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			<content><view isenabled="True" title="" causesvalidation="Yes" viewid="VIEW-20000027" viewname="CordisDirectRequestAccess" width="100%"><span><table isenabled="True" title="" controltype="table" causesvalidation="Yes" width="100%" cellspacing="5" cellpadding="5"><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><table isenabled="True" title="" class="Border" controltype="table" causesvalidation="Yes" width="100%" cellspacing="5" cellpadding="5" style="width:100%;"><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-Header" style="pointer-events:none;">Request Online Access</span></div><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-Subheader" style="pointer-events:none;">If you are currently a customer of Cordis, and do not have an account to access the customer portal, please submit below information and you will be contacted shortly to complete your online access.</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><table id="Form" name="Form" containerid="VIEW-20000027" isenabled="True" title="" class="Border" controltype="table" causesvalidation="Yes" width="100%" cellspacing="5" cellpadding="5" style="width:100%;"><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" valign="Top" controltype="cell" causesvalidation="Yes" style="width:50%;"><table isenabled="True" title="" class="Border" controltype="table" causesvalidation="Yes" width="100%" cellspacing="5" cellpadding="5" style="width:100%;"><tr><td colspan="1"><table class="CDRAForm-SectionTitle" style=""><tr><td onclick="javascript:void(0);" style="cursor: unset;">Account Information</td></tr></table></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-FieldDescLabel" style="pointer-events:none;">Customer Number *</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><label template="Modern" class="text-field-wrap" visible=""><input id="CustomerNumber" name="CustomerNumber" containerid="VIEW-20000027" isenabled="True" title="" isrequired="Yes" requireerrormessage="Customer Number is required" description="" htmlvalidation="true" validationgroup="Default" validatordisplaymode="" controltype="textbox" causesvalidation="Yes" maxlength="8" oninputtimeout="" type="text" value="" placeholder="" style="width:100%;" onkeydown="TextBox_Submit(event, this, '')" /><span class="label-text" visible=""><span>*</span></span></label></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-FieldDescLabel" style="pointer-events:none;">Company Name *</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><label template="Modern" class="text-field-wrap" visible=""><input id="CompanyName" name="CompanyName" containerid="VIEW-20000027" isenabled="True" title="" isrequired="Yes" requireerrormessage="Company Name is required" description="" htmlvalidation="true" validationgroup="Default" validatordisplaymode="" controltype="textbox" causesvalidation="Yes" maxlength="30" oninputtimeout="" type="text" value="" placeholder="" style="width:100%;" onkeydown="TextBox_Submit(event, this, '')" /><span class="label-text" visible=""><span>*</span></span></label></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-FieldDescLabel" style="pointer-events:none;">Phone Number *</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><label template="Modern" class="text-field-wrap" visible=""><input id="PhoneNumber" name="PhoneNumber" containerid="VIEW-20000027" isenabled="True" title="" isrequired="Yes" requireerrormessage="Phone Number is required" description="" htmlvalidation="true" validationgroup="Default" validatordisplaymode="" controltype="textbox" causesvalidation="Yes" maxlength="20" oninputtimeout="" type="text" value="" placeholder="" style="width:100%;" onkeydown="TextBox_Submit(event, this, '')" /><span class="label-text" visible=""><span>*</span></span></label></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-FieldDescLabel" style="pointer-events:none;">Website Address</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><label template="Modern" class="text-field-wrap" visible=""><input id="WebsiteAddress" name="WebsiteAddress" containerid="VIEW-20000027" isenabled="True" title="" controltype="textbox" causesvalidation="Yes" maxlength="255" oninputtimeout="" type="text" value="" placeholder="" style="width:100%;" onkeydown="TextBox_Submit(event, this, '')" /><span class="label-text" visible=""></span></label></td></tr></table></td><td isenabled="True" title="" valign="Top" controltype="cell" causesvalidation="Yes" style="width:50%;"><table isenabled="True" title="" class="Border" controltype="table" causesvalidation="Yes" width="100%" cellspacing="5" cellpadding="5" style="width:100%;"><tr><td colspan="1"><table class="CDRAForm-SectionTitle" style=""><tr><td onclick="javascript:void(0);" style="cursor: unset;">Address</td></tr></table></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-FieldDescLabel" style="pointer-events:none;">Address Line 1 *</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><label template="Modern" class="text-field-wrap" visible=""><input