$meshednew->firmname = mysql_real_escape_string($_REQUEST['firm_name']);
$meshednew->address = mysql_real_escape_string($_REQUEST['address']);
$meshednew->phone = mysql_real_escape_string($_REQUEST['p_phone']);
$meshednew->fax = mysql_real_escape_string($_REQUEST['p_fax']);
$meshednew->contactp = mysql_real_escape_string($_REQUEST['p_contact_person']);
$meshednew->position = mysql_real_escape_string($_REQUEST['p_position']);
$meshednew->p_email = mysql_real_escape_string($_REQUEST['p_email']);
$meshednew->other_documents_m = $_POST['other_documents'];
$meshednew->travel_m = $_POST['travel_bills'];
$meshednew->medical_bills_m = $_POST['medical_bills'];
$meshednew->medical_records_m = $_POST['medical_records'];
$meshednew->product_label_m = $_POST['product_label'];
$meshednew->s_m_r_f_m = $_POST['signed_medical_records'];
$meshednew->user_email_m = $_SESSION['email'];
$case_type = "4";
$final = $meshednew->MeshedStep($form_id, $user_id, $att_id, $case_type);
if ($final == 1) {
echo "<div class='thank_message'>Your Form is Submitted Successfully. You will get an email when form is accepted by Admin</div>";
header("Refresh:3; url=index.php");
unset($_SESSION['email']);
}
}
?>
<h1>General Surgery Step-2 Form</h1>
<form name="meshed" method="post" action="" id="registration">
<div class="client_2">
<h2>Attorney / Case Manager Information</h2>
<?php
$c_att_informaiton = mysql_query("SELECT * FROM `members` where `id`= '{$att_id}'") or die(mysql_error());
$get_att_information = mysql_fetch_object($c_att_informaiton);
?>
