=\"required\">*<\/span> \n\t\t\t\t<span class=\"tooltip-icon\"><img decoding=\"async\" src=\"\/portal\/wp-json\/wp\/v2\/pages\/2wp-content\/uploads\/2024\/12\/Tooltip_Manager_PNG_270x170icon.png\" style=\"\n    height: 20;\n    width: 20px;\n\" class=\"tooltip-icon\"><\/span>\n                    <span class=\"tooltip-text\">We respect your privacy, we'll only send important updates\/reminders to your mobile.<\/span>\n                <\/label>\n                <input type=\"text\" name=\"mobile\" required>\n            <\/div>\n\n            <div class=\"form-group\">\n                <label for=\"gender\">Gender <span class=\"required\">*<\/span><\/label>\n                <select name=\"gender\" id=\"gender\" required>\n                    <option value=\"\">Select Gender<\/option>\n                    <option value=\"Male\">Male<\/option>\n                    <option value=\"Female\">Female<\/option>\n                    <option value=\"Other\">Other<\/option>\n                <\/select>\n            <\/div>\n        <\/div>\n        <!--<p>\n            <label for=\"gender\">Gender <span class=\"required\">*<\/span><\/label>\n            <input type=\"text\" name=\"gender\" required>\n        <\/p>-->\n        <div class=\"form-group-wrap\">\n\n            <div class=\"form-group\">\n                <label for=\"dob\">Date of Birth <span class=\"required\">*<\/span><\/label>\n                <input type=\"date\" name=\"dob\" required>\n            <\/div>\n\n            <div class=\"form-group\">\n                <label for=\"profession\">Profession <span class=\"required\">*<\/span><\/label>\n                <input type=\"text\" name=\"profession\" required>\n            <\/div>\n        <\/div>\n\n        <div class=\"form-group-wrap\">\n            <div class=\"form-group\">\n                <label for=\"gym_name\">Gym Name <span class=\"required\">*<\/span><\/label>\n                <input type=\"text\" name=\"gym_name\" required>\n            <\/div>\n            <div class=\"form-group\">\n                <label for=\"gym_location\">Gym Location <span class=\"required\">*<\/span><\/label>\n                <input type=\"text\" name=\"gym_location\" required>\n            <\/div>\n        <\/div>\n        <div class=\"btns-group\">\n            <button type=\"button\" class=\"prev-step\">Previous<\/button>\n            <button type=\"button\" class=\"next-step\">Next<\/button>\n        <\/div>\n    <\/div>\n\n    <!-- Step 3: Address Details -->\n    <div class=\"form-step step-3\">\n        <h2>Address Details<\/h2>\n        <div class=\"form-group-wrap\">\n            <div class=\"form-group\">\n                <label for=\"street\">Street <span class=\"required\">*<\/span><\/label>\n                <input type=\"text\" name=\"street\" required>\n            <\/div>\n            <div class=\"form-group\">\n                <label for=\"city\">City <span class=\"required\">*<\/span><\/label>\n                <input type=\"text\" name=\"city\" required>\n            <\/div>\n        <\/div>\n        <div class=\"form-group-wrap\">\n            <div class=\"form-group\">\n                <label for=\"state\">State <span class=\"required\">*<\/span><\/label>\n                <input type=\"text\" name=\"state\" required>\n            <\/div>\n            <div class=\"form-group\">\n                <label for=\"zipcode\">Zip Code <span class=\"required\">*<\/span><\/label>\n                <input type=\"text\" name=\"zipcode\" required>\n            <\/div>\n        <\/div>\n        <div class=\"form-group-wrap\">\n            <div class=\"form-group\">\n                <label for=\"password\">Password <span class=\"required\">*<\/span><\/label>\n                <input type=\"password\" name=\"password\" required>\n            <\/div>\n            <div class=\"form-group\">\n                <label for=\"confirm_password\">Confirm Password <span class=\"required\">*<\/span><\/label>\n                <input type=\"password\" name=\"confirm_password\" required>\n            <\/div>\n        <\/div>\n        <div class=\"btns-group\">\n            <button type=\"button\" class=\"prev-step\">Previous<\/button>\n            <button type=\"button\" class=\"next-step\">Next<\/button>\n        <\/div>\n    <\/div>\n\n    <!