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fbRequireJSScript.addEventListener("load", conditionalSectionJs);var conditionalSectionJs = function () {\
    requirejs([window.formHost + \'/Scripts/require/fbRequire.config.js\'], function (fbRequireConfig) {\
        var fbRequire = fbRequireConfig.fbRequire;\
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        fbRequire([\'jquery\', \'he\'], function ($, he) {\
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fbRequireJSScript.addEventListener("load", conditionalSectionJs);var conditionalSectionJs = function () {\
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        fbRequire([\'jquery\', \'he\'], function ($, he) {\
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\
                if (conditionOperator === \'and\') {\
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fbRequireJSScript.addEventListener("load", conditionalSectionJs);var conditionalSectionJs = function () {\
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        fbRequire([\'jquery\', \'he\'], function ($, he) {\
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                sectionConditions.forEach(function (sectionCondition) {\
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                showHideSection(shouldShowSection);\
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                function checkSelect(sectionCondition) {\
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                    for (var i = 0; i < matchingCheckboxes.length; i++) {\
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                            shouldShowSection = mergeCondition(shouldShowSection, matchingCheckboxes[i].checked, matchingCheckboxes[i]);\
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                function checkRadio(sectionCondition) {\
                    var matchingRadios = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']");\
                    \
                    for (var i = 0; i < matchingRadios.length; i++) {\
                        if (encode(matchingRadios[i].value) === sectionCondition.Value) {\
                            shouldShowSection = mergeCondition(shouldShowSection, matchingRadios[i].checked, matchingRadios[i]);\
                        }\
                    }\
                }\
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            function mergeCondition(overallResult, newResult, element) {\
                newResult = newResult && isParentVisible(element);\
\
                if (conditionOperator === \'and\') {\
                    return overallResult && newResult;\
                } else {\
                    return overallResult || newResult;\
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            }\
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            function isParentVisible(element) {\
                var parentSectionDiv = $(\'#\' + element.id).closest(".fb-section");\
                return parentSectionDiv && !parentSectionDiv.is(":hidden");\
            }\
\
            function encode(myString) {\
                myString = he.encode(he.escape(myString));\
\
                /* Fixes issues with single quote and backtick encoding */\
                var i,\
                    entities = [\
                        [\'&#x27;\', \'&#39;\'],\
                        [\'&#x60;\', \'`\']\
                    ];\
\
                for (i = 0; i < entities.length; i++) {\
                    myString = String(myString).replace(new RegExp(entities[i][0], \'g\'), entities[i][1]);\
                }\
\
                return myString;\
            }\
\
            function showHideSection(showSection) {\
                if (showSection) {\
