Personal tools
Navigation
 

FH consent form

HTML with button links to 2 other eforms.

HTML icon FH-Regional-Consent-for-Health-Care-Form-With-Buttons.html — HTML, 11 kB (11586 bytes)

File contents

<html>
<head>
<title>FH Regional Consent for Health Care</title>

<style type="text/css" media="print">
 .DoNotPrint {
	 display: none;
 }
 .noborder {
	 border : 0px;
	 background: transparent;
	 scrollbar-3dlight-color: transparent;
	 scrollbar-3dlight-color: transparent;
	 scrollbar-arrow-color: transparent;
	 scrollbar-base-color: transparent;
	 scrollbar-darkshadow-color: transparent;
	 scrollbar-face-color: transparent;
	 scrollbar-highlight-color: transparent;
	 scrollbar-shadow-color: transparent;
	 scrollbar-track-color: transparent;
	 background: transparent;
	 overflow: hidden;
 }
 </style>

<!-- js graphics scripts -->
<script type="text/javascript" src="${oscar_image_path}jsgraphics.js"></script>
<script language="javascript">
function formPrint(){
	 if (document.getElementById('DrawCheckmark').checked){ 
			printCheckboxes();
	 }else{
			window.print();
	 } 
} 
</script>

<!-------Script to optimize window on loading----------->
<script language="JavaScript">
top.window.moveTo(0,0);
if (document.all) {
top.window.resizeTo(screen.availWidth,screen.availHeight);
}
else if (document.layers||document.getElementById) {
if (top.window.outerHeight<screen.availHeight||top.window.outerWidth<screen.availWidth){
top.window.outerHeight = screen.availHeight;
top.window.outerWidth = 850;
}
}
</script>
<!----------End optimize window script---------->

<!----------Script for button link to booking form---------->

<script>
function onBodyLoad()
{
var re = new RegExp( "[?&]" + 'demographic_no' + "=([^&$]*)", "i" );
var offset=window.opener.location.search.search(re);
if(offset==-1){ 
re = new RegExp( "[?&]" + 'demographicNo' + "=([^&$]*)", "i" );
offset=window.opener.location.search.search(re);
}
var pathArray=window.opener.location.pathname.split('/');
    //var theIFrame;
    theIFrame = document.createElement("IFRAME");
    theIFrame.setAttribute("id", "dynamicIFrame");
    theIFrame.setAttribute("src", '/'+pathArray[1]+'/eform/efmformslistadd.jsp?demographic_no='+RegExp.$1+'&curProvider=&appointment=&parentAjaxId=eforms');
    theIFrame.setAttribute("onload","doIFrameOnLoad();");
    theIFrame.style.width = 0+"px";
    theIFrame.style.height = 0+"px";
    document.body.appendChild(theIFrame);
}
function doIFrameOnLoad()
{
var re = new RegExp( "[?&]" + 'demographic_no' + "=([^&$]*)", "i" );
var offset=window.opener.location.search.search(re);
if(offset==-1){ 
re = new RegExp( "[?&]" + 'demographicNo' + "=([^&$]*)", "i" );
offset=window.opener.location.search.search(re);
}
var demographic=RegExp.$1;

}

function Link1()
{
window.open("../eform/efmformadd_data.jsp?fid=287&demographic_no="+RegExp.$1+"&apptProvider=&appointment=" );
}

function Link2()
{
window.open("../eform/efmformadd_data.jsp?fid=288&demographic_no="+RegExp.$1+"&apptProvider=&appointment=" );
}

</script>

<!----------End button link script---------->

<!-- scripts to confirm closing of window if it hadn't been saved yet -->
<script language="javascript">
//keypress events trigger dirty flag
var needToConfirm = false;
document.onkeyup=setDirtyFlag;
function setDirtyFlag(){
		needToConfirm = true;
}
function releaseDirtyFlag(){
		needToConfirm = false; //Call this function if doesn't requires an alert.
//this could be called when save button is clicked
}
window.onbeforeunload = confirmExit;
function confirmExit(){
	 if (needToConfirm){
		 return "You have attempted to leave this page. If you have made any changes to the fields without clicking the Save button, your changes will be lost. Are you sure you want to exit this page?";
	 }
}
</script>

