portal/account/register.php

   1 <?php
   2
   3 /**
   4  * Portal Registration Wizard
   5  *
   6  * @package   OpenEMR
   7  * @link      http://www.open-emr.org
   8  * @author    Jerry Padgett <sjpadgett@gmail.com>
   9  * @author    Brady Miller <brady.g.miller@gmail.com>
  10  * @copyright Copyright (c) 2017-2019 Jerry Padgett <sjpadgett@gmail.com>
  11  * @copyright Copyright (c) 2019 Brady Miller <brady.g.miller@gmail.com>
  12  * @license   https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3
  13  */
  14
  15 // script is brought in as require_once in index.php when applicable
  16
  17 use OpenEMR\Common\Logging\SystemLogger;
  18 use OpenEMR\Core\Header;
  19
  20 if ($portalRegistrationAuthorization !== true) {
  21     (new SystemLogger())->debug("attempted to use register.php directly, so failed");
  22     OpenEMR\Common\Session\SessionUtil::portalSessionCookieDestroy();
  23     echo xlt("Not Authorized");
  24     header('HTTP/1.1 401 Unauthorized');
  25     die();
  26 }
  27
  28 if (empty($GLOBALS['portal_onsite_two_register']) || empty($GLOBALS['google_recaptcha_site_key']) || empty($GLOBALS['google_recaptcha_secret_key'])) {
  29     (new SystemLogger())->debug("attempted to use register.php despite register feature being turned off, so failed");
  30     OpenEMR\Common\Session\SessionUtil::portalSessionCookieDestroy();
  31     echo xlt("Not Authorized");
  32     header('HTTP/1.1 401 Unauthorized');
  33     die();
  34 }
  35
  36 unset($_SESSION['itsme']);
  37 $_SESSION['authUser'] = 'portal-user';
  38 $_SESSION['pid'] = true;
  39 $_SESSION['register'] = true;
  40 $_SESSION['register_silo_ajax'] = true;
  41
  42 $landingpage = "index.php?site=" . urlencode($_SESSION['site_id']);
  43
  44 ?>
  45 <!DOCTYPE html>
  46 <html>
  47 <head>
  48     <title><?php echo xlt('New Patient'); ?> | <?php echo xlt('Register'); ?></title>
  49     <meta name="description" content="Developed By sjpadgett@gmail.com" />
  50
  51     <?php Header::setupHeader(['no_main-theme',  'portal-theme', 'datetime-picker']); ?>
  52
  53     <script>
  54         var webRoot = <?php echo js_escape($GLOBALS['web_root']); ?>;
  55         top.webroot_url = webRoot;
  56         var provider = 0;
  57
  58         function restoreSession() {
  59             //dummy functions so the dlgopen function will work in the patient portal
  60             return true;
  61         }
  62
  63         $(function () {
  64             var navListItems = $('div.setup-panel div a'),
  65                 allWells = $('.setup-content'),
  66                 allNextBtn = $('.nextBtn'),
  67                 allPrevBtn = $('.prevBtn');
  68
  69             allWells.hide();
  70
  71             navListItems.click(function (e) {
  72                 e.preventDefault();
  73                 if (!$(this).hasClass('disabled')) {
  74                     navListItems.removeClass('btn-primary').addClass('btn-light');
  75                     $(this).addClass('btn-primary').removeClass('btn-light');
  76                     allWells.hide();
  77                     $($(this).attr('href')).show();
  78                     $($(this).attr('href')).find('input:eq(0)').focus();
  79                 }
  80             });
  81
  82             allPrevBtn.click(function () {
  83                 var curStep = $(this).closest(".setup-content"),
  84                     curStepBtn = curStep.attr("id"),
  85                     prevstepwiz = $('div.setup-panel div a[href="#' + curStepBtn + '"]').parent().prev().children("a");
  86                 prevstepwiz.removeClass('disabled').trigger('click');
  87             });
  88
  89             allNextBtn.click(function () {
  90                 var profile = $("#profileFrame").contents();
  91
  92                 // Fix for iFrame height
  93                 window.addEventListener('message', function (e) {
  94                     var scroll_height = e.data;
  95                     document.getElementById('profileFrame').style.height = scroll_height + 'px';
  96                 }, false);
  97
  98                 var curStep = $(this).closest(".setup-content"),
  99                     curStepBtn = curStep.attr("id"),
 100                     nextstepwiz = $('div.setup-panel div a[href="#' + curStepBtn + '"]').parent().next().children("a"),
 101                     curInputs = curStep.find("input[type='text'],input[type='email'],select"),
 102                     isValid = true;
 103