                    $(\'#FormField275_fb167f60-9c87-432f-b9eb-808687217ada\').show();\
                } else {\
                    $(\'#FormField275_fb167f60-9c87-432f-b9eb-808687217ada\').hide();\
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                $("#FormField275_fb167f60-9c87-432f-b9eb-808687217ada .conditionalSectionListSelection").each(function (i, obj) {\
                    if (obj.type === \'radio\' || obj.type === \'checkbox\') {\
                        if (obj.checked) {\
                            $(\'#\' + obj.id).change();\
                        }\
                    } else {\
                        $(\'#\' + obj.id).change();\
                    }\
                });\
            }\
        });\
    });\
};\
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fbRequireJSScript.addEventListener("load", conditionalSectionJs);var conditionalSectionJs = function () {\
    requirejs([window.formHost + \'/Scripts/require/fbRequire.config.js\'], function (fbRequireConfig) {\
        var fbRequire = fbRequireConfig.fbRequire;\
\
        fbRequire([\'jquery\', \'he\'], function ($, he) {\
            he.encode.options.decimal = true;\
            he.encode.options.allowUnsafeSymbols = true;\
\
            var sectionConditions = JSON.parse(\'[{"ElementName":"FormField172_fb167f60-9c87-432f-b9eb-808687217ada","Value":"Bicuspid Aortic Valve (BAV) Screening - $90 (Must have an immediate family member with a history of BAV)"}]\');\
            var conditionOperator = \'and\';\
\
            sectionConditions.forEach(function (sectionCondition) {\
                $("select[id=" + sectionCondition.ElementName + "]").addClass(\'conditionalSectionListSelection\');\
                $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").addClass(\'conditionalSectionListSelection\');\
                $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").addClass(\'conditionalSectionListSelection\');\
                \
                $("select[id=" + sectionCondition.ElementName + "]").on(\'change\', function () {\
                    checkShowHide();\
                });\
                \
                $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").on(\'change\', function () {\
                    checkShowHide();\
                });\
                \
                $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").on(\'change\', function () {\
                    checkShowHide();\
                });\
            });\
            \
            function checkShowHide() {\
                var shouldShowSection = conditionOperator === \'and\'; /* set default to true for AND operation and false for OR operation */\
\
                sectionConditions.forEach(function (sectionCondition) {\
                    checkSelect(sectionCondition);                \
                    checkCheckbox(sectionCondition);                \
                    checkRadio(sectionCondition);                    \
                });\
\
                showHideSection(shouldShowSection);\
\
                function checkSelect(sectionCondition) {\
                    var matchingSelect = $("select[id=" + sectionCondition.ElementName + "]")[0];\
\
                    if (!matchingSelect) {\
                        return;\
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\
                    if (matchingSelect.type === \'select-multiple\') {\
                        var hasOneMatchingValue = false;\
\
                        for (var i = 0; i < matchingSelect.selectedOptions.length; i++) {\
                            if (encode(matchingSelect.selectedOptions[i].value) === sectionCondition.Value) {\
                                hasOneMatchingValue = true;\
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\
