document.write("<form method=\"post\" action=\"\" name=\"myform\" id=\"myform\" class=\"formstyle\" target=\"id_iframe3\">     <table width=\"100%\" border=\"2\" cellspacing=\"0\" cellpadding=\"0\">          <tr>               <td class=\"tit\">就<br>                    医<br>                    需<br>                    求</td>               <td class=\"nr nr1\"><p><span>人数：</span>                         <input type=\"text\" class=\"inputstyle\" name=\"info[renshu]\">                    </p>                    <p><span>出发日期：</span>                         <input type=\"text\" class=\"inputstyle\" name=\"info[chufariqi]\">                         <span class=\"color1 spanstyle\" style=\"color:#F00;\">（日期填写格式：2017-01-01，如不确定出发日期，请填写“不确定”）</span></p>                    <p><span>过往体检报告：</span>                         <label class=\"check2\">                              <input type=\"radio\" value=\"有\" id=\"RadioGroup1_0\" name=\"info[tjbg]\">                              有</label>                         <label class=\"check2\">                              <input type=\"radio\" value=\"无\" id=\"RadioGroup1_1\" name=\"info[tjbg]\">                              无</label>                    </p>                    <p style=\"margin-bottom:20px;\"><span>就医需求：</span>                         <input type=\"text\" class=\"inputstyle2\" name=\"info[xuqiu]\">                    </p></td>          </tr>          <tr>               <td class=\"tit\">服<br>                    务<br>                    内<br>                    容</td>               <td class=\"nr nr2\"><p> <span>定制类型：</span>                         <label class=\"check2\">                              <input type=\"radio\" value=\"超值\" id=\"RadioGroup2_0\" name=\"info[leixing]\">                              超值</label>                         <label class=\"check2\">                              <input type=\"radio\" value=\"优质\" id=\"RadioGroup2_1\" name=\"info[leixing]\">                              优质</label>                         <label class=\"check2\">                              <input type=\"radio\" value=\"高端\" id=\"RadioGroup2_2\" name=\"info[leixing]\">                              高端</label>                         <label class=\"check2\">                              <input type=\"radio\" value=\"奢华\" id=\"RadioGroup2_3\" name=\"info[leixing]\">                              奢华</label>                    </p>                    <p> <span>定制内容：</span>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"健康体检\" id=\"CheckboxGroup1_0\" name=\"neirong\">                              健康体检</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"专项检查\" id=\"CheckboxGroup1_1\" name=\"neirong\">                              专项检查</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"整形美容\" id=\"CheckboxGroup1_2\" name=\"neirong\">                              整形美容</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"冻龄美肤\" id=\"CheckboxGroup1_3\" name=\"neirong\">                              冻龄美肤</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"排癌检查\" id=\"CheckboxGroup1_4\" name=\"neirong\">                              排癌检查</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"抗癌治疗\" id=\"CheckboxGroup1_5\" name=\"neirong\">                              抗癌治疗</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"美体塑形\" id=\"CheckboxGroup1_6\" name=\"neirong\">                              美体塑形</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"休闲疗养\" id=\"CheckboxGroup1_7\" name=\"neirong\">                              休闲疗养</label>                         <label class=\"check3 check33\">                              <input type=\"checkbox\" value=\"线路设计\" id=\"CheckboxGroup1_8\" name=\"neirong\">                              线路设计</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"酒店\" id=\"CheckboxGroup1_9\" name=\"neirong\">                              酒店</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"用车\" id=\"CheckboxGroup1_10\" name=\"neirong\">                              用车</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"导游\" id=\"CheckboxGroup1_11\" name=\"neirong\">                              导游</label>                         <label class=\"check3 check33\">                              <input type=\"checkbox\" value=\"门票\" id=\"CheckboxGroup1_12\" name=\"neirong\">                              门票</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"用餐\" id=\"CheckboxGroup1_13\" name=\"neirong\">                              用餐</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"签证\" id=\"CheckboxGroup1_14\" name=\"neirong\">                              