 104                 $(".form-group").removeClass("has-error");
 105                 for (var i = 0; i < curInputs.length; i++) {
 106                     if (!curInputs[i].validity.valid) {
 107                         isValid = false;
 108                         $(curInputs[i]).closest(".form-group").addClass("has-error");
 109                     }
 110                 }
 111                 if (isValid) {
 112                     if (curStepBtn == 'step-1') { // leaving step 1 setup profile frame. Prob not nec but in case
 113                         let fn = $("#fname").val().replace(/^./, $("#fname").val()[0].toUpperCase());
 114                         let ln = $("#lname").val().replace(/^./, $("#lname").val()[0].toUpperCase());
 115                         profile.find('input#fname').val(fn);
 116                         profile.find('input#mname').val($("#mname").val());
 117                         profile.find('input#lname').val(ln);
 118                         profile.find('input#dob').val($("#dob").val());
 119                         profile.find('input#email').val($("#emailInput").val());
 120                         // disable to prevent already validated field changes.
 121                         profile.find('input#fname').prop("disabled", true);
 122                         profile.find('input#mname').prop("disabled", true);
 123                         profile.find('input#lname').prop("disabled", true);
 124                         profile.find('input#dob').prop("disabled", true);
 125                         profile.find('input#email').prop("disabled", true);
 126                         profile.find('input#emailDirect').prop("disabled", true);
 127                         profile.find('input#pid').prop('disabled', true);
 128                         profile.find('input#pid').val('');
 129
 130                         profile.find('input[name=allowPatientPortal]').val(['YES']);
 131                         profile.find('input[name=hipaaAllowemail]').val(['YES']);
 132                         // need these for validation.
 133                         profile.find('select#providerid option:contains("Unassigned")').val('');
 134                         // must have a provider for many reasons. w/o save won't work.
 135                         //profile.find('select#providerid').attr('required', true);
 136                         profile.find('select#sex option:contains("Unassigned")').val('');
 137                         profile.find('select#sex').attr('required', true);
 138                     }
 139                     nextstepwiz.removeClass('disabled').trigger('click');
 140                 }
 141             });
 142
 143             $("#profileNext").click(function () {
 144                 var profile = $("#profileFrame").contents();
 145                 var curStep = $(this).closest(".setup-content"),
 146                     curStepBtn = curStep.attr("id"),
 147                     nextstepwiz = $('div.setup-panel div a[href="#' + curStepBtn + '"]').parent().next().children("a"),
 148                     curInputs = profile.find("input[type='text'],input[type='email'],select"),
 149                     isValid = true;
 150                 $(".form-group").removeClass("has-error");
 151                 let flg = 0;
 152                 for (var i = 0; i < curInputs.length; i++) {
 153                     if (!curInputs[i].validity.valid) {
 154                         isValid = false;
 155                         if (!flg) {
 156                             curInputs[i].scrollIntoView();
 157                             curInputs[i].focus();
 158                             flg = 1;
 159                         }
 160                         $(curInputs[i]).closest(".form-group").addClass("has-error");
 161                     }
 162                 }
 163                 if (isValid) {
 164                     provider = profile.find('select#providerid').val();
 165                     nextstepwiz.removeClass('disabled').trigger('click');
 166                 }
 167             });
 168
 169             $("#submitPatient").click(function () {
 170                 let profile = $("#profileFrame").contents();
 171                 if (checkRegistration()) {
 172                     // Use portals rest api. flag 1 is write to chart. flag 0 writes an audit record for review in dashboard.
 173                     //  (unclear what above means since no flags here and is being saved directly in chart)
 174                     // Save the new patient.