id="AddressLine1" name="AddressLine1" containerid="VIEW-20000027" isenabled="True" title="" isrequired="Yes" requireerrormessage="Address Line 1 is required" description="" htmlvalidation="true" validationgroup="Default" validatordisplaymode="" controltype="textbox" causesvalidation="Yes" maxlength="40" oninputtimeout="" type="text" value="" placeholder="" style="width:100%;" onkeydown="TextBox_Submit(event, this, '')" /><span class="label-text" visible=""><span>*</span></span></label></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-FieldDescLabel" style="pointer-events:none;">Address Line 2</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><label template="Modern" class="text-field-wrap" visible=""><input id="AddressLine2" name="AddressLine2" containerid="VIEW-20000027" isenabled="True" title="" controltype="textbox" causesvalidation="Yes" maxlength="40" oninputtimeout="" type="text" value="" placeholder="" style="width:100%;" onkeydown="TextBox_Submit(event, this, '')" /><span class="label-text" visible=""></span></label></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-FieldDescLabel" style="pointer-events:none;">City *</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><label template="Modern" class="text-field-wrap" visible=""><input id="City" name="City" containerid="VIEW-20000027" isenabled="True" title="" isrequired="Yes" requireerrormessage="City is required" description="" htmlvalidation="true" validationgroup="Default" validatordisplaymode="" controltype="textbox" causesvalidation="Yes" maxlength="25" oninputtimeout="" type="text" value="" placeholder="" style="width:100%;" onkeydown="TextBox_Submit(event, this, '')" /><span class="label-text" visible=""><span>*</span></span></label></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><table isenabled="True" title="" class="Border" controltype="table" causesvalidation="Yes" width="100%" cellspacing="5" cellpadding="5" style="width:100%;"><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:50%;"><table isenabled="True" title="" class="Border" controltype="table" causesvalidation="Yes" width="100%" cellspacing="0" cellpadding="0" style="width:100%;"><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-FieldDescLabel" style="pointer-events:none;">State *</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><span><label class="text-field-wrap" visible=""><select id="State" name="State" containerid="VIEW-20000027" isenabled="True" title="" isrequired="Yes" requireerrormessage="State is required" description="" htmlvalidation="true" validationgroup="Default" validatordisplaymode="" controltype="dropdown" causesvalidation="Yes" selectispreselect="True" ispreselect="True" template="Modern" style="width:100%;"><option value="">- Select -</option><option value="AL">Alabama</option><option value="AK">Alaska</option><option value="AZ">Arizona</option><option value="AR">Arkansas</option><option value="CA">California</option><option value="CO">Colorado</option><option value="CT">Connecticut</option><option value="DE">Delaware</option><option value="FL">Florida</option><option value="GA">Georgia</option><option value="HI">Hawaii</option><option value="ID">Idaho</option><option value="IL">Illinois</option><option value="IN">Indiana</option><option value="IA">Iowa</option><option value="KS">Kansas</option><option value="KY">Kentucky</option><option value="LA">Louisiana</option><option value="ME">Maine</option><option value="MD">Maryland</option><option value="MA">Massachusetts</option><option value="MI">Michigan</option><option value="MN">Minnesota</option><option value="MS">Mississippi</option><option value="MO">Missouri</option><option value="MT">Montana</option><option value="NE">Nebraska</option><option value="NV">Nevada</option><option value="NH">New Hampshire</option><option value="NJ">New Jersey</option><option value="NM">New Mexico</option><option value="NY">New York</option><option value="NC">North Carolina</option><option value="ND">North Dakota</option><option value="OH">Ohio</option><option value="OK">Oklahoma</option><option value="OR">Oregon</option><option value="PA">Pennsylvania</option><option value="RI">Rhode Island</option><option value="SC">South Carolina</option><option value="SD">South Dakota</option><option value="TN">Tennessee</option><option value="TX">Texas</option><option value="UT">Utah</option><option value="VT">Vermont</option><option value="VA">Virginia</option><option value="WA">Washington</option><option value="WV">West Virginia</option><option value="WI">Wisconsin</option><option value="WY">Wyoming</option></select><span class="label-text" visible=""><span>*</span></span></label></span></td></tr></table></td><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:50%;"><table isenabled="True" title="" class="Border" controltype="table" causesvalidation="Yes" width="100%" cellspacing="0" cellpadding="0" style="width:100%;"><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-FieldDescLabel" style="pointer-events:none;">Zip Code *</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><label template="Modern" class="text-field-wrap" visible=""><input