function checkForm() {

	var formError = Boolean(false);
	var fieldList = new Array();
	
	var typeFeedback = document.getElementById('Feedback').checked;
	var typeAssistance = document.getElementById('Assistance').checked;
	if(!typeFeedback && !typeAssistance) {
		formError = true;
		fieldList.push("Type of Inquiry/Comment");
	}
	
	if(typeAssistance && document.getElementById('First_name').value == "") {
		formError = true;
		fieldList.push("First Name");
	}
	
	if(typeAssistance && document.getElementById('Last_name').value == "") {
		formError = true;
		fieldList.push("Last Name");
	}

	if(typeAssistance && document.getElementById('Address').value == "") {
		formError = true;
		fieldList.push("Address");
	}

	if(typeAssistance && document.getElementById('City').value == "") {
		formError = true;
		fieldList.push("City");
	}

	if(typeAssistance && document.getElementById('State').value == "") {
		formError = true;
		fieldList.push("State");
	}

	if(typeAssistance && document.getElementById('Zip').value == "") {
		formError = true;
		fieldList.push("Zip");
	}

	if(typeAssistance && document.getElementById('Email').value == "") {
		formError = true;
		fieldList.push("Email");
	}

	if(typeAssistance && document.getElementById('What_information_are_you_trying_to_find').value == "") {
		formError = true;
		fieldList.push("What information are you trying to find?");
	}


	var findYes = document.getElementById('find_yes').checked;
	var findNo = document.getElementById('find_no').checked;
	if(typeFeedback && !findYes && !findNo) {
		formError = true;
		fieldList.push("Did you find what you needed?");
	}
	
	if(typeFeedback && document.getElementById('What_were_you_trying_to_find').value == "") {
		formError = true;
		fieldList.push("What were you trying to find?");
	}
	
	var easyYes = document.getElementById('easy_yes').checked;
	var easyNo = document.getElementById('easy_no').checked;
	if(typeFeedback && !easyYes && !easyNo) {
		formError = true;
		fieldList.push("Was it easy to find?");
	}
	
	var visitDaily = document.getElementById('daily').checked;
	var visitMonthly = document.getElementById('monthly').checked;
	var visitWeekly = document.getElementById('weekly').checked;
	var visitFirst = document.getElementById('first_time').checked;
	if(!visitDaily && !visitMonthly && !visitWeekly && visitFirst) {
		formError = true;
		fieldList.push("How often do you visit our website?");
	}
	
	var visitYes = document.getElementById('visit_yes').checked;
	var visitNo = document.getElementById('visit_no').checked;
	if(!visitYes && !visitNo) {
		formError = true;
		fieldList.push("Will you visit our site again?");
	}
	
	var isMember = document.getElementById('PHP_member').checked;
	var isPatient = document.getElementById('Patient').checked;
	if(!isMember && !isPatient && document.getElementById('Other').value == "") {
		formError = true;
		fieldList.push("Are you?");
	}
	
	if(formError) {
		alert("Please check the listed fields, and try again:\n\n" + fieldList.join("\n"));
		return false;
	} else {
		return true;
	}
	
}