  [% META title = 'Admin &raquo; Clinician &raquo; Location Edit' -%]
<!-- BEGIN [% template.name %] -->
    [% # INCLUDE dumper.tt dump = data.as_tree %]
    [% # INCLUDE dumper.tt dump = d.as_tree FOREACH d IN departments %]
    
	<h2 class="header">Edit Clinician Location Details</h2>

    <form name="form" action="[% app_url %]/config/clinicians/location/[% data.id %]">
        <input type="hidden" name="referrer_id" value="[% data.referrer_id %]" />
        <table class="indent">
            <tr>
                <th>Clinician</th>
                <th>GMC Code</th>
                <th>Parent Organisation</th>
                <th>Department</th>
                <th>Active</th>
            </tr>        
            <tr>
                <td>[% data.referrer.name %]</td>
                <td>[% data.referrer.national_code %]</td>
                <td>
                    [% data.parent_organisation.description %]
                    [[% data.parent_organisation.parent_code %]]
                </td>
                <td>
                    <select name="hospital_department_code">
                    [% FOREACH d IN departments %]
                        <option value="[% d.id %]" [% 'selected' IF
                            d.display_name == data.hospital_department.display_name %]>
                            [% d.display_name %]
                        </option>
                    [% END %]
                </td>
                <td>
                    <select name="is_active">
                    [% FOREACH o IN ['yes' 'no'] %]
                        <option value="[% o %]" [% 'selected' IF data.is_active.match(o) %]>
                            [% o %]
                        </option>
                    [% END %]
                    </select>
                </td>
                <td>
                    [% site.html.submit %]
                </td>
            </tr>        
        </table>
    </form>
<!-- END [% template.name %] -->
