<!-- Begin
var submitcount=0;

function reset() {
document.claimform.name.value="Your Name is";
}


function checkFields() {                    
if ((document.claimform.name.value==""))  
   {
   alert("Please enter your Name.");
   return false;
   }
if ((document.claimform.contact_number.value==""))  
   {
   alert("Please enter your Home or Mobile Number.");
   return false;
   }
if ((document.claimform.accident_type.value=="please select"))  
   {
   alert("Please enter Type of accident you've had.");
   return false;
   }
if ((document.claimform.date.value==""))  
   {
   alert("Please enter date of an accident.");
   return false;
   }
if ((document.claimform.human.value!="6"))  
   {
   alert("Please write 6");
   return false;
   }
else 
   {
   if (submitcount == 0)
      {
      submitcount++;
      return true;
      }
   else 
      {
      alert("This form has already been submitted.");
      return false;
      }
   }
}
//  End -->


<!-- Begin
var submitcount=1;

function reset() {
document.callbackform.first_name.value="Your Name is";
}