function validate_form ( )
{
	valid = true;
	if ( document.pharmacy.RX_Number_1.value == "" )
    {
	    alert ( "You are required to enter at least one RX Number." );
        valid = false;
    }
	if ( document.pharmacy.lid.value == "" )
    {
	    alert ( "Please select whether or not you want an easy open lid." );
        valid = false;
    }
	if ( document.pharmacy.delivery.value == "" )
    {
	    alert ( "Please select whether you would like to pick up your prescription or if you would like it delivered." );
        valid = false;
    }
	if ( document.pharmacy.name.value == "" )
    {
	    alert ( "Please fill in your Full Name." );
        valid = false;
    }
  	if ( document.pharmacy.address.value == "" )
	{
	    alert ( "Please fill in your Address." );
	    valid = false;
	}
	if ( document.pharmacy.city.value == "" )
	{
	    alert ( "Please fill in your City." );
	    valid = false;
	}
	if ( document.pharmacy.state.value == "" )
    {
	    alert ( "Please fill in your State." );
	    valid = false;
	}
	if ( document.pharmacy.zip.value == "" )
    {
	    alert ( "Please fill in your Zip Code." );
	    valid = false;
	}
    if ( document.pharmacy.phone.value == "" )
	{
	    alert ( "Please fill in your Phone Number." );
	    valid = false;
	}

	if ( document.pharmacy.email.value == "" )
    {
	    alert ( "Please fill in your Email Address." );
        valid = false;
    } 
    return valid;
}