id="ZipCode" name="ZipCode" containerid="VIEW-20000027" isenabled="True" title="" isrequired="Yes" requireerrormessage="Zip Code is required" description="" htmlvalidation="true" validationgroup="Default" validatordisplaymode="" controltype="textbox" causesvalidation="Yes" maxlength="12" oninputtimeout="" type="text" value="" placeholder="" style="width:100%;" onkeydown="TextBox_Submit(event, this, '')" /><span class="label-text" visible=""><span>*</span></span></label></td></tr></table></td></tr></table></td></tr></table></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" valign="Top" controltype="cell" causesvalidation="Yes" style="width:50%;"><table isenabled="True" title="" class="Border" controltype="table" causesvalidation="Yes" width="100%" cellspacing="5" cellpadding="5" style="width:100%;"><tr><td colspan="1"><table class="CDRAForm-SectionTitle" style=""><tr><td onclick="javascript:void(0);" style="cursor: unset;">Contact</td></tr></table></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-FieldDescLabel" style="pointer-events:none;">First Name *</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><label template="Modern" class="text-field-wrap" visible=""><input id="FirstName" name="FirstName" containerid="VIEW-20000027" isenabled="True" title="" isrequired="Yes" requireerrormessage="First Name is required" description="" htmlvalidation="true" validationgroup="Default" validatordisplaymode="" controltype="textbox" causesvalidation="Yes" maxlength="25" oninputtimeout="" type="text" value="" placeholder="" style="width:100%;" onkeydown="TextBox_Submit(event, this, '')" /><span class="label-text" visible=""><span>*</span></span></label></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-FieldDescLabel" style="pointer-events:none;">Last Name *</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><label template="Modern" class="text-field-wrap" visible=""><input id="LastName" name="LastName" containerid="VIEW-20000027" isenabled="True" title="" isrequired="Yes" requireerrormessage="Last Name is required" description="" htmlvalidation="true" validationgroup="Default" validatordisplaymode="" controltype="textbox" causesvalidation="Yes" maxlength="25" oninputtimeout="" type="text" value="" placeholder="" style="width:100%;" onkeydown="TextBox_Submit(event, this, '')" /><span class="label-text" visible=""><span>*</span></span></label></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-FieldDescLabel" style="pointer-events:none;">Email *</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><label template="Modern" class="text-field-wrap" visible=""><input id="Email" name="Email" containerid="VIEW-20000027" isenabled="True" title="" isrequired="Yes" requireerrormessage="Email is required" description="" htmlvalidation="true" validationgroup="Default" validatordisplaymode="" controltype="textbox" causesvalidation="Yes" maxlength="256" oninputtimeout="" type="text" value="" placeholder="" style="width:100%;" onkeydown="TextBox_Submit(event, this, '')" /><span class="label-text" visible=""><span>*</span></span></label></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-FieldDescLabel" style="pointer-events:none;">Contact Phone Number *</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><label template="Modern" class="text-field-wrap" visible=""><input id="ContactPhoneNumber" name="ContactPhoneNumber" containerid="VIEW-20000027" isenabled="True" title="" isrequired="Yes" requireerrormessage="Contact Phone Number is required" description="" htmlvalidation="true" validationgroup="Default" validatordisplaymode="" controltype="textbox" causesvalidation="Yes" maxlength="20" oninputtimeout="" type="text" value="" placeholder="" style="width:100%;" onkeydown="TextBox_Submit(event, this, '')" /><span class="label-text" visible=""><span>*</span></span></label></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-FieldDescLabel" style="pointer-events:none;">Contact Title *</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><label template="Modern" class="text-field-wrap" visible=""><input id="ContactTitle" name="ContactTitle" containerid="VIEW-20000027" isenabled="True" title="" isrequired="Yes" requireerrormessage="Contact Title is required" description="" htmlvalidation="true" validationgroup="Default" validatordisplaymode="" controltype="textbox" causesvalidation="Yes" maxlength="30" oninputtimeout="" type="text" value="" placeholder="" style="width:100%;" onkeydown="TextBox_Submit(event, this, '')" /><span class="label-text" visible=""><span>*</span></span></label></td></tr></table></td><td isenabled="True" title="" valign="Top" controltype="cell" causesvalidation="Yes" style="width:50%;"><table isenabled="True" title="" class="Border" controltype="table" causesvalidation="Yes" width="100%" cellspacing="5" cellpadding="5" style="width:100%;"><tr><td colspan="1"><table class="CDRAForm-SectionTitle" style=""><tr><td onclick="javascript:void(0);" style="cursor: unset;">Additional Account Numbers</td></tr></table></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-FieldDescLabel" style="pointer-events:none;">Please