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199 lines
7.2 KiB
199 lines
7.2 KiB
<?php |
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/** |
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* treatment plan form. |
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* |
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* @package OpenEMR |
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* @link http://www.open-emr.org |
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* @author Naina Mohamed <naina@capminds.com> |
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* @author Brady Miller <brady.g.miller@gmail.com> |
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* @copyright Copyright (c) 2012-2013 Naina Mohamed <naina@capminds.com> CapMinds Technologies |
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* @copyright Copyright (c) 2017-2019 Brady Miller <brady.g.miller@gmail.com> |
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* @license https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3 |
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*/ |
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require_once(__DIR__ . "/../../globals.php"); |
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require_once("$srcdir/api.inc"); |
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require_once("$srcdir/patient.inc"); |
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require_once("$srcdir/options.inc.php"); |
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use OpenEMR\Common\Csrf\CsrfUtils; |
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use OpenEMR\Core\Header; |
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formHeader("Form:Treatment Planning"); |
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$returnurl = 'encounter_top.php'; |
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$formid = (int) (isset($_GET['id']) ? $_GET['id'] : 0); |
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$obj = $formid ? formFetch("form_treatment_plan", $formid) : array(); |
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// Get the providers list. |
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$ures = sqlStatement("SELECT id, username, fname, lname FROM users WHERE " . |
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"authorized != 0 AND active = 1 ORDER BY lname, fname"); |
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?> |
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<html><head> |
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<?php Header::setupHeader('datetime-picker'); ?> |
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<script> |
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$(function () { |
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var win = top.printLogSetup ? top : opener.top; |
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win.printLogSetup(document.getElementById('printbutton')); |
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$('.datepicker').datetimepicker({ |
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<?php $datetimepicker_timepicker = false; ?> |
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<?php $datetimepicker_showseconds = false; ?> |
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<?php $datetimepicker_formatInput = false; ?> |
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<?php require($GLOBALS['srcdir'] . '/js/xl/jquery-datetimepicker-2-5-4.js.php'); ?> |
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<?php // can add any additional javascript settings to datetimepicker here; need to prepend first setting with a comma ?> |
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}); |
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}); |
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</script> |
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</head> |
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<body class="body_top"> |
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<p><span class="forms-title"><?php echo xlt('Treatment Planning'); ?></span></p> |
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<br /> |
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<?php |
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echo "<form method='post' name='my_form' " . |
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"action='$rootdir/forms/treatment_plan/save.php?id=" . attr_url($formid) . "'>\n"; |
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?> |
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<input type="hidden" name="csrf_token_form" value="<?php echo attr(CsrfUtils::collectCsrfToken()); ?>" /> |
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<table border="0"> |
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<tr> |
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<td align="left" class="forms" class="forms"><?php echo xlt('Client Name'); ?>:</td> |
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<td class="forms"> |
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<label class="forms-data"> <?php if (is_numeric($pid)) { |
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$result = getPatientData($pid, "fname,lname,squad"); |
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echo text($result['fname']) . " " . text($result['lname']); |
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} |
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$patient_name = ($result['fname']) . " " . ($result['lname']); |
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?> |
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</label> |
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<input type="hidden" name="client_name" value="<?php echo attr($patient_name);?>"> |
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</td> |
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<td align="left" class="forms"><?php echo xlt('DOB'); ?>:</td> |
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<td class="forms"> |
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<label class="forms-data"> <?php if (is_numeric($pid)) { |
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$result = getPatientData($pid, "*"); |
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echo text($result['DOB']); |
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} |
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$dob = ($result['DOB']); |
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?> |
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</label> |
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<input type="hidden" name="DOB" value="<?php echo attr($dob);?>"> |
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</td> |
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</tr> |
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<tr> |
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<td align="left" class="forms"><?php echo xlt('Client Number'); ?>:</td> |
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<td class="forms"> |
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<label class="forms-data" > <?php if (is_numeric($pid)) { |
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$result = getPatientData($pid, "*"); |
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echo text($result['pid']); |
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} |
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$patient_id = $result['pid']; |
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?> |
