contrib/forms/xmlformgen/communication_log.xml

   1 <?xml version="1.0" encoding="ISO-8859-1"?>
   2 <!-- Generated by Hand -->
   3 <form>
   4   <table type="form">form_communication</table>
   5   <RealName>Communication Log</RealName>
   6   <safename>communication_log</safename>
   7   <style cells_per_row="4">layout</style>
   8   <acl table="patients">med</acl>
   9   <manual>
  10     <section name="contact" label="Who">
  11       <field name="contact_date" label="Date" type="date" hoverover="Date contact occured/was attempted" labelcols="1" cols="3"/>
  12       <field name="contact_name" label="Name" type="textfield" hoverover="Person we are attempting to contact/were contacted by" length="50" maxlength="255" labelcols="1" cols="3"/>
  13       <field name="phone" label="Phone #" type="textfield" hoverover="Phone number dialed or number of caller(if known)" length="15" maxlength="15" labelcols="1" cols="3"/>
  14       <field name="direction" label="Outgoing Call?" type="checkbox_list" list="yesno" hoverover="Was the call outbound?" labelcols="1" cols="1"/>
  15       <field name="contact_success" label="Contact Successful?" type="checkbox_list" list="yesno" hoverover="If the call was outbound, did you get ahold of someone who could help?" labelcols="1" cols="1"/>
  16       <field name="reason" label="Reasons for contact" type="textarea" rows="3" columns="10" hoverover="the principal reason or reasons contact was attempted" labelcols="1" cols="1"/>
  17       <field name="result" label="Results of conversation" type="textarea" rows="3" columns="10" labelcols="1" cols="1"/>
  18     </section>
  19     <section name="staff" label="Agency Representitive">
  20       <field name="screener" label="Access Screener" type="provider" hoverover="Staff Member" labelcols="1" cols="1"/>
  21       <field name="signature_box" label="Signature" type="textfield" maxlength="60" hoverover="Sign here to signify all information in this form is correct" labelcols="1" cols="1"/>
  22     </section>
  23   </manual>
  24   <!-- list is empty, as its already in OpenEMR -->
  25   <list name="yesno" label="Yes/No" type="standard" id="yesno" import="no"/>
  26 </form>