[% META title = 'Admin » Clinicians' -%]
[% PROCESS site/autosuggest.tt varname = 'hospital' %]
[% new_clinician_dfv_js %]
[% PROCESS admin/referral_nav.tt page = 'clinicians' %]
<h2 align="center">Clinicians</h2>
[% IF dfv_errors %]
<p class="error">[% c.config('msg').dfv_errors %]</p>
[% END %]
[% # PROCESS dumper.tt dump = referral_types %]
<p class="title">
[% div_name = 'new'; INCLUDE site/snippets/toggleview.tt %]
Add new entry
</p>
<div class="[% dfv_errors ? 'visible' : 'itemhidden' %]" id="[% div_name %]">
<div class="indent">
<form method="get" action="[% app_url %]/config/clinicians/add_new"
name="new_clinicians" id="new_clinicians" [% new_clinician_onsubmit %]>
[% PROCESS site/lookup.tt type = 'clinician', fname = 'popup2' %]
<table>
<tr>
<td class="label">Designation:</td>
<td>
<select name="prefix">
<option value="">-- select one --</option>
[%- FOREACH entry IN referral_types -%]
[%- NEXT UNLESS entry.prefix -%]
<option value="[% entry.prefix -%]"
[%- 'selected' IF entry.prefix == c.query.param('prefix') -%]>
[%- entry.description | html -%]
</option>
[% END %]
</select>
[% error_prefix %]
</td>
</tr>
<tr>
<td class="label">Code:</td>
<td>
[% PROCESS site/ajax_input.tt field = 'national_code' %]
[% error_national_code %]
</td>
</tr>
<tr>
<td class="label">Surname:</td>
<td>
<input type="text" name="surname" value="[% c.query.param('surname') %]" />
[% error_surname %]
</td>
</tr>
<tr>
<td class="label">Initials:</td>
<td>
[% FOREACH i IN [1..4]; inits = 'initials_' _ i %]
<input type="text" name="[% inits %]" size="1" maxlength="1"
value="[% c.query.param(inits) %]" />
[% END %]
[% IF error_initials_1; error_initials_1; # can only list 1st one %]
[% ELSE %]enter up to 4 initials[% END %]
</td>
</tr>
<tr>
<td class="label">Hospital:</td>
<td class="search_bar">
<input style="width: 300px" type="text" id="location_name" name="_display_name"
value="[% c.query.param('_display_name') %]"/>
<input type="hidden" id="source_id" name="referral_source_id"
value="[% c.query.param('referral_source_id') %]" />
[% IF error_referral_source_id %]
[% error_referral_source_id %]
[% ELSE %]
[ <a href="[% app_url %]/config/referral-sources">new</a> ]
[% END %]
</td>
</tr>
<tr>
<td class="label">Department:</td>
<td>
<select name="hospital_department_code">
<option value="">-- select one --</option>
[% FOREACH department IN departments %]
<option value="[% department.id %]"
[% 'selected' IF department.id == c.query.param('hospital_department_code') %]>
[% department.display_name | html %]
</option>
[% END %]
</select>
[% error_hospital_department_code %]
</td>
</tr>
<tr>
<td class="borderless" colspan="2" align="center">[% site.html.submit %]</td>
</tr>
</table>
</form>
</div>
</div>
<hr />
<p class="title">Search for an existing clinician:</p>
<div class="indent">
[% PROCESS search/referrer_search.tt referrer_type = 'clinicians' %]
</div>