                        shouldShowSection = mergeCondition(shouldShowSection, hasOneMatchingValue, matchingSelect);\
                    } else {\
                        shouldShowSection = mergeCondition(shouldShowSection, encode(matchingSelect.value) === sectionCondition.Value, matchingSelect);\
                    }\
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<input type=\'text\' name=\'FormField286_5c675f12-8464-46f8-9e3c-165b04573c04\' id=\'FormField286_5c675f12-8464-46f8-9e3c-165b04573c04\' class=\'form-control input-medium \' value=\'\'   data-export-label=\'Primary_Care_Provider\'  placeholder=\'\'  />\
<div class=\'formHelp\'>Please list the name of your primary care provider. If you have none, please enter N/A</div></div></div></div><hr><p><strong><span style=\'color: rgb(0, 113, 187); font-size: 24px;\'>Heart, Stroke and Vascular Screening Options<br></span></strong><em>Eligibility requirements differentiate by screening. Please ensure you meet the required criteria before registering for a screening.</em></p><div class=\'form-group\'><label  class=\'control-label  hidden-label\'>Heart, Stroke and Vascular Screening Options<span class=\'fb-required\'>*</span></label><div><div><fieldset class=\'CheckboxGroup\'><div class=\'separate Chkbx\'><input type=\'checkbox\' value=\'Peripheral Arterial Disease (PAD) Screening - $20 (65+ or 55-64 with health conditions)\' required data-msg-required=\'Heart, Stroke and Vascular Screening Options is required.\' name=\'5098ab48-8a49-4199-9269-de3cb930c4a7_FormField172_fb167f60-9c87-432f-b9eb-808687217ada_checkbox_172\' id=\'FormField172_fb167f60-9c87-432f-b9eb-808687217ada_1\' class=\'fo-right-margin-5\' data-export-label=\'Heart_Stroke_Vascular_Screening_Options\' ><label for=\'FormField172_fb167f60-9c87-432f-b9eb-808687217ada_1\'>Peripheral Arterial Disease (PAD) Screening - $20 (65+ or 55-64 with health conditions)</label></div><div class=\'separate Chkbx\'><input type=\'checkbox\' value=\'Abdominal Aortic Ultrasound Screening - $40 (65+ or 55-64 with health conditions)\' required data-msg-required=\'Heart, Stroke and Vascular Screening Options is required.\' name=\'5098ab48-8a49-4199-9269-de3cb930c4a7_FormField172_fb167f60-9c87-432f-b9eb-808687217ada_checkbox_172\' id=\'FormField172_fb167f60-9c87-432f-b9eb-808687217ada_2\' class=\'fo-right-margin-5\' data-export-label=\'Heart_Stroke_Vascular_Screening_Options\' ><label for=\'FormField172_fb167f60-9c87-432f-b9eb-808687217ada_2\'>Abdominal Aortic Ultrasound Screening - $40 (65+ or 55-64 with health conditions)</label></div><div class=\'separate Chkbx\'><input type=\'checkbox\' value=\'Carotid Artery Ultrasound Screening - $40 (65+ or 55-64 with health conditions)\' required data-msg-required=\'Heart, Stroke and Vascular Screening Options is required.\' name=\'5098ab48-8a49-4199-9269-de3cb930c4a7_FormField172_fb167f60-9c87-432f-b9eb-808687217ada_checkbox_172\' id=\'FormField172_fb167f60-9c87-432f-b9eb-808687217ada_3\' class=\'fo-right-margin-5\' data-export-label=\'Heart_Stroke_Vascular_Screening_Options\' ><label for=\'FormField172_fb167f60-9c87-432f-b9eb-808687217ada_3\'>Carotid Artery Ultrasound Screening - $40 (65+ or 55-64 with health conditions)</label></div><div class=\'separate Chkbx\'><input type=\'checkbox\' value=\'Bicuspid Aortic Valve (BAV) Screening - $90 (Must have an immediate family member with a history of BAV)\' required data-msg-required=\'Heart, Stroke and Vascular Screening Options is required.