-- Step 4: Insurance Selection -->\n    <div class=\"form-step step-4\">\n        <h2>Insurance<\/h2>\n        <p>Do you have insurance?<\/p>\n        <div class=\"insurance-selection\">\n            <button type=\"button\" class=\"insurance-option\" data-insurance=\"yes\">Yes<\/button>\n            <button type=\"button\" class=\"insurance-option\" data-insurance=\"no\">No<\/button>\n            <input type=\"hidden\" name=\"insurance\" id=\"selected-insurance\" required>\n        <\/div>\n        <div class=\"btns-group\">\n            <button type=\"button\" name=\"prev_step\" class=\"prev-step\">Previous<\/button>\n            <button type=\"button\" name=\"next_step\" class=\"next-step\">Next<\/button>\n            <input type=\"submit\" name=\"register_user\" value=\"Register\" style=\"display: none;\">\n        <\/div>\n    <\/div>\n\n    <!-- Step 5: Conditional Insurance Details and Final Submit -->\n    <div class=\"form-step step-5\" id=\"insurance-details\">\n        <h2>Insurance Details<\/h2>\n        <div id=\"insurance-fields\">\n\t\t\t<div class=\"form-group\">\n                <label for=\"group_id\">Insurance\/Payer Name <span class=\"required\">*<\/span><\/label>\n\t\t\t\t\n                <div class=\"ast-container\">\n\t\t            <input type=\"text\" id=\"payer-name-search\" placeholder=\"Search Payer Name...\">\n                    <select id=\"search-results\" style=\"display:none;\" size=\"5\">\n                        <option value=\"other\">Other<\/option> <!-- Default option -->\n                    <\/select> \n\t\t            * Please select Other if your plan is not present in this list.\n                    <script>jQuery('#search-results').change(function() {\n\n                        var selectedPayer = jQuery(this).val();\n                        if (selectedPayer) {\n                            \/\/alert(selectedPayer);\n                            console.log(\"Selected Payer: \" + selectedPayer);\n                            jQuery('#pname').val(selectedPayer);\n                            jQuery('#payer-name-search').val(selectedPayer);\n                            jQuery('#search-results').hide();\n                            \/\/ Do something with the selected Payer Name (e.g., show details, etc.)\n                        }\n                    });\n                    <\/script>\n\t\t\t    <\/div>\n            <\/div>\n            <div class=\"form-group\">\n               \n                <input type=\"hidden\" name=\"group_id\" id=\"pname\">\n            <\/div>\n            <div class=\"form-group\">\n                <label for=\"insurance_number\">Insurance Number <span class=\"required\">*<\/span><\/label>\n                <input type=\"text\" name=\"insurance_number\">\n            <\/div>\n\t\t\t<div class=\"form-group\">\n                <label for=\"insurance_number\">Insurance Type <span class=\"required\">*<\/span><\/label>\n                <select name=\"insurance_type\"><option><\/option>\n\t\t\t\t <option value=\"MEDICARE\">MEDICARE<\/option>\n\t\t\t\t  <option value=\"MEDICAID\">MEDICAID<\/option>\n\t\t\t\t  <option value=\"TRICARE CHAMPUS\">TRICARE CHAMPUS<\/option>\n\t\t\t\t  <option value=\"CHAMPVA\">CHAMPVA<\/option>\n\t\t\t\t  <option value=\"GROUP HEALTH PLAN\">GROUP HEALTH PLAN<\/option>\n\t\t\t\t  <option value=\"FECA BLK LUNG\">FECA BLK LUNG<\/option>\n\t\t\t\t  <option value=\"OTHER\" Selected>OTHER<\/option>\n\t\t\t\t  <\/Select>\n            <\/div>\n\t\t\t<div class=\"form-group\">\n                <label for=\"insurance_number\">Patient Relationship <span class=\"required\">*<\/span><\/label>\n\t\t\t\t  <select name=\"patient_relationship\"><option><\/option>\n\t\t\t\t  <option value=\"Self\">Self<\/option>\n\t\t\t\t  <option value=\"Spouse\">Spouse<\/option>\n\t\t\t\t  <option value=\"Child\">Child<\/option>\n\t\t\t\t  <option value=\"Other\">Other<\/option>\n\t\t\t\t  <option value=\"Employee \/ Other\">Employee \/ Other<\/option>\n\t\t\t\t  <\/Select>\n           <input Type=\"hidden\" value=\"\" name=\"payer_id\" id=\"payer_id\"> \n            <\/div>\n        <\/div>\n        <div class=\"btns-group\">\n            <button type=\"button\" class=\"prev-step\">Previous<\/button>\n            <input type=\"submit\" name=\"register_user\" value=\"Register\">\n        <\/div>\n    <\/div>\n\n<\/form>\n\n<script>\ndocument.addEventListener('DOMContentLoaded', function () {\n    const steps = document.querySelectorAll('.form-step');\n    let currentStep = 0;\n\n    function showStep(step) {\n        steps.forEach((el, index) => {\n            el.classList.toggle('active', index === step);\n        });\n    }\n\t\n\tfunction updateButtons() {\n\t\tconst registerButton = document.querySelector('.step-4 .btns-group input[name=\"register_user\"]');\n\t\tconst nextButton = document.querySelector('.step-4 .btns-group .next-step') ;\n\t\tconst selectedInsurance = document.getElementById('selected-insurance').value;\n\n\t\t\/\/ Hide both buttons by default\n\t\tnextButton.style.display = 'none'; \n\t\tregisterButton.style.display = 'none';\n\n\t\t\/\/ Check if we are on step 4\n\t\tif (currentStep === 3) {\n\t\t\tif (selectedInsurance === 'yes') {\n                console.log(selectedInsurance)\n\t\t\t\tnextButton.style.display = 'inline-block'; \/\/ Show Next button\n\t\t\t} else if (selectedInsurance === 'no') {\n\t\t\t\tregisterButton.style.display = 'inline-block'; \/\/ Show Register button\n\t\t\t}\n\t\t} else {\n\t\t\tnextButton.style.display = 'inline-block'; \/\/ Show Next button for other steps\n\t\t}\n\t}\n\n\t\n    function validateStep() {\n        if (currentStep === 0) {\n            \/\/ Validation for Step 1 (role selection)\n            const selectedRole = document.getElementById('selected-role').value;\n            if (!selectedRole) {\n                roleError.style.display = 'block';\n                return false;\n            }\n        } else if (currentStep === 1) {\n            \/\/ Validation for Step 2 (personal information)\n            const firstName = document.querySelector('input[name=\"first_name\"]');\n            const lastName = document.querySelector('input[name=\"last_name\"]');\n            const email = document.querySelector('input[name=\"email\"]');\n            const mobile = document.querySelector('input[name=\"mobile\"]');\n            const gender = document.querySelector('select[name=\"gender\"]');\n            const dob = document.querySelector('input[name=\"dob\"]');\n            const profession = document.querySelector('input[name=\"profession\"]');\n            const gymName = document.querySelector('input[name=\"gym_name\"]');\n            const gymLocation = document.querySelector('input[name=\"gym_location\"]');\n\n            const namePattern = \/^[A-Za-z]+$\/;\n            const emailPattern = \/^[^\\s@]+@[^\\s@]+\\.[^\\s@]+$\/;\n            const phonePattern = \/^\\d{10}$\/;\n            const textPattern = \/^[A-Za-z\\s]+$\/;\n\n            \/\/ Clear previous error messages\n            document.querySelectorAll(\".error-message\").forEach(el => el.remove());\n\n            let isValid = true;\n\n            if (!firstName.value || !namePattern.test(firstName.value)) {\n                displayError(firstName, \"Please enter a valid first name (letters only).\");\n                isValid = false;\n            }\n            if (!lastName.value || !namePattern.test(lastName.value)) {\n                displayError(lastName, \"Please enter a valid last name (letters only).\");\n                isValid = false;\n            }\n            if (!email.value || !emailPattern.test(email.value)) {\n                displayError(email, \"Please enter a valid email address.\");\n                isValid = false;\n            }\n            if (!mobile.value || !phonePattern.test(mobile.value)) {\n                displayError(mobile, \"Please enter a valid 10-digit phone number.\");\n                isValid = false;\n            }\n            if (!gender.value) {\n                displayError(gender, \"Please select gender.\");\n                isValid = false;\n            } \n            if (!dob.value) {\n                displayError(dob, \"Please enter your date of birth.