[% content_only = 1 # no html wrappers %]
[% # PROCESS dumper.tt dump = packs %]
<!-- BEGIN [% template.name %] -->
<html>
<head>
<title>Outreach Pack Dispatches</title>
<link type="text/css" rel="stylesheet" href="/css/outreach.css" />
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
</head>
<body>
[% FOREACH entry IN packs; # PROCESS dumper.tt dump = entry %]
<div style="page-break-after: always">
[%
INCLUDE worklist/local/outreach/request_form.tt;
INCLUDE worklist/local/outreach/eq5d_form.tt;
%]
<div class="symptoms">
<div align="center">
<img src='/images/outreach_header.png' alt="" />
</div>
<p align="center">
[% entry.first_name | ucfirst %] [% entry.last_name | upper %]
:: [% INCLUDE site/nhs_number.tt nhs_number = entry.nhs_number %]
:: [% entry.dob.strftime('%d.%b.%Y') %]
</p>
<div class="details">
<p class="contact">
Please complete this form and return it with the blood samples.
In case of any problems with samples or symptoms, please contact or
Carol Reid or Andy Rawstron on [% c.cfg('settings').service_telno %]
andy.rawstron@nhs.net
</p>
[%
IF entry.diagnosis.match('MGUS|gammopathy');
IF entry.diagnosis.match('IgM') # IgM MGUS gets b-lpd:
OR entry.electrophoresis.match('IgM');
INCLUDE worklist/local/outreach/blpd_questionnaire.tt;
ELSIF entry.neoplastic_b_cells; # non-IgM MGUS with neo-B gets combined:
INCLUDE worklist/local/outreach/combined_questionnaire.tt;
ELSE; # non-IgM MGUS without neo-B gets mgus:
INCLUDE worklist/local/outreach/mgus_questionnaire.tt;
END;
ELSE; # all others get b-lpd:
INCLUDE worklist/local/outreach/blpd_questionnaire.tt;
END %]
<p>
<u>Other common symptoms:</u>
</p>
<p>
<i>Infections:</i>
Your blood disorder can make you more susceptible to infections. Please
contact your GP at the first signs of an infections as they will be aware
that you need prompt access to antibiotic or antiviral drugs.
</p>
<p>
<i>Fatigue or tiredness:</i>
This is a common problem and is often unrelated to your blood disorder.
The blood tests that we do can detect some causes of fatigue. If we find
anything, we will let you know whether this should be followed up at
your local surgery or at the haematology clinic.
</p>
<p>
If you have any other symptoms that you think may be related to the
blood disorder, please record them overleaf. You should also discuss
it with your GP if it is a persistent problem that is concerning you.
</p>
<p>
<b>Please also complete the general health questionnaire</b>
</p>
</div>
[% INCLUDE worklist/local/outreach/address.tt %]
</div>
</div>
<div>
[% INCLUDE worklist/local/outreach/path_request_forms.tt %]
</div>
[% END %]
</body>
</html>
<!-- END [% template.name %] -->