enter additional customer numbers, separated by a comma (Ex: 10000031, 1000032, 1000033)</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><label template="Modern" class="text-field-wrap" visible=""><textarea id="AddlCustomerNumbers" name="AddlCustomerNumbers" containerid="VIEW-20000027" isenabled="True" title="" controltype="textbox" causesvalidation="Yes" maxlength="200" oninputtimeout="" value="" placeholder="" style="width:100%;" onkeydown="TextBox_Submit(event, this, '')"></textarea><span class="label-text" visible=""></span></label></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-FieldDescLabel" style="pointer-events:none;">Please select the option(s) you wish to request access to</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><span ischecked="False" ispreselect="True" type="checkbox" containerid="VIEW-20000027" htmlid="OrderStatusCheckbox"><input id="OrderStatusCheckbox" name="OrderStatusCheckbox" containerid="VIEW-20000027" htmlid="OrderStatusCheckbox" value="" textval="Order Status" isenabled="True" title="" controltype="checkbox" causesvalidation="Yes" type="checkbox" /><label id="OrderStatusCheckbox_Text" for="OrderStatusCheckbox" name="OrderStatusCheckbox_Text">Order Status</label></span></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><span ischecked="False" ispreselect="True" type="checkbox" containerid="VIEW-20000027" htmlid="QuickOrderCheckbox"><input id="QuickOrderCheckbox" name="QuickOrderCheckbox" containerid="VIEW-20000027" htmlid="QuickOrderCheckbox" value="" textval="Quick Order" isenabled="True" title="" controltype="checkbox" causesvalidation="Yes" type="checkbox" /><label id="QuickOrderCheckbox_Text" for="QuickOrderCheckbox" name="QuickOrderCheckbox_Text">Quick Order</label></span></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><span ischecked="False" ispreselect="True" type="checkbox" containerid="VIEW-20000027" htmlid="InvoicePaymentsCheckbox"><input id="InvoicePaymentsCheckbox" name="InvoicePaymentsCheckbox" containerid="VIEW-20000027" htmlid="InvoicePaymentsCheckbox" value="" textval="Invoice Payments" isenabled="True" title="" controltype="checkbox" causesvalidation="Yes" type="checkbox" /><label id="InvoicePaymentsCheckbox_Text" for="InvoicePaymentsCheckbox" name="InvoicePaymentsCheckbox_Text">Invoice Payments</label></span></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><span ischecked="False" ispreselect="True" type="checkbox" containerid="VIEW-20000027" htmlid="AccountBalanceCheckbox"><input id="AccountBalanceCheckbox" name="AccountBalanceCheckbox" containerid="VIEW-20000027" htmlid="AccountBalanceCheckbox" value="" textval="Account Balance" isenabled="True" title="" controltype="checkbox" causesvalidation="Yes" type="checkbox" /><label id="AccountBalanceCheckbox_Text" for="AccountBalanceCheckbox" name="AccountBalanceCheckbox_Text">Account Balance</label></span></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-FieldDescLabel" style="pointer-events:none;">Could you please provide the most recent PO number for the account?</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><label template="Modern" class="text-field-wrap" visible=""><input id="RecentPO" name="RecentPO" containerid="VIEW-20000027" isenabled="True" title="" controltype="textbox" causesvalidation="Yes" maxlength="30" oninputtimeout="" type="text" value="" placeholder="" style="width:100%;" onkeydown="TextBox_Submit(event, this, '')" /><span class="label-text" visible=""></span></label></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;" /></tr></table></td></tr></table></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><table isenabled="True" title="" class="Border" controltype="table" causesvalidation="Yes" width="100%" cellspacing="5" cellpadding="5" style="width:100%;"><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-FieldDescLabel" style="pointer-events:none;">How did you hear about CordisDirect.com? *</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><span><label class="text-field-wrap" visible=""><select id="HowDidYouHear" name="HowDidYouHear" containerid="VIEW-20000027" isenabled="True" title="" isrequired="Yes" requireerrormessage="How Did You Hear About Us is required" description="" htmlvalidation="true" validationgroup="Default" validatordisplaymode="" controltype="dropdown" causesvalidation="Yes" selectispreselect="True" ispreselect="True" template="Modern" style="width:100%;"><option value=""></option><option value="A">
																																																																																																																													Search Engine: i.e., Google</option><option value="B">
																																																																																																																														Sales Manager</option><option value="C">
																																																																																																																															Customer Service</option><option value="D">