\");\n                isValid = false;\n            }\n            if (!profession.value || !textPattern.test(profession.value)) {\n                displayError(profession, \"Please enter a valid profession (letters only).\");\n                isValid = false;\n            }\n            if (!gymName.value || !textPattern.test(gymName.value)) {\n                displayError(gymName, \"Please enter a valid gym name (letters only).\");\n                isValid = false;\n            }\n            if (!gymLocation.value || !textPattern.test(gymLocation.value)) {\n                displayError(gymLocation, \"Please enter a valid gym location (letters only).\");\n                isValid = false;\n            }\n\n            return isValid;\n        } else if (currentStep === 2) {\n            \/\/ Validation for Step 3 (address and password)\n            const street = document.querySelector('input[name=\"street\"]');\n            const city = document.querySelector('input[name=\"city\"]');\n            const state = document.querySelector('input[name=\"state\"]');\n            const zipcode = document.querySelector('input[name=\"zipcode\"]');\n            const password = document.querySelector('input[name=\"password\"]');\n            const confirmPassword = document.querySelector('input[name=\"confirm_password\"]');\n\n            const textPattern = \/^[A-Za-z\\s]+$\/;\n            const zipPattern = \/^\\d{5}$\/; \/\/ Adjust as needed for ZIP code format\n            \/\/const passwordPattern = \/.{6,}\/; \/\/ At least 6 characters\n            const passwordPattern = \/^(?=.*[A-Z])(?=.*[a-z])(?=.*\\d)(?=.*[@$!%*?&])[A-Za-z\\d@$!%*?&]{8,}$\/;\n\n            \/\/ Clear previous error messages\n            document.querySelectorAll(\".error-message\").forEach(el => el.remove());\n\n            let isValid = true;\n\n            if (!street.value) {\n                displayError(street, \"Please enter your street address.\");\n                isValid = false;\n            }\n            if (!city.value || !textPattern.test(city.value)) {\n                displayError(city, \"Please enter a valid city (letters only).\");\n                isValid = false;\n            }\n            if (!state.value || !textPattern.test(state.value)) {\n                displayError(state, \"Please enter a valid state (letters only).\");\n                isValid = false;\n            }\n            if (!zipcode.value || !zipPattern.test(zipcode.value)) {\n                displayError(zipcode, \"Please enter a valid 5-digit ZIP code.\");\n                isValid = false;\n            }\n            if (!password.value || !passwordPattern.test(password.value)) {\n                displayError(password, \"Password must be at least 8 characters, with one uppercase letter, one lowercase letter, one number, and one special character.\");\n                isValid = false;\n            }\n            if (password.value !== confirmPassword.value) {\n                displayError(confirmPassword, \"Passwords do not match.\");\n                isValid = false;\n            }\n\n            return isValid;\n        }\n\t\telse if (currentStep === 3) {\n            \/\/ Validation for Step 4 (insurance selection)\n            const selectedInsurance = document.getElementById('selected-insurance').value;\n            if (!selectedInsurance) {\n                displayError(document.querySelector('.insurance-selection'), \"Please select an insurance option.\");\n                return false;\n            }\n        }\n\t\telse if (currentStep === 4) {\n\t\t\tconst groupid = document.querySelector('input[name=\"group_id\"]');\n            const insurancenumber = document.querySelector('input[name=\"insurance_number\"]');\n\t\t\t\/\/ Clear previous error messages\n            document.querySelectorAll(\".error-message\").forEach(el => el.remove());\n\n            let isValid = true;\n\n            if (!groupid.value) {\n                displayError(groupid, \"Please enter Insurance\/Payer Name.\");\n                isValid = false;\n            }\n            if (!insurancenumber.value) {\n                displayError(insurancenumber, \"Please enter Insurance Number.