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</label> |
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<input type="hidden" name="client_number" value="<?php echo attr($patient_id);?>"> |
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</td> |
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<td align="left" class="forms"><?php echo xlt('Admit Date'); ?>:</td> |
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<td class="forms"> |
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<input type='text' size='10' class='datepicker' name='admit_date' id='admission_date' <?php echo attr($disabled) ?>; |
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value='<?php echo attr($obj["admit_date"]); ?>' |
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title='<?php echo xla('yyyy-mm-dd Date of service'); ?>' /> |
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</td> |
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</tr> |
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<tr> |
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<td align="left" class="forms"><?php echo xlt('Provider'); ?>:</td> |
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<td class="forms" width="280px"> |
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<?php |
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echo "<select name='provider' style='width:60%' />"; |
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while ($urow = sqlFetchArray($ures)) { |
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echo " <option value='" . attr($urow['lname']) . "'"; |
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if ($urow['lname'] == attr($obj["provider"])) { |
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echo " selected"; |
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} |
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echo ">" . text($urow['lname']); |
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if ($urow['fname']) { |
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echo ", " . text($urow['fname']); |
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} |
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echo "</option>\n"; |
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} |
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echo "</select>"; |
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?> |
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</td> |
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</tr> |
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<tr> |
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<td colspan='3' nowrap style='font-size:8pt'> |
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</td> |
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</tr> |
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<tr> |
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<td align="left" class="forms"><?php echo xlt('Presenting Issue(s)'); ?>:</td> |
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<td colspan="3"><textarea name="presenting_issues" rows="2" cols="60" wrap="virtual name"><?php echo text($obj["presenting_issues"]);?></textarea></td> |
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</tr> |
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<tr> |
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<td align="left" class="forms"><?php echo xlt('Patient History'); ?>:</td> |
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<td colspan="3"><textarea name="patient_history" rows="2" cols="60" wrap="virtual name"><?php echo text($obj["patient_history"]);?></textarea></td> |
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</tr> |
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<tr> |
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<td align="left" class="forms"><?php echo xlt('Medications'); ?>:</td> |
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<td colspan="3"><textarea name="medications" rows="2" cols="60" wrap="virtual name"><?php echo text($obj["medications"]);?></textarea></td> |
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</tr> |
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<tr> |
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<td align="left" class="forms"><?php echo xlt('Anyother Relevant Information'); ?>:</td> |
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<td colspan="3"><textarea name="anyother_relevant_information" rows="2" cols="60" wrap="virtual name"><?php echo text($obj["anyother_relevant_information"]);?></textarea></td> |
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</tr> |
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<tr> |
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<td align="left" class="forms"><?php echo xlt('Diagnosis'); ?>:</td> |
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<td colspan="3"><textarea name="diagnosis" rows="2" cols="60" wrap="virtual name"><?php echo text($obj["diagnosis"]);?></textarea></td> |
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</tr> |
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<tr> |
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<td align="left" class="forms"><?php echo xlt('Treatment Received'); ?>:</td> |
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<td colspan="3"><textarea name="treatment_received" rows="2" cols="60" wrap="virtual name"><?php echo text($obj["treatment_received"]);?></textarea></td> |
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</tr> |
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<tr> |
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<td align="left" class="forms"><?php echo xlt('Recommendation For Follow Up'); ?>:</td> |
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<td colspan="3"><textarea name="recommendation_for_follow_up" rows="2" cols="60" wrap="virtual name"><?php echo text($obj["recommendation_for_follow_up"]);?></textarea></td> |
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</tr> |
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<tr> |
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<td align="left colspan="3" style="padding-bottom:7px;"></td> |
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</tr> |
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<tr> |
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<td align="left colspan="3" style="padding-bottom:7px;"></td> |
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</tr> |
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<tr> |
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<td></td> |
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<td><input type='submit' value='<?php echo xla('Save');?>' class="button-css"> |
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<input type='button' value='<?php echo xla('Print'); ?>' id='printbutton' /> |
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<input type='button' class="button-css" value='<?php echo xla('Cancel');?>' |
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onclick="parent.closeTab(window.name, false)" /></td> |
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</tr> |
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</table> |
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</form> |
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<?php |
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formFooter(); |
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?>
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