<!-----------------script for current date--------->

<script language="javascript">

<!-- hide javascript

function doDate() {
      var digital = new Date();
      var days = digital.getDate();
      var months = digital.getMonth()*1 +1;
      var years = digital.getFullYear();
      var date =" " + days + "/" + months + "/" + years + " " ;
      return date;
}

// done hiding -->

</script>

</head>

<body onload="document.FormName.Today.value=doDate(); document.FormName.Today2.value=doDate(); document.FormName.Today3.value=doDate(); onBodyLoad();">




<img id='BGImage' src="${oscar_image_path}FH-Regional-Consent-for-Health-Care-Form-CWXX104852A-1.png" style="position: absolute; left: 0px; top: 0px; width:750px">

<!-- You can remove ${oscar_image_path} as you develop the form, but make sure you put it back before uploading to OSCAR otherwise the image wouldn't show.
<!-- Also note: the image filename IS CASE SENSITIVE INCLUDING THE EXTENSION. It may work otherwise in Windows, but not in OSCAR because it's based on a Linux platform -->

<form method="post" action="" name="FormName" id="FormName" >

<div id="chkCanvas" style="position:absolute; left:0px; top:0px; width:750; height:750;" onmouseover="putInBack();"></div>

<div class="DoNotPrint" id="linkButtons" style="position: absolute; top:5px; left:100px;">

<tr>
	<td width="600">
		<table  width="600" class="noborder">
	      <tr>
		     <td width = 25%><input value="Click here to go to booking form" name="bookingformlink1" id="bookingformlink1" type="button" onclick="Link1();"></td>
		     <td width = 25%><input value="Click here to go to Pre-Op Order form" name="PreOpOrderformlink1" id="PreOpOrderformlink1" type="button" onclick="Link2();"></td>
                      
             </tr>

                  </table>
       </td>
</tr>

</div>


<input name="patient_name" id="patient_nameL" type="text" class="noborder" style="position:absolute; left:31px; top:235px; width:475px; height:25px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; background-color:white;"  oscarDB=patient_name>


<input name="DOB" id="DOB" type="text" class="noborder" style="position:absolute; left:514px; top:235px; width:107px; height:25px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; background-color:white;"  oscarDB=dobc>


<input name="PHN" id="PHN" type="text" class="noborder" style="position:absolute; left:626px; top:235px; width:116px; height:25px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; background-color:white;"  oscarDB=hinc>


<textarea name="Procedure" id="Procedure" class="noborder" style="position:absolute; left:29px; top:324px; width:710px; height:72px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; text-decoration:underline; background-color:white;" ></textarea>


<input name="ProviderName" id="ProviderName" type="text" class="noborder" style="position:absolute; left:161px; top:440px; width:169px; height:28px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; text-decoration:underline; background-color:white;"  oscarDB=doctor>


<span name="Signature" id="Signature" style="position:absolute; left: 398px; top: 446px; width: 168px; font-family:sans-serif; font-style:italic; font-weight:bold; font-size: 14px; text-align:left; background-color:white;">"Electronically Signed"</span>


<input name="Today" id="Today" type="text" class="noborder" style="position:absolute; left:658px; top:440px; width:79px; height:28px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; text-decoration:underline; background-color:white;">


<input name="PtFLName" id="PtFLName" type="text" class="noborder" style="position:absolute; left:44px; top:559px; width:222px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; text-decoration:underline; background-color:white;"  oscarDB=first_last_name>

<input name="ConsentPt" id="ConsentPt" type="checkbox" style="position:absolute; left: 105px; top: 800px;">

<input name="ConsentGuardian" id="ConsentGuardian" type="checkbox" style="position:absolute; left: 176px; top:800px;">

<input name="ConsentSDM" id="ConsentSDM" type="checkbox" style="position:absolute; left: 319px; top:800px;">