 175                     document.getElementById('profileFrame').contentWindow.postMessage({submitForm: true}, window.location.origin);
 176                     // lets force a second here to ensure above patient import is called to server prior than the insurance import
 177                     //  (this order is critical because the patient import sets up the pid to be used on the backend, so that no
 178                     //   pid adjustments can be made on the frontend)
 179                     delayPromise(1000).then(() => $("#insuranceForm").submit());
 180                 }
 181             });
 182
 183             $('div.setup-panel div a.btn-primary').trigger('click');
 184
 185             $('.datepicker').datetimepicker({
 186                 <?php $datetimepicker_timepicker = false; ?>
 187                 <?php $datetimepicker_showseconds = false; ?>
 188                 <?php $datetimepicker_formatInput = false; ?>
 189                 <?php require($GLOBALS['srcdir'] . '/js/xl/jquery-datetimepicker-2-5-4.js.php'); ?>
 190             });
 191
 192             $("#insuranceForm").submit(function (e) {
 193                 e.preventDefault();
 194                 let url = "account/account.php?action=new_insurance";
 195                 $.ajax({
 196                     url: url,
 197                     type: 'post',
 198                     data: $("#insuranceForm").serialize()
 199                 }).done(function (serverResponse) {
 200                         doCredentials(provider) // this is the end for session.
 201                         return false;
 202                     });
 203             });
 204
 205             $('#inscompany').on('change', function () {
 206                 if ($('#inscompany').val().toUpperCase() === 'SELF') {
 207                     $("#insuranceForm input").removeAttr("required");
 208                     let message = <?php echo xlj('You have chosen to be self insured or currently do not have insurance. Click next to continue registration.'); ?>;
 209                     //alert(message);
 210                 }
 211             });
 212
 213             $("#dob").on('blur', function () {
 214                 let bday = $(this).val() ?? '';
 215                 let age = Math.round(Math.abs((new Date().getTime() - new Date(bday).getTime())));
 216                 age = Math.round(age / 1000 / 60 / 60 / 24);
 217                 // need to be at least 30 days old otherwise likely an error.
 218                 if (age < 30) {
 219                     let msg = <?php echo(xlj("Invalid Date format or value! Type date as YYYY-MM-DD or use the calendar.")); ?> ;
 220                     $(this).val('');
 221                     $(this).prop('placeholder', 'Invalid Date');
 222                     alert(msg);
 223                     return false;
 224                 }
 225             });
 226
 227         }); // ready end
 228
 229         function delayPromise(time) {
 230             return new Promise(resolve => setTimeout(resolve, time));
 231         }
 232
 233         function doCredentials(provider) {
 234             window.location.href = "account/account.php?action=do_signup&provider=" + encodeURIComponent(provider);
 235         }
 236
 237         function checkRegistration() {
 238             var profile = $("#profileFrame").contents();
 239             var curStep = $("#step-2"),
 240                 curStepBtn = curStep.attr("id"),
 241                 nextstepwiz = $('div.setup-panel div a[href="#' + curStepBtn + '"]').parent().next().children("a"),
 242                 curInputs = $("#profileFrame").contents().find("input[type='text'],input[type='email'],select"),
 243                 isValid = true;
 244             $(".form-group").removeClass("has-error");
 245             let flg = 0;
 246             for (let i = 0; i < curInputs.length; i++) {
 247                 if (!curInputs[i].validity.valid) {