签证</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"机票\" id=\"CheckboxGroup1_15\" name=\"neirong\">                              机票</label>                         <input type=\"text\" name=\"info[neirong]\" id=\"neirong\" style=\"display:none;\">                         <script type=\"text/javascript\">                         function checkneirong(){                             obj = document.getElementsByName(\"neirong\");                             check_val = [];                             for(k in obj){                                 if(obj[k].checked)                                     check_val.push(obj[k].value);                             }                             document.getElementById(\"neirong\").value = check_val;                         }                         </script> </p>                    <p> <span style=\"margin-top:5px;\">其他：</span>                         <input type=\"text\" class=\"inputstyle2\" name=\"info[otherneirong]\">                    </p>                    <p> <span>酒店需求：</span>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"三星舒适\" id=\"CheckboxGroup2_0\" disabled name=\"jiudian\">                              三星舒适</label>                         <label class=\"check3\">                              <input type=\"checkbox\" id=\"CheckboxGroup2_1\" value=\"四星高端\" disabled name=\"jiudian\">                              四星高端</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"五星豪华\" id=\"CheckboxGroup2_2\" disabled name=\"jiudian\">                              五星豪华</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"商务连锁\" id=\"CheckboxGroup2_3\" disabled name=\"jiudian\">                              商务连锁</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"特色民宿\" id=\"CheckboxGroup2_4\" disabled name=\"jiudian\">                              特色民宿</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"温泉酒店\" id=\"CheckboxGroup2_5\" disabled name=\"jiudian\">                              温泉酒店</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"主题度假\" id=\"CheckboxGroup2_6\" disabled name=\"jiudian\">                              主题度假</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"不限\" id=\"CheckboxGroup2_7\" disabled name=\"jiudian\">                              不限</label>                         <input type=\"text\" name=\"info[jiudian]\" id=\"jiudian\" style=\"display:none;\">                         <script type=\"text/javascript\">                         function checkjiudian(){                             objs = document.getElementsByName(\"jiudian\");                             check_vals = [];                             for(a in objs){                                 if(objs[a].checked)                                     check_vals.push(objs[a].value);                             }                             document.getElementById(\"jiudian\").value = check_vals;                         }                         </script>                     </p>                    <p style=\"margin-bottom:20px;\"> <span>用餐需求：</span>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"当地特色\" id=\"CheckboxGroup3_0\" disabled name=\"yongcan\">                              当地特色</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"定制师推荐\" id=\"CheckboxGroup3_1\" disabled name=\"yongcan\">                              定制师推荐</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"怀石料理\" id=\"CheckboxGroup3_2\" disabled name=\"yongcan\">                              怀石料理</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"米其林经典\" id=\"CheckboxGroup3_3\" disabled name=\"yongcan\">                              米其林经典</label>                         <input type=\"text\" name=\"info[yongcan]\" id=\"yongcan\" style=\"display:none;\">                         <script type=\"text/javascript\">                         function checkyongcan(){                             objss = document.getElementsByName(\"yongcan\");                             check_valss = [];                             for(b in objss){                                 if(objss[b].checked)                                     check_valss.push(objss[b].value);                             }                             document.getElementById(\"yongcan\").value = check_valss;                         }                         </script>                     </p></td>          </tr>          <tr>               <td class=\"tit\">特<br>                    色<br>                    定<br>                    制</td>               <td class=\"nr