<input name="Today2" id="Today2" type="text" class="noborder" style="position:absolute; left:658px; top:783px; width:79px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; text-decoration:underline; background-color:white;">

<input name="BloodNA" id="BloodNA" type="checkbox" style="position:absolute; left:612px; top:853px; ">

<input name="YesBloodConsent" id="YesBloodConsent" type="checkbox" style="position:absolute; left: 26px; top: 902px;">

<input name="NoBloodConsent" id="NoBloodConsent" type="checkbox" style="position:absolute; left: 355px; top: 902px;">

<input name="BloodConsentPt" id="BloodConsentPt" type="checkbox" style="position:absolute; left:105px; top:950px;">

<input name="BloodConsentGuardian" id="BloodConsentGuardian" type="checkbox" style="position:absolute; left:179px; top:950px;">

<input name="BloodConsentSDM id="BloodConsentSDM" type="checkbox" style="position:absolute; left:321px; top:950px;">

<input name="Today3" id="Today3" type="text" class="noborder" style="position:absolute; left:658px; top:933px; width:79px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; text-decoration:underline; background-color:white;">


 <div class="DoNotPrint" id="BottomButtons" style="position: absolute; top:1020px; left:0px;">
	 <table><tr><td>
		 Subject: <input name="subject" size="40" type="text"> 
			<input value="Submit" name="SubmitButton" id="SubmitButton" type="submit" onclick=" releaseDirtyFlag();"> 
			<input value="Reset" name="ResetButton" id="ResetButton" type="reset"> 
			<input value="Print" name="PrintButton" id="PrintButton" type="button" onclick="formPrint();"> 
			<input value="Print & Submit" name="PrintSubmitButton" id="PrintSubmitButton" type="button" onclick="formPrint();releaseDirtyFlag();setTimeout('SubmitButton.click()',1000);"> 
			<input name="DrawCheckmark" id="DrawCheckmark" type="checkbox" checked><span style="font-family:sans-serif; font-size:12px;">Draw Checkmarks</span> 
	 </td></tr></table>
 </div>
 </form>

<script type="text/javascript">
<!-- Drawing in checkmarks -->
var chkcnv = document.getElementById('chkCanvas');
var chkjg = new jsGraphics(chkcnv);
var chkcnvLeft = parseInt(chkcnv.style.left);
var chkcnvTop = parseInt(chkcnv.style.top);
chkjg.setPrintable(true);
function drawCheckmark(x,y){
var offset = 6;
var x = parseInt(x) + offset;
var y = parseInt(y) + offset;
chkjg.setColor('black');
chkjg.setStroke(3);
		// draws checkmark
		var x1 = x;
		var y1 = y+4;
		var x2 = x1 + 3;
		var y2 = y1 + 4;
		var x3 = x2 + 4;
		var y3 = y2 - 12;
		chkjg.drawLine(x1,y1,x2,y2);
		chkjg.drawLine(x2,y2,x3,y3);
		chkjg.paint();
}
function replaceCheckmarks(){
var f = document.getElementById("FormName");
		 for (var i=0;i<f.length;i++){
				if ((f.elements[i].type == 'checkbox') && (f.elements[i].checked)){
					var a = f.elements[i].style.left;
					var b = f.elements[i].style.top;
					drawCheckmark(a,b);
				}
		 }
}
function printCheckboxes(){
		putInFront();
		replaceCheckmarks();
		window.print();
}
function putInFront(){
		chkcnv.style.zIndex = "999999";	
}
function putInBack(){
		chkcnv.style.zIndex = "-999999";	
}
</script>
</body>
</html>

Document Actions

 

Download button

DOWNLOAD OSCAR FOR TESTING

 

eForms button

DOWNLOAD SHARED E-FORMS


 Customize button

FIND PLUG-INS AND TWEAKS
FOR YOUR OSCAR EMR

 

Subscribe Button

SUBSCRIBE TO DISCUSSION LIST 
(SEE ALL LISTS)

  

Help button

ACCESS THE ONLINE MANUALS
(PAID SUPPORT)