<% Function SendMail(strfrom,strto,cc,bcc,subject,body,component) component=UCase(component) format=UCase(format) Select case component Case "CDO": Set mobj=Server.CreateObject("CDO.Message") mobj.Configuration.Fields.Item("http://schemas.microsoft.com/cdo/configuration/sendusing")=1 mobj.Configuration.Fields.Item("http://schemas.microsoft.com/cdo/configuration/smtpserver")="localhost" mobj.Configuration.Fields.Item("http://schemas.microsoft.com/cdo/configuration/smtpserverpickupdirectory")="C:\Inetpub\mailroot\Pickup" mobj.Configuration.Fields.Item("http://schemas.microsoft.com/cdo/configuration/smtpserverport")=25 mobj.Configuration.Fields.Update mobj.From=strfrom mobj.ReplyTo=strfrom mobj.To=strto mobj.Subject=subject mobj.HTMLbody=body mobj.Cc=cc mobj.Bcc=bcc mobj.Send Set mobj=Nothing Case "CDONTS": Set mobj=Server.CreateObject("CDONTS.NewMail") mobj.From=strfrom mobj.To=strto mobj.Value("Reply-To")=strfrom mobj.Subject=subject mobj.body=body mobj.MailFormat = 0 mobj.BodyFormat = 0 mobj.Cc=cc mobj.Bcc=bcc mobj.Send Set mobj=Nothing End Select End Function '---------------------------------- %> <% function TestCaptcha(byval valSession, byval valCaptcha) dim tmpSession valSession = Trim(valSession) valCaptcha = Trim(valCaptcha) if (valSession = vbNullString) or (valCaptcha = vbNullString) then TestCaptcha = false else tmpSession = valSession valSession = Trim(Session(valSession)) Session(tmpSession) = vbNullString if valSession = vbNullString then TestCaptcha = false else valCaptcha = Replace(valCaptcha,"i","I") if StrComp(valSession,valCaptcha,1) = 0 then TestCaptcha = true else TestCaptcha = false end if end if end if end function %> <% action=Request("action") if Request.ServerVariables("REQUEST_METHOD") = "POST" then if TestCaptcha("ASPCAPTCHA", Request.Form("captchacode")) then bdy="
"& _ "New comments:
"& _ "Date: "& now & _ "
"& _ "

"& _ "Company Name: "& Request("company_name") &"
" & _ "Name: "& Request("name") &"
" & _ "Email: "& Request("email") &"
" & _ "Phone: "& Request("phone") &"
" & _ "Comments:

"& Request("comments") &"

"& _ "

"& _ "
" Sender=Request.Form("email") Recepient="jenniferpare@midvtmedicalbilling.com" SendMail Sender,Recepient,"","","Mid VT Medical Billing Contact Us Form",(bdy),"cdo" ErrMsg="Your information has been sent successfully.
" else ErrMsg="Image verification did not pass, please try again.
" end if end if %> Contact Mid-Vermont Medical Billing, Rutland, Vermont  
 
 
   


 

 

 

 

 

 

 

<%=ErrMsg%>


Fields Marked With * Are Required

Company Name:


*Your Name:



*Email:


*Phone:


Comments:

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