PHP Page Error

EXCEPTION TYPE: E_NOTICE_EXCEPTION
MESSAGE: Undefined variable: product
SITE PAGE: https://homemedical.thedacare.org/product-order-request
LOCATION: E:\Inetpub\homemedical.thedacare.org\modules\forms\product-order-request.php
LINE NUMBER: 4
USER AGENT: CCBot/2.0 (https://commoncrawl.org/faq/)
OPERATING SYSTEM: unknown
BROWSER: unknown unknown
MOBILE: No
ROBOT: No
IP ADDRESS: 3.234.208.66
ERROR TIME: February 24, 2020 9:11 pm

--------------------------------------------------------------------------- PHP STACK TRACE ---------------------------------------------------------------------------
#1 E:\Inetpub\homemedical.thedacare.org\vpanel\pagebuilder\classes\class_pagebase.php(23) : eval()'d code(7): include_once('E:\\Inetpub\\home...')
#2 E:\Inetpub\homemedical.thedacare.org\vpanel\pagebuilder\classes\class_pagebase.php(23): eval()
#3 E:\Inetpub\homemedical.thedacare.org\pagebase.php(19): Template->publish()
#4 E:\Inetpub\homemedical.thedacare.org\library\functions.php(481): require_once('E:\\Inetpub\\home...')
#5 E:\Inetpub\homemedical.thedacare.org\handlers\request_handler.php(148): serverTransfer('E:\\Inetpub\\home...')
#6 {main}