Improve flexibility of which code types are used in claims and other misc.
[openemr.git] / contrib / forms / ped_pain / new.php
blobb4fd93a942ad89084a6e690b505289d14f7af18e
1 <?php
3 // file new.php
5 // presents a blank form for evaluating pediatric pain
7 // this file made by andres@paglayan.com on 2004-09-23
9 // input designed by Lowell Gordon, MD lgordon@whssf.org
11 // to max the billing complexity coding
15 include_once("../../globals.php");
17 include_once("../../../library/api.inc");
19 formHeader("Pediatric Pain Evaluation");
25 <html><head>
26 <?php html_header_show();?>
28 <link rel="stylesheet" href="<?php echo $css_header;?>" type="text/css">
30 </head>
32 <body class="body_top">
36 <!--REM note that every input method has the same name as a valid column, this will make things easier in save.php -->
40 <br>
42 <form method='post' action="<?php echo $rootdir;?>/forms/ped_pain/save.php?mode=new" name='ped_pain' >
46 <!-- the form goes here -->
48 <?php
50 $obj=array(); // just to avoid undeclared var warning
52 include ('form.php'); // to use a single file for both, empty and editing
56 <!-- the form ends here -->
60 <!--REM note our nifty jscript submit -->
62 <a href="javascript:top.restoreSession();document.ped_pain.submit();" class="link_submit">[Save]</a>
64 <br>
68 <a href="<?php echo $GLOBALS['form_exit_url']; ?>" class="link" onclick="top.restoreSession()">[Don't Save]</a>
70 </form>
74 <?php
76 formFooter();