<!-- BEGIN outreach/questionnaire/service.tt -->
<div class="indent">
<h4 class="blue">Service assessment:</h4>
<table class="xborders">
<tr>
<td class="title" align="right" valign="top">Location preference:</td>
<td valign="top">
<select name="location_preference">
<option value="">--select one--</option>
[% FOREACH opt IN outreach.menu_options.location_preference %]
<option value="[% opt %]"
[% 'selected' IF questionnaire.location_preference == opt %]>
[% opt %]
</option>
[% END %]
</select>
[% error_location_preference %]
</td>
<td colspan="2">
<b>Monitoring quality opinion: </b>
<div>
<textarea name="monitoring_comments" cols="40"
rows="1">[% questionnaire.details.monitoring_quality %]</textarea>
</div>
[% error_monitoring_quality %]
</td>
</tr>
<tr>
<td class="title" align="right" valign="top">
<span class="acronym" title="default value: 999">
Waiting duration</span>:
</td>
<td>
<input type="text" name="waiting_duration" size="5"
value="[% questionnaire.waiting_duration %]" /> mins
[% error_waiting_duration %]
</td>
<td><b>Excessive</b>:
Yes<input type="radio" name="excessive_wait"
[% 'checked' IF questionnaire.excessive_wait == 'Y' %] value="Y" />
No<input type="radio" name="excessive_wait"
[% 'checked' IF questionnaire.excessive_wait == 'N' %] value="N" />
[% error_excessive_wait %]
</td>
</tr>
<tr>
<td class="title" valign="top" align="right">Transport difficulties: </td>
<td valign="top">
Yes<input type="radio" name="transport_difficulty"
[% 'checked' IF questionnaire.transport_difficulty == 'Y' %] value="Y" />
No<input type="radio" name="transport_difficulty"
[% 'checked' IF questionnaire.transport_difficulty == 'N' %] value="N" />
[% error_transport_difficulty %]
</td>
<td valign="top">
<div class="bold">Transport difficulty details:</div>
<textarea name="transport_difficulty_details" cols="40"
rows="1">[% questionnaire.details.transport_difficulty %]</textarea>
[% error_transport_difficulty_details %]
</td>
</tr>
<tr>
<td class="title">Transport arrangements:</td>
<td>
<select name="transport_arrangements">
<option value="">--select one--</option>
[% FOREACH opt IN outreach.menu_options.transport_arrangements %]
<option value="[% opt %]"
[% 'selected' IF questionnaire.transport_arrangements == opt %]>
[% opt %]
</option>
[% END %]
</select>
[% error_transport_arrangements %]
</td>
</tr>
</table>
</div>
<!-- BEGIN outreach/questionnaire/service.tt -->