\' name=\'5098ab48-8a49-4199-9269-de3cb930c4a7_FormField172_fb167f60-9c87-432f-b9eb-808687217ada_checkbox_172\' id=\'FormField172_fb167f60-9c87-432f-b9eb-808687217ada_4\' class=\'fo-right-margin-5\' data-export-label=\'Heart_Stroke_Vascular_Screening_Options\' ><label for=\'FormField172_fb167f60-9c87-432f-b9eb-808687217ada_4\'>Bicuspid Aortic Valve (BAV) Screening - $90 (Must have an immediate family member with a history of BAV)</label></div></fieldset></div></div></div><div class=\'form-group\'><label  class=\'control-label  \'>By checking this box, I confirm that I have only chosen a screening(s) that I am eligible for. It is my responsibility to review eligibility requirements prior to registering for a heart &amp; vascular screening.<span class=\'fb-required\'>*</span></label><div><div><div class=\'flow Chkbx\'><input type=\'checkbox\' value=\'Yes\' required data-msg-required=\'By checking this box, I confirm that I have only chosen a screening(s) that I am eligible for. It is my responsibility to review eligibility requirements prior to registering for a heart &amp; vascular screening. is required.\' name=\'5098ab48-8a49-4199-9269-de3cb930c4a7_FormField108_fb167f60-9c87-432f-b9eb-808687217ada_checkbox_108\' id=\'FormField108_fb167f60-9c87-432f-b9eb-808687217ada_1\' class=\'fo-right-margin-5\' data-export-label=\'waiver\' ><label for=\'FormField108_fb167f60-9c87-432f-b9eb-808687217ada_1\'>Yes</label></div></div></div></div><hr><p><strong><span style=\'color: rgb(0, 113, 187); font-size: 24px;\'>Preferred Screening Date<br></span></strong><em>We will use this date when contacting you to schedule your screening(s). 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class=\'fb-required\'>*</span></label><div><div><div class=\'flow Chkbx\'><input type=\'checkbox\' value=\'Yes\' required data-msg-required=\'A response is required.\' name=\'5098ab48-8a49-4199-9269-de3cb930c4a7_FormField126_fb167f60-9c87-432f-b9eb-808687217ada_checkbox_126\' id=\'FormField126_fb167f60-9c87-432f-b9eb-808687217ada_1\' class=\'fo-right-margin-5\' data-export-label=\'Contact_Disclaimer\' ><label for=\'FormField126_fb167f60-9c87-432f-b9eb-808687217ada_1\'>Yes</label></div></div></div></div><hr><div class=\'fb-section\' style=\'display: none;\' id=\'FormField105_fb167f60-9c87-432f-b9eb-808687217ada\'><p><strong><span style=\'color: rgb(0, 113, 187); font-size: 24px;\'>Your Cart:</span></strong></p></div><div class=\'fb-section\' style=\'display: none;\' id=\'FormField271_fb167f60-9c87-432f-b9eb-808687217ada\'><div class=\'\'><div class=\'form-group\'><input type=\'hidden\' name=\'FormField272_5c675f12-8464-46f8-9e3c-165b04573c04_description\' id=\'FormField272_5c675f12-8464-46f8-9e3c-165b04573c04_description\' data-export-label=\'Peripheral_Arterial_Disease_description\' value=\'Peripheral Arterial Disease\'><input type=\'hidden\' name=\'FormField272_5c675f12-8464-46f8-9e3c-165b04573c04_amount\' id=\'FormField272_5c675f12-8464-46f8-9e3c-165b04573c04_amount\' data-export-label=\'Peripheral_Arterial_Disease_amount\' value=\'20\'><input type=\'hidden\' name=\'FormField272_5c675f12-8464-46f8-9e3c-165b04573c04_item_total\' id=\'FormField272_5c675f12-8464-46f8-9e3c-165b04573c04_item_total\' data-export-label=\'Peripheral_Arterial_Disease_item_total\' value=\'20\'><label class=\'control-label  \' >Peripheral Arterial Disease</label><span> ($20.00)</span></div><input type=\'hidden\' name=\'FormField272_5c675f12-8464-46f8-9e3c-165b04573c04_quantity\' id=\'FormField272_5c675f12-8464-46f8-9e3c-165b04573c04_quantity\' data-export-label=\'Peripheral_Arterial_Disease_quantity\' value=\'1\'></div></div><div class=\'fb-section\' style=\'display: none;\' id=\'FormField273_fb167f60-9c87-432f-b9eb-808687217ada\'><div class=\'\'><div class=\'form-group\'><input type=\'hidden\' name=\'FormField274_5c675f12-8464-46f8-9e3c-165b04573c04_description\' id=\'FormField274_5c675f12-8464-46f8-9e3c-165b04573c04_description\' data-export-label=\'Abdominal_Aortic_Ultrasound_description\' value=\'Abdominal Aortic Ultrasound\'><input