\");\n                isValid = false;\n            }\n\t\t\treturn isValid;\n\t\t}\n        return true;\n    }\n\n    function displayError(inputElement, message) {\n        const error = document.createElement(\"span\");\n        error.className = \"error-message\";\n        error.style.color = \"red\";\n        error.textContent = message;\n        inputElement.parentNode.appendChild(error);\n    }\n\n    \/\/ Role selection\n    document.querySelectorAll('.role-option').forEach(button => {\n        button.addEventListener('click', function () {\n            document.getElementById('selected-role').value = this.getAttribute('data-role');\n            document.querySelectorAll('.role-option').forEach(btn => btn.classList.remove('selected'));\n            this.classList.add('selected');\n            roleError.style.display = 'none'; \/\/ Hide error when a role is selected\n        });\n    });\n\t\n\t\/\/ Insurance selection\n    document.querySelectorAll('.insurance-option').forEach(button => {\n        button.addEventListener('click', function () {\n            document.getElementById('selected-insurance').value = this.getAttribute('data-insurance');\n            document.querySelectorAll('.insurance-option').forEach(btn => btn.classList.remove('selected'));\n            this.classList.add('selected');\n\n            \/\/ Remove error message if option selected\n            const errorMessage = document.querySelector('.insurance-selection .error-message');\n            if (errorMessage) errorMessage.remove();\n\n            updateButtons(); \/\/ Update button visibility based on selection\n        });\n    });\n\n    \/\/ Create and insert an error message for role selection\n    const roleError = document.createElement('p');\n    roleError.textContent = \"Please select a role to proceed.\";\n    roleError.style.color = \"red\";\n    roleError.style.display = \"none\";\n    document.querySelector('.role-selection').appendChild(roleError);\n\n    \/\/ Handle \"Next\" and \"Previous\" buttons\n    document.querySelectorAll('.next-step').forEach(button => {\n        button.addEventListener('click', () => {\n            if (validateStep()) {\n                currentStep = Math.min(currentStep + 1, steps.length - 1);\n                showStep(currentStep);\n            }\n        });\n    });\n\n    document.querySelectorAll('.prev-step').forEach(button => {\n        button.addEventListener('click', () => {\n            currentStep = Math.max(currentStep - 1, 0);\n            showStep(currentStep);\n        });\n    });\n\n    \/\/ Ensure form submits correctly at the last step\n    document.querySelector('#gym-multistep-form').addEventListener('submit', function (e) {\n        if (!validateStep()) {\n            e.preventDefault();\n        }\n    });\n\n    showStep(currentStep);\n});\n\njQuery(document).ready(function($){\n    $('#payer-name-search').keyup(function(){\n        var searchValue = $(this).val();  \/\/ Get the value of the search input\n\n        if (searchValue.length >= 3) {  \/\/ Optional: Start search after 3 characters\n            jQuery('#search-results').show();\n\t\t\t$.ajax({\n                url: ajaxsearch.url,\n                type: 'POST',\n                data: {\n                    action: ajaxsearch.action,\n                    search: searchValue\n                },\n                success: function(response) {\n                    var resultsContainer = $('#search-results');\n                    resultsContainer.empty();  \/\/ Clear previous results\n\n                    if (response) {\n                        var data = JSON.parse(response);  \/\/ Parse the JSON response\n                        if (data.length > 0) {\n                            \/\/resultsContainer.append('<option value=\"\"><\/option>'); \/\/ Add a default option\n                            \/\/ Loop through the results and add options to the select dropdown\n                            data.forEach(function(row) {\n\n                                resultsContainer.append('<option attr=\"' + row.Payer_Id + '\" value=\"' + row.Payer_Name + '\">' + row.Payer_Name + '<\/option>');\n               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