																																																																																																																																Social Media/Email</option><option value="E">
																																																																																																																																	Cordis Communication</option><option value="F">
																																																																																																																																		Bill/Invoice/Statement</option><option value="G">
																																																																																																																																			Other</option></select><span class="label-text" visible=""><span>*</span></span></label></span></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><div isenabled="True" title="" controltype="label" causesvalidation="Yes" control-type="label"><div control-title="" style="pointer-events:none;"></div><span class="CDRAForm-FieldDescLabel" style="pointer-events:none;">Add Additional Comments Below</span></div></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><label template="Modern" class="text-field-wrap" visible=""><textarea id="AdditionalComments" name="AdditionalComments" containerid="VIEW-20000027" isenabled="True" title="" controltype="textbox" causesvalidation="Yes" maxlength="1000" oninputtimeout="" value="" placeholder="" style="width:100%;" onkeydown="TextBox_Submit(event, this, '')"></textarea><span class="label-text" visible=""></span></label></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><span id="CordisDirectRequestAccess_Submit_click_ScriptTag" style="display:none;"><script>
																																																																																																																																									function CordisDirectRequestAccess_Submit_click(event, target, loopIndex, modelDataObj, returnValueToFormValue, returnValueToFormDescription) { if(loopIndex == null || loopIndex == undefined || loopIndex == "") { loopIndex = 0; if(event.detail?.WorkData?._LoopData?.LoopIndex) { loopIndex = event.detail.WorkData._LoopData.LoopIndex } } if(target != null && target != undefined) { let targetId = target.id; if(targetId != null && targetId != undefined && targetId !="") { let modelDataObjAttribute = document.getElementById(targetId).getAttribute("modelDataObjclick"); if(modelDataObjAttribute != null && modelDataObjAttribute != undefined && modelDataObjAttribute !=  "") { modelDataObjAttribute = modelDataObjAttribute.replaceAll("'", "\""); let tempModelDataObj = JSON.parse(modelDataObjAttribute); if(tempModelDataObj != null && tempModelDataObj != undefined) { modelDataObj = tempModelDataObj; } } } }let args = {"WorkData":{"TenantId":"","TenantName":"","ApplicationId":"","ApplicationName":"","ViewName":"","EventName":"","SearchElement":"","ControlId":"","Action":"","_LoopData":{"LoopIndex":""},"_ControllerParameters":{"AccountBalance":"","AdditionalAccountNo":"","AddressLine1":"","AddressLine2":"","CaptchaToken":"","City":"","Comments":"","CompanyName":"","CustomerNumber":"","Email":"","FirstName":"","InformationSource":"","InvoicePayments":"","LastName":"","LatestPONumber":"","OrderStatus":"","PhoneNumber":"","PhoneNumber2":"","QuickOrder":"","State":"","Title":"","WebSite":"","ZipCode":""}}}; args.WorkData.TenantId = '1093'; args.WorkData.TenantName = 'Cordis'; args.WorkData.ApplicationId = '21001335'; args.WorkData.ApplicationName = 'CordisSales'; args.WorkData.ViewName = 'CordisDirectRequestAccess'; args.WorkData.EventName = 'Submit'; args.WorkData.ControlId = 'c_100254'; try { if (event.target) { args.WorkData.Action = event.target.getAttribute('action'); } } catch {}let CordisDirectRequestAccess_Submit_click_1_CallbackFunction = function() {}; let searchElement = null; let parent = $(target).parents('view[viewid="VIEW-20000027"]'); if (parent != null && parent != undefined && parent.length != 0) { searchElement = parent[0]; } else { if(target?.tagName?.toLowerCase() == 'view') { let viewIdAttribute = target.getAttribute('viewid'); if(viewIdAttribute && viewIdAttribute != '') { if(viewIdAttribute == 'VIEW-20000027') { searchElement = target; } else { searchElement = document; }} else { searchElement = target; }} else { searchElement = document; } } console.warn("Event Search Element", searchElement); let eventSearchElement = null; let tempESE = $(searchElement).parentsUntil('view')[$(searchElement).parentsUntil('view').length - 1]; if(tempESE != null && tempESE != undefined) { eventSearchElement = tempESE.parentElement; } else { eventSearchElement = document; }let options = { ThisHtmlId: 'Submit',CauseValidation: 'True',GroupToValidate: 'Default',ValidationLocation: 'Inline',TemplateWidgetControllerMode: 'All',TemplateWidgetControllerRow: '0',SearchElement: searchElement,EventTimeout: 5,ShowTimeoutMessage: true,AllowKillRequest: true,AllowContinueInBackground: true};try { if((options && options?.ThisHtmlId != '' && options?.ThisHtmlId == 'CustomerNumber') || 'Submit' == 