type=\'hidden\' name=\'FormField274_5c675f12-8464-46f8-9e3c-165b04573c04_amount\' id=\'FormField274_5c675f12-8464-46f8-9e3c-165b04573c04_amount\' data-export-label=\'Abdominal_Aortic_Ultrasound_amount\' value=\'40\'><input type=\'hidden\' name=\'FormField274_5c675f12-8464-46f8-9e3c-165b04573c04_item_total\' id=\'FormField274_5c675f12-8464-46f8-9e3c-165b04573c04_item_total\' data-export-label=\'Abdominal_Aortic_Ultrasound_item_total\' value=\'40\'><label class=\'control-label  \' >Abdominal Aortic Ultrasound</label><span> ($40.00)</span></div><input type=\'hidden\' name=\'FormField274_5c675f12-8464-46f8-9e3c-165b04573c04_quantity\' id=\'FormField274_5c675f12-8464-46f8-9e3c-165b04573c04_quantity\' data-export-label=\'Abdominal_Aortic_Ultrasound_quantity\' value=\'1\'></div></div><div class=\'fb-section\' style=\'display: none;\' id=\'FormField275_fb167f60-9c87-432f-b9eb-808687217ada\'><div class=\'\'><div class=\'form-group\'><input type=\'hidden\' name=\'FormField276_5c675f12-8464-46f8-9e3c-165b04573c04_description\' id=\'FormField276_5c675f12-8464-46f8-9e3c-165b04573c04_description\' data-export-label=\'Carotid_Artery_Ultrasound_description\' value=\'Carotid Artery Ultrasound\'><input type=\'hidden\' name=\'FormField276_5c675f12-8464-46f8-9e3c-165b04573c04_amount\' id=\'FormField276_5c675f12-8464-46f8-9e3c-165b04573c04_amount\' data-export-label=\'Carotid_Artery_Ultrasound_amount\' value=\'40\'><input type=\'hidden\' name=\'FormField276_5c675f12-8464-46f8-9e3c-165b04573c04_item_total\' id=\'FormField276_5c675f12-8464-46f8-9e3c-165b04573c04_item_total\' data-export-label=\'Carotid_Artery_Ultrasound_item_total\' value=\'40\'><label class=\'control-label  \' >Carotid Artery Ultrasound</label><span> ($40.00)</span></div><input type=\'hidden\' name=\'FormField276_5c675f12-8464-46f8-9e3c-165b04573c04_quantity\' id=\'FormField276_5c675f12-8464-46f8-9e3c-165b04573c04_quantity\' data-export-label=\'Carotid_Artery_Ultrasound_quantity\' value=\'1\'></div></div><div class=\'fb-section\' style=\'display: none;\' id=\'FormField277_fb167f60-9c87-432f-b9eb-808687217ada\'><div class=\'\'><div class=\'form-group\'><input type=\'hidden\' name=\'FormField278_5c675f12-8464-46f8-9e3c-165b04573c04_description\' id=\'FormField278_5c675f12-8464-46f8-9e3c-165b04573c04_description\' data-export-label=\'Bicuspid_Aortic_Valve_description\' value=\'Bicuspid Aortic Valve\'><input type=\'hidden\' name=\'FormField278_5c675f12-8464-46f8-9e3c-165b04573c04_amount\' id=\'FormField278_5c675f12-8464-46f8-9e3c-165b04573c04_amount\' data-export-label=\'Bicuspid_Aortic_Valve_amount\' value=\'90\'><input type=\'hidden\' name=\'FormField278_5c675f12-8464-46f8-9e3c-165b04573c04_item_total\' id=\'FormField278_5c675f12-8464-46f8-9e3c-165b04573c04_item_total\' data-export-label=\'Bicuspid_Aortic_Valve_item_total\' value=\'90\'><label class=\'control-label  \' >Bicuspid Aortic Valve</label><span> ($90.00)</span></div><input type=\'hidden\' name=\'FormField278_5c675f12-8464-46f8-9e3c-165b04573c04_quantity\' id=\'FormField278_5c675f12-8464-46f8-9e3c-165b04573c04_quantity\' data-export-label=\'Bicuspid_Aortic_Valve_quantity\' value=\'1\'></div></div><div class=\'\'><div class=\'form-group\' style=\'display:none\'><label class=\'control-label\'><strong>Subtotal:</strong></label><span class=\'subtotalCostAmount\'></span></div><div class=\'form-group\' style=\'display:none\'><label class=\'control-label\'><strong>Discount:</strong></label><span class=\'promoCodeDiscount\'></span>&nbsp;&#40;<span class=\'appliedPromoCode\'></span>&#41;</div><div class=\'form-group\'><label class=\'control-label  \'><strong>Total Cost:</strong></label><span class=\'totalCostAmount\'></span></div></div><div class=\'overridePayment\'>\
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