'addClientForm','onsubmit'=>'return checkFrequencyStatus()')); ?>
getId()); ?>
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Client ID: |
'30')); ?> |
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Client Name: |
'30')); ?> |
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Address: |
'30')); ?> |
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'30')); ?> |
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City: |
'30')); ?> |
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State: |
'Please Select...',
'AL' => 'Alabama',
'AK' => 'Alaska',
'AZ' => 'Arizona',
'AR' => 'Arkansas',
'CA' => 'California',
'CO' => 'Colorado',
'CT' => 'Connecticut',
'DE' => 'Delaware',
'DC' => 'District of Columbia',
'FL' => 'Florida',
'GA' => 'Georgia',
'HI' => 'Hawaii',
'ID' => 'Idaho',
'IL' => 'Illinois',
'IN' => 'Indiana',
'IA' => 'Iowa',
'KS' => 'Kansas',
'KY' => 'Kentucky',
'LA' => 'Louisiana',
'ME' => 'Maine',
'MD' => 'Maryland',
'MA' => 'Massachusetts',
'MI' => 'Michigan',
'MN' => 'Minnesota',
'MS' => 'Mississippi',
'MO' => 'Missouri',
'MT' => 'Montana',
'NE' => 'Nebraska',
'NV' => 'Nevada',
'NH' => 'New Hampshire',
'NJ' => 'New Jersey',
'NM' => 'New Mexico',
'NY' => 'New York',
'NC' => 'North Carolina',
'ND' => 'North Dakota',
'OH' => 'Ohio',
'OK' => 'Oklahoma',
'OR' => 'Oregon',
'PA' => 'Pennsylvania',
'RI' => 'Rhode Island',
'SC' => 'South Carolina',
'SD' => 'South Dakota',
'TN' => 'Tennessee',
'TX' => 'Texas',
'UT' => 'Utah',
'VT' => 'Vermont',
'VA' => 'Virginia',
'WA' => 'Washington',
'WV' => 'West Virginia',
'WI' => 'Wisconsin',
'WY' => 'Wyoming'), $stateValue)); ?> |
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Zip: |
'5')); ?> |
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Attn: |
'30')); ?> |
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Email: |
'30')); ?> |
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Phone: |
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Primary Address: >
Secondary Address(Edit): >
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Secondary Address
Address | |
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City | |
State | 'Please Select...',
'AL' => 'Alabama',
'AK' => 'Alaska',
'AZ' => 'Arizona',
'AR' => 'Arkansas',
'CA' => 'California',
'CO' => 'Colorado',
'CT' => 'Connecticut',
'DE' => 'Deleware',
'DC' => 'District of Columbia',
'FL' => 'Florida',
'GA' => 'Georgia',
'HI' => 'Hawaii',
'ID' => 'Idaho',
'IL' => 'Illinois',
'IN' => 'Indiana',
'IA' => 'Iowa',
'KS' => 'Kansas',
'KY' => 'Kentucky',
'LA' => 'Louisiana',
'ME' => 'Maine',
'MD' => 'Maryland',
'MA' => 'Massachusetts',
'MI' => 'Michigan',
'MN' => 'Minnesota',
'MS' => 'Mississippi',
'MO' => 'Missouri',
'MT' => 'Montana',
'NE' => 'Nebraska',
'NV' => 'Nevada',
'NH' => 'New Hampshire',
'NJ' => 'New Jersey',
'NM' => 'New Mexico',
'NY' => 'New York',
'NC' => 'North Carolina',
'ND' => 'North Dakota',
'OH' => 'Ohio',
'OK' => 'Oklahoma',
'OR' => 'Oregon',
'PA' => 'Pennsylvania',
'RI' => 'Rhode Island',
'SC' => 'South Carolina',
'SD' => 'South Dakota',
'TN' => 'Tennessee',
'TX' => 'Texas',
'UT' => 'Utah',
'VT' => 'Vermont',
'VA' => 'Virginia',
'WA' => 'Washington',
'WV' => 'West Virginia',
'WI' => 'Wisconsin',
'WY' => 'Wyoming'), $secondaryState)); ?> |
Zip | |
Attn | |
| |
|
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Category: |
'Please Select...',
'cardiology' => 'Cardiology',
'chiropractic' => 'Chiropractic',
'endoscopy' => 'Endoscopy',
'entsurgery' => 'Ent Surgery',
'eyesurgery' => 'Eye Surgery',
'hospital' => 'Hospital',
'hospitalsatellite' => 'Hospital Satellite',
'plasticsurgery' => 'Plastic Surgery',
'podiatrist' => 'Podiatrist',
'physicaltherapy' => 'Physical Therapy',
'veterinary' => 'Veterinary'), $categoryValue)); ?> |
All Devices: |
getAllDevices(), 'size=1').' hrs'; ?>
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Notes: |
'30')); ?> |
'disabled') : array();
?>
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Legacy |
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Quarterly |
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Room air exchange |
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Medgas |
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Imaging |
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Neptune |
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Anesthesia |
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Annual |
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Semi |
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Quarterly |
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Sterilizer |
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Trace gas |
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ERT |
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Room air exchange |
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Medgas |
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Imaging |
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Neptune |
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Anesthesia |
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'_blank'));
?>
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