'CustomerNumber'){args.WorkData._ControllerParameters["CustomerNumber"] = $(target).val();}else{if(false){args.WorkData._ControllerParameters["CustomerNumber"] = $($(searchElement).find('[containerId="VIEW-20000027"][name="CustomerNumber"]')[loopIndex]).val();}else{args.WorkData._ControllerParameters["CustomerNumber"] = $(searchElement).find('#CustomerNumber').val();}} } catch {}try { if((options && options?.ThisHtmlId != '' && options?.ThisHtmlId == 'CompanyName') || 'Submit' == 'CompanyName'){args.WorkData._ControllerParameters["CompanyName"] = $(target).val();}else{if(false){args.WorkData._ControllerParameters["CompanyName"] = $($(searchElement).find('[containerId="VIEW-20000027"][name="CompanyName"]')[loopIndex]).val();}else{args.WorkData._ControllerParameters["CompanyName"] = $(searchElement).find('#CompanyName').val();}} } catch {}try { if((options && options?.ThisHtmlId != '' && options?.ThisHtmlId == 'PhoneNumber') || 'Submit' == 'PhoneNumber'){args.WorkData._ControllerParameters["PhoneNumber"] = $(target).val();}else{if(false){args.WorkData._ControllerParameters["PhoneNumber"] = $($(searchElement).find('[containerId="VIEW-20000027"][name="PhoneNumber"]')[loopIndex]).val();}else{args.WorkData._ControllerParameters["PhoneNumber"] = $(searchElement).find('#PhoneNumber').val();}} } catch {}try { if((options && options?.ThisHtmlId != '' && options?.ThisHtmlId == 'WebsiteAddress') || 'Submit' == 'WebsiteAddress'){args.WorkData._ControllerParameters["WebSite"] = $(target).val();}else{if(false){args.WorkData._ControllerParameters["WebSite"] = $($(searchElement).find('[containerId="VIEW-20000027"][name="WebsiteAddress"]')[loopIndex]).val();}else{args.WorkData._ControllerParameters["WebSite"] = $(searchElement).find('#WebsiteAddress').val();}} } catch {}try { if((options && options?.ThisHtmlId != '' && options?.ThisHtmlId == 'FirstName') || 'Submit' == 'FirstName'){args.WorkData._ControllerParameters["FirstName"] = $(target).val();}else{if(false){args.WorkData._ControllerParameters["FirstName"] = $($(searchElement).find('[containerId="VIEW-20000027"][name="FirstName"]')[loopIndex]).val();}else{args.WorkData._ControllerParameters["FirstName"] = $(searchElement).find('#FirstName').val();}} } catch {}try { if((options && options?.ThisHtmlId != '' && options?.ThisHtmlId == 'LastName') || 'Submit' == 'LastName'){args.WorkData._ControllerParameters["LastName"] = $(target).val();}else{if(false){args.WorkData._ControllerParameters["LastName"] = $($(searchElement).find('[containerId="VIEW-20000027"][name="LastName"]')[loopIndex]).val();}else{args.WorkData._ControllerParameters["LastName"] = $(searchElement).find('#LastName').val();}} } catch {}try { if((options && options?.ThisHtmlId != '' && options?.ThisHtmlId == 'Email') || 'Submit' == 'Email'){args.WorkData._ControllerParameters["Email"] = $(target).val();}else{if(false){args.WorkData._ControllerParameters["Email"] = $($(searchElement).find('[containerId="VIEW-20000027"][name="Email"]')[loopIndex]).val();}else{args.WorkData._ControllerParameters["Email"] = $(searchElement).find('#Email').val();}} } catch {}try { if((options && options?.ThisHtmlId != '' && options?.ThisHtmlId == 'ContactPhoneNumber') || 'Submit' == 'ContactPhoneNumber'){args.WorkData._ControllerParameters["PhoneNumber2"] = $(target).val();}else{if(false){args.WorkData._ControllerParameters["PhoneNumber2"] = $($(searchElement).find('[containerId="VIEW-20000027"][name="ContactPhoneNumber"]')[loopIndex]).val();}else{args.WorkData._ControllerParameters["PhoneNumber2"] = $(searchElement).find('#ContactPhoneNumber').val();}} } catch {}try { if((options && options?.ThisHtmlId != '' && options?.ThisHtmlId == 'ContactTitle') || 'Submit' == 'ContactTitle'){args.WorkData._ControllerParameters["Title"] = $(target).val();}else{if(false){args.WorkData._ControllerParameters["Title"] = $($(searchElement).find('[containerId="VIEW-20000027"][name="ContactTitle"]')[loopIndex]).val();}else{args.WorkData._ControllerParameters["Title"] = $(searchElement).find('#ContactTitle').val();}} } catch {}try { if((options && options?.ThisHtmlId != '' && options?.ThisHtmlId == 'AddressLine1') || 'Submit' == 'AddressLine1'){args.WorkData._ControllerParameters["AddressLine1"] = $(target).val();}else{if(false){args.WorkData._ControllerParameters["AddressLine1"] = $($(searchElement).find('[containerId="VIEW-20000027"][name="AddressLine1"]')[loopIndex]).val();}else{args.WorkData._ControllerParameters["AddressLine1"] = $(searchElement).find('#AddressLine1').val();}} } catch {}try { if((options && options?.ThisHtmlId != '' && options?.ThisHtmlId == 'AddressLine2') || 'Submit' == 'AddressLine2'){args.WorkData._ControllerParameters["AddressLine2"] = $(target).val();}else{if(false){args.WorkData._ControllerParameters["AddressLine2"] = $($(searchElement).find('[containerId="VIEW-20000027"][name="AddressLine2"]')[loopIndex]).val();}else{args.WorkData._ControllerParameters["AddressLine2"] = $(searchElement).find('#AddressLine2').val();}} } catch {}try { if((options && options?.ThisHtmlId != '' && options?.ThisHtmlId == 'City') || 'Submit' == 