nr3\"><p><span>关键字：</span>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"蜜月旅行\" id=\"CheckboxGroup4_0\" name=\"keywords\">                              蜜月旅行</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"怀石料理\" id=\"CheckboxGroup4_1\" name=\"keywords\">                              怀石料理</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"历史名迹\" id=\"CheckboxGroup4_2\" name=\"keywords\">                              历史名迹</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"二次元\" id=\"CheckboxGroup4_3\" name=\"keywords\">                              二次元</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"樱花季\" id=\"CheckboxGroup4_4\" name=\"keywords\">                              樱花季</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"迪士尼\" id=\"CheckboxGroup4_5\" name=\"keywords\">                              迪士尼</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"茶道体验\" id=\"CheckboxGroup4_6\" name=\"keywords\">                              茶道体验</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"和服体验\" id=\"CheckboxGroup4_7\" name=\"keywords\">                              和服体验</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"滑雪\" id=\"CheckboxGroup4_8\" name=\"keywords\">                              滑雪</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"富士山\" id=\"CheckboxGroup4_9\" name=\"keywords\">                              富士山</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"环球影城\" id=\"CheckboxGroup4_10\" name=\"keywords\">                              环球影城</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"购物\" id=\"CheckboxGroup4_11\" name=\"keywords\">                              购物</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"温泉\" id=\"CheckboxGroup4_12\" name=\"keywords\">                              温泉</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"医疗美容\" id=\"CheckboxGroup4_13\" name=\"keywords\">                              医疗美容</label>                         <label class=\"check3 marginleft\">                              <input type=\"checkbox\" value=\"极限运动\" id=\"CheckboxGroup4_14\" name=\"keywords\">                              极限运动</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"休闲度假\" id=\"CheckboxGroup4_15\" name=\"keywords\">                              休闲度假</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"北海道\" id=\"CheckboxGroup4_16\" name=\"keywords\">                              北海道</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"冲绳\" id=\"CheckboxGroup4_17\" name=\"keywords\">                              冲绳</label>                         <input type=\"text\" name=\"info[keywords]\" id=\"keywords\" style=\"display:none;\">                         <script type=\"text/javascript\">                         function checkkeywords(){                             objsss = document.getElementsByName(\"keywords\");                             check_valsss = [];                             for(c in objsss){                                 if(objsss[c].checked)                                     check_valsss.push(objsss[c].value);                             }                             document.getElementById(\"keywords\").value = check_valsss;                         }                         </script>                     </p>                    <p style=\"margin-bottom:20px;\"><span style=\"margin-top:5px;\">其他需求：</span>                         <input type=\"text\" class=\"inputstyle2\" name=\"info[otherxuqiu]\">                    </p></td>          </tr>          <tr>               <td class=\"tit\">联<br>                    系<br>                    人<br>                    信<br>                    息</td>               <td class=\"nr nr4\"><p><span>姓名：</span>                         <input type=\"text\" class=\"inputstyle\" name=\"info[yname]\">                         <span>性别：</span>                         <select class=\"sexstyle\" name=\"info[ysex]\">                              <option value=\"男\">男</option>                              <option value=\"女\">女</option>                         </select>                    </p>                    <p><span>手机号码：</span>                         <input type=\"text\" class=\"inputstyle\" name=\"info[iphone]\">                    </p>                    <p><span>邮箱：</span>                         <input type=\"text\" class=\"inputstyle\" name=\"info[email]\">                         <span>微信：</span>                         <input type=\"text\" class=\"inputstyle\" name=\"info[weixin]\">                         <span>QQ：</span>                         <input type=\"text\" class=\"inputstyle\" name=\"info[qqnumber]\">                    </p>                    <p><span class=\"lx\">您希望的联系方式：</span>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"电话\" id=\"CheckboxGroup5_0\" name=\"howtocontact\">                              电话</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"微信\" id=\"CheckboxGroup5_1\" name=\"howtocontact\">                              微信</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"QQ\" id=\"CheckboxGroup5_2\" name=\"howtocontact\">                              QQ</label>                         <label class=\"check3\">                              <input type=\"checkbox\" value=\"邮箱\" id=\"CheckboxGroup5_3\" name=\"howtocontact\">                              邮箱</label>                         <input type=\"text\" name=\"info[howtocontact]\" id=\"howtocontact\" style=\"display:none;\">                         <script type=\"text/javascript\">                         function checkhowtocontact(){                             objssss = document.getElementsByName(\"howtocontact\");                             check_valssss = [];                             for(d in objssss){                                 if(objssss[d].checked)                                     check_valssss.push(objssss[d].value);                             }                             document.getElementById(\"howtocontact\").value = check_valssss;                         }                         </script>                     </p>                    <p class=\"color3\">*手机，邮箱，微信，QQ 四种联系方式至少输入1 种</p></td>          </tr>     </table>     <input type=\"submit\" value=\"提交定制需求\" class=\"subdzxq\"  onClick=\"addUser()\" name=\"dosubmit\" id=\"dosubmit\"></form><iframe id=\"id_iframe3\" name=\"id_iframe3\" style=\" display:none;\"></iframe><script type=\"text/javascript\">$(document).ready(function(){$(\"#CheckboxGroup1_9\").click(function(){   if($(this).attr(\"checked\")==\"checked\"){$(\"#CheckboxGroup2_0\").not($(this)).removeAttr(\"disabled\");$(\"#CheckboxGroup2_1\").not($(this)).removeAttr(\"disabled\");$(\"#CheckboxGroup2_2\").not($(this)).removeAttr(\"disabled\");$(\"#CheckboxGroup2_3\").not($(this)).removeAttr(\"disabled\");$(\"#CheckboxGroup2_4\").not($(this)).removeAttr(\"disabled\");$(\"#CheckboxGroup2_5\").not($(this)).removeAttr(\"disabled\");$(\"#CheckboxGroup2_6\").not($(this)).removeAttr(\"disabled\");$(\"#CheckboxGroup2_7\").not($(this)).removeAttr(\"disabled\");    } else{ $(\"#CheckboxGroup2_0\").not($(this)).attr(\"disabled\",true); $(\"#CheckboxGroup2_0\").not($(this)).removeAttr(\"checked\",true); $(\"#CheckboxGroup2_1\").not($(this)).attr(\"disabled\",true); $(\"#CheckboxGroup2_1\").not($(this)).removeAttr(\"checked\",true); $(\"#CheckboxGroup2_2\").not($(this)).attr(\"disabled\",true); $(\"#CheckboxGroup2_2\").not($(this)).removeAttr(\"checked\",true); $(\"#CheckboxGroup2_3\").not($(this)).attr(\"disabled\",true); $(\"#CheckboxGroup2_3\").not($(this)).removeAttr(\"checked\",true); $(\"#CheckboxGroup2_4\").not($(this)).attr(\"disabled\",true); $(\"#CheckboxGroup2_4\").not($(this)).removeAttr(\"checked\",true); $(\"#CheckboxGroup2_5\").not($(this)).attr(\"disabled\",true); $(\"#CheckboxGroup2_5\").not($(this)).removeAttr(\"checked\",true); $(\"#CheckboxGroup2_6\").not($(this)).attr(\"disabled\",true); $(\"#CheckboxGroup2_6\").not($(this)).removeAttr(\"checked\",true); $(\"#CheckboxGroup2_7\").not($(this)).attr(\"disabled\",true); $(\"#CheckboxGroup2_7\").not($(this)).removeAttr(\"checked\",true);    }      });    $(\"#CheckboxGroup1_13\").click(function(){   if($(this).attr(\"checked\")==\"checked\"){    $(\"#CheckboxGroup3_0\").not($(this)).removeAttr(\"disabled\");$(\"#CheckboxGroup3_1\").not($(this)).removeAttr(\"disabled\");$(\"#CheckboxGroup3_2\").not($(this)).removeAttr(\"disabled\");$(\"#CheckboxGroup3_3\").not($(this)).removeAttr(\"disabled\");   }   else{     $(\"#CheckboxGroup3_0\").not($(this)).attr(\"disabled\",true); $(\"#CheckboxGroup3_0\").not($(this)).removeAttr(\"checked\",true); $(\"#CheckboxGroup3_1\").not($(this)).attr(\"disabled\",true); $(\"#CheckboxGroup3_1\").not($(this)).removeAttr(\"checked\",true); $(\"#CheckboxGroup3_2\").not($(this)).attr(\"disabled\",true); $(\"#CheckboxGroup3_2\").not($(this)).removeAttr(\"checked\",true); $(\"#CheckboxGroup3_3\").not($(this)).attr(\"disabled\",true); $(\"#CheckboxGroup3_3\").not($(this)).removeAttr(\"checked\",true);   } });}); </script> <script type=\"text/javascript\"> function addUser(){ checkneirong(); checkjiudian(); checkyongcan(); checkkeywords(); checkhowtocontact(); document.getElementById(\"myform\").submit();     alert(\"定制成功，我们会尽快与您联系！\");}</script>");