'City'){args.WorkData._ControllerParameters["City"] = $(target).val();}else{if(false){args.WorkData._ControllerParameters["City"] = $($(searchElement).find('[containerId="VIEW-20000027"][name="City"]')[loopIndex]).val();}else{args.WorkData._ControllerParameters["City"] = $(searchElement).find('#City').val();}} } catch {}try { if((options && options?.ThisHtmlId != '' && options?.ThisHtmlId == 'State') || 'Submit' == 'State'){args.WorkData._ControllerParameters["State"] = $(target).val();}else{if(false){args.WorkData._ControllerParameters["State"] = $($(searchElement).find('[containerId="VIEW-20000027"][name="State"]')[loopIndex]).val();}else{args.WorkData._ControllerParameters["State"] = $(searchElement).find('#State').val();}} } catch {}try { if((options && options?.ThisHtmlId != '' && options?.ThisHtmlId == 'ZipCode') || 'Submit' == 'ZipCode'){args.WorkData._ControllerParameters["ZipCode"] = $(target).val();}else{if(false){args.WorkData._ControllerParameters["ZipCode"] = $($(searchElement).find('[containerId="VIEW-20000027"][name="ZipCode"]')[loopIndex]).val();}else{args.WorkData._ControllerParameters["ZipCode"] = $(searchElement).find('#ZipCode').val();}} } catch {}try { if((options && options?.ThisHtmlId != '' && options?.ThisHtmlId == 'AddlCustomerNumbers') || 'Submit' == 'AddlCustomerNumbers'){args.WorkData._ControllerParameters["AdditionalAccountNo"] = $(target).val();}else{if(false){args.WorkData._ControllerParameters["AdditionalAccountNo"] = $($(searchElement).find('[containerId="VIEW-20000027"][name="AddlCustomerNumbers"]')[loopIndex]).val();}else{args.WorkData._ControllerParameters["AdditionalAccountNo"] = $(searchElement).find('#AddlCustomerNumbers').val();}} } catch {}try { let checkArray15 = new Array(); $($(searchElement).find('input[containerId="VIEW-20000027"][name="OrderStatusCheckbox"][type="checkbox"]')).each(function() { checkArray15.push($(this).prop('checked'));});args.WorkData._ControllerParameters["OrderStatus"] = checkArray15; } catch {}try { let checkArray16 = new Array(); $($(searchElement).find('input[containerId="VIEW-20000027"][name="QuickOrderCheckbox"][type="checkbox"]')).each(function() { checkArray16.push($(this).prop('checked'));});args.WorkData._ControllerParameters["QuickOrder"] = checkArray16; } catch {}try { let checkArray17 = new Array(); $($(searchElement).find('input[containerId="VIEW-20000027"][name="InvoicePaymentsCheckbox"][type="checkbox"]')).each(function() { checkArray17.push($(this).prop('checked'));});args.WorkData._ControllerParameters["InvoicePayments"] = checkArray17; } catch {}try { let checkArray18 = new Array(); $($(searchElement).find('input[containerId="VIEW-20000027"][name="AccountBalanceCheckbox"][type="checkbox"]')).each(function() { checkArray18.push($(this).prop('checked'));});args.WorkData._ControllerParameters["AccountBalance"] = checkArray18; } catch {}try { if((options && options?.ThisHtmlId != '' && options?.ThisHtmlId == 'HowDidYouHear') || 'Submit' == 'HowDidYouHear'){args.WorkData._ControllerParameters["InformationSource"] = $(target).val();}else{if(false){args.WorkData._ControllerParameters["InformationSource"] = $($(searchElement).find('[containerId="VIEW-20000027"][name="HowDidYouHear"]')[loopIndex]).val();}else{args.WorkData._ControllerParameters["InformationSource"] = $(searchElement).find('#HowDidYouHear').val();}} } catch {}try { if((options && options?.ThisHtmlId != '' && options?.ThisHtmlId == 'RecentPO') || 'Submit' == 'RecentPO'){args.WorkData._ControllerParameters["LatestPONumber"] = $(target).val();}else{if(false){args.WorkData._ControllerParameters["LatestPONumber"] = $($(searchElement).find('[containerId="VIEW-20000027"][name="RecentPO"]')[loopIndex]).val();}else{args.WorkData._ControllerParameters["LatestPONumber"] = $(searchElement).find('#RecentPO').val();}} } catch {}try { if((options && options?.ThisHtmlId != '' && options?.ThisHtmlId == 'AdditionalComments') || 'Submit' == 'AdditionalComments'){args.WorkData._ControllerParameters["Comments"] = $(target).val();}else{if(false){args.WorkData._ControllerParameters["Comments"] = $($(searchElement).find('[containerId="VIEW-20000027"][name="AdditionalComments"]')[loopIndex]).val();}else{args.WorkData._ControllerParameters["Comments"] = $(searchElement).find('#AdditionalComments').val();}} } catch {}args.WorkData._ControllerParameters["CaptchaToken"] = '';EPEvent(args, event, options, CordisDirectRequestAccess_Submit_click_1_CallbackFunction); }</script></span><button id="Submit" name="Submit" containerid="VIEW-20000027" type="button" value="Submit" validationgroup="" disableonclick="No" iseof="False" isdefault="false" isenabled="True" title="" visible="True" class="CDRAForm-Button" controltype="button" controlid="c_100254" causesvalidation="Yes" onclick="CordisDirectRequestAccess_Submit_click(event, event.target, 0, {}, '', '');" modelDataObjclick="{}">Submit</button></td></tr><tr isenabled="True" title="" controltype="row" causesvalidation="Yes" style=""><td isenabled="True" title="" controltype="cell" causesvalidation="Yes" style="width:100%;"><span isenabled="True" title="" controltype="htmlcontent" causesvalidation="Yes"><script>
document.querySelectorAll(".label-text span").forEach(star => star.remove());
["CustomerNumber", "PhoneNumber", "ContactPhoneNumber"].forEach(id => {
    const el = document.getElementById(id);
    if (!el) return;
    el.inputMode = "numeric";

    el.addEventListener("input", function () {
        this.value = this.value.replace(/\D/g, "");
    });
});
</script></span></td></tr></table></td></tr></table></td></tr></table><script>function CordisDirectRequestAccess_Submit(event, target, loopIndex, modelDataObj, options, callbackFunction, returnValueToFormValue, returnValueToFormDescription) { if(loopIndex == null || loopIndex == undefined || loopIndex == "") { loopIndex = 0; if(event.detail?.WorkData?._LoopData?.LoopIndex) { loopIndex = event.detail.WorkData._LoopData.LoopIndex } } if(target != null && target != undefined) { let targetId = target.id; if(targetId != null && targetId != undefined && targetId !="") { let modelDataObjAttribute = document.getElementById(targetId).getAttribute("modelDataObjSubmit"); if(modelDataObjAttribute != null && modelDataObjAttribute != undefined && modelDataObjAttribute !=  "") { modelDataObjAttribute = modelDataObjAttribute.replaceAll("'", "\""); let tempModelDataObj = JSON.parse(modelDataObjAttribute); if(tempModelDataObj != null && tempModelDataObj != undefined) { modelDataObj = tempModelDataObj; } } } }let args = {"WorkData":{"TenantId":"","TenantName":"","ApplicationId":"","ApplicationName":"","ViewName":"","EventName":"","SearchElement":"","ControlId":"","Action":"","_LoopData":{"LoopIndex":""},"_ControllerParameters":{}}}; args.WorkData.TenantId = '1093'; args.WorkData.TenantName = 'Cordis'; args.WorkData.ApplicationId = '21001335'; args.WorkData.ApplicationName = 'CordisSales'; args.WorkData.ViewName = 'CordisDirectRequestAccess'; args.WorkData.EventName = 'Submit'; if (target != undefined && target != null) { args.WorkData.ControlId = target.getAttribute('ControlId'); args.WorkData.Action = target.getAttribute('Action'); } let searchElement = null; let parent = $(target).parents('view[viewid="VIEW-20000027"]'); if (parent != null && parent != undefined && parent.length != 0) { searchElement = parent[0]; } else { if(target?.tagName?.toLowerCase() == 'view') { let viewIdAttribute = target.getAttribute('viewid'); if(viewIdAttribute && viewIdAttribute != '') { if(viewIdAttribute == 'VIEW-20000027') { searchElement = target; } else { searchElement = document; }} else { searchElement = target; }} else { searchElement = document; } } let eventSearchElement = null; let tempESE = $(searchElement).parentsUntil('view')[$(searchElement).parentsUntil('view').length - 1]; if(tempESE != null && tempESE != undefined) { eventSearchElement = tempESE.parentElement; } else { eventSearchElement = document; }args.WorkData._ControllerParameters["CustomerNumber"] = '';args.WorkData._ControllerParameters["CompanyName"] = '';args.WorkData._ControllerParameters["PhoneNumber"] = '';args.WorkData._ControllerParameters["WebSite"] = '';args.WorkData._ControllerParameters["FirstName"] = '';args.WorkData._ControllerParameters["LastName"] = '';args.WorkData._ControllerParameters["Email"] = '';args.WorkData._ControllerParameters["PhoneNumber2"] = '';args.WorkData._ControllerParameters["Title"] = '';args.WorkData._ControllerParameters["AddressLine1"] = '';args.WorkData._ControllerParameters["AddressLine2"] = '';args.WorkData._ControllerParameters["City"] = '';args.WorkData._ControllerParameters["State"] = '';args.WorkData._ControllerParameters["ZipCode"] = '';args.WorkData._ControllerParameters["AdditionalAccountNo"] = '';args.WorkData._ControllerParameters["OrderStatus"] = '';args.WorkData._ControllerParameters["QuickOrder"] = '';args.WorkData._ControllerParameters["InvoicePayments"] = '';args.WorkData._ControllerParameters["AccountBalance"] = '';args.WorkData._ControllerParameters["InformationSource"] = '';args.WorkData._ControllerParameters["LatestPONumber"] = '';args.WorkData._ControllerParameters["Comments"] = '';args.WorkData._ControllerParameters["CaptchaToken"] = '';if(options?.WorkflowAction != null && options?.WorkflowAction != undefined && options?.WorkflowAction != '') { args.WorkData['_Workflow'] = {}; args.WorkData._Workflow['Action'] = options.WorkflowAction; args.WorkData['Action'] = options.WorkflowAction; } else if(options?.WorkflowStatusAction != null && options?.WorkflowStatusAction != undefined && options?.WorkflowStatusAction != '') { args.WorkData['_Workflow'] = {}; args.WorkData._Workflow['Action'] = options.WorkflowStatusAction; args.WorkData['Action'] = options.WorkflowStatusAction; }EPEvent(args, event, options, callbackFunction);  }</script></span></view><input id="EP_CacheId" name="EP_CacheId" type="hidden" value ="09010c97d147419f8d1afbaa4cd3abf1" isenabled="True"></input></content>
		</div>
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	<div class="modal fade" id="notificationsModal" tabindex="-1" aria-labelledby="notificationsModal" aria-hidden="true">
		<div class="modal-dialog modal-dialog-scrollable">
			<div class="modal-content">
				<div class="modal-header">
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