 248                     isValid = false;
 249                     if (!flg) {
 250                         curInputs[i].scrollIntoView();
 251                         curInputs[i].focus();
 252                         flg = 1;
 253                     }
 254                     $(curInputs[i]).closest(".form-group").addClass("has-error");
 255                 }
 256             }
 257             return isValid;
 258         }
 259
 260     </script>
 261 </head>
 262 <style>
 263   body {
 264     margin-top: 20px
 265   }
 266
 267   .btn-circle {
 268     border-radius: .9375rem !important
 269   }
 270
 271   .embedded-content {
 272     border: 0;
 273     width: 100% !important
 274   }
 275
 276   .reg-email {
 277     margin-left: auto;
 278     margin-right: auto;
 279     width: 50%
 280   }
 281
 282   @media (max-width: 1024px) {
 283     .reg-email {
 284       width: 100%
 285     }
 286   }
 287
 288   .stepwiz-row {
 289     display: table-row
 290   }
 291
 292   .stepwiz-row::before {
 293     background-color: var(--gray400);
 294     bottom: 0;
 295     content: " ";
 296     height: 1px;
 297     position: absolute;
 298     top: 14px;
 299     width: 100%
 300   }
 301
 302   .stepwiz {
 303     display: table;
 304     margin-top: 20px;
 305     position: relative;
 306     width: 100%
 307   }
 308
 309   .stepwiz-step {
 310     display: table-cell;
 311     position: relative;
 312     text-align: center
 313   }
 314
 315   .stepwiz-step p {
 316     margin-top: 10px
 317   }
 318
 319   .stepwiz-step button[disabled] {
 320     filter: alpha(opacity=100) !important;
 321     opacity: 1 !important
 322   }
 323
 324   .btn-circle {
 325     border-radius: 16px;
 326     font-size: 12px;
 327     font-weight: 700;
 328     height: 35px;
 329     line-height: 1.428571429;
 330     padding: 6px 0;
 331     text-align: center;
 332     width: 35px
 333   }
 334
 335   fieldset, input[type=date], input[type=email], input[type=text], select {
 336     -webkit-appearance: none;
 337     -moz-appearance: none;
 338     appearance: none;
 339     box-sizing: border-box
 340   }
 341
 342   input:focus:invalid, input:required:invalid {
 343     background-image: url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAGXRFWHRTb2Z0d2FyZQBBZG9iZSBJbWFnZVJlYWR5ccllPAAAAeVJREFUeNqkU01oE1EQ/mazSTdRmqSxLVSJVKU9RYoHD8WfHr16kh5EFA8eSy6hXrwUPBSKZ6E9V1CU4tGf0DZWDEQrGkhprRDbCvlpavan3ezu+LLSUnADLZnHwHvzmJlvvpkhZkY7IqFNaTuAfPhhP/8Uo87SGSaDsP27hgYM/lUpy6lHdqsAtM+BPfvqKp3ufYKwcgmWCug6oKmrrG3PoaqngWjdd/922hOBs5C/jJA6x7AiUt8VYVUAVQXXShfIqCYRMZO8/N1N+B8H1sOUwivpSUSVCJ2MAjtVwBAIdv+AQkHQqbOgc+fBvorjyQENDcch16/BtkQdAlC4E6jrYHGgGU18Io3gmhzJuwub6/fQJYNi/YBpCifhbDaAPXFvCBVxXbvfbNGFeN8DkjogWAd8DljV3KRutcEAeHMN/HXZ4p9bhncJHCyhNx52R0Kv/XNuQvYBnM+CP7xddXL5KaJw0TMAF8qjnMvegeK/SLHubhpKDKIrJDlvXoMX3y9xcSMZyBQ+tpyk5hzsa2Ns7LGdfWdbL6fZvHn92d7dgROH/730YBLtiZmEdGPkFnhX4kxmjVe2xgPfCtrRd6GHRtEh9zsL8xVe+pwSzj+OtwvletZZ/wLeKD71L+ZeHHWZ/gowABkp7AwwnEjFAAAAAElFTkSuQmCC);
 344     background-position: right top;
 345     background-repeat: no-repeat;
 346     box-shadow: none
 347   }
 348
 349   input:required:valid {
 350     background-image: url(data:image/png;base64,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);
 351     background-position: right top;
 352     background-repeat: no-repeat
 353   }
 354 </style>
 355
 356 <body class="mt-4 skin-blue">
 357     <div class="container-lg">
 358         <h1 class="text-center"><?php echo xlt('Account Registration'); ?></h1>
 359         <div class="stepwiz">
 360             <div class="stepwiz-row setup-panel">
 361                 <div class="stepwiz-step">
 362                     <a href="#step-1" type="button" class="btn btn-primary btn-circle">1</a>
 363                     <p><?php echo xlt('Verify Email') ?></p>
 364                 </div>
 365                 <div class="stepwiz-step">
 366                     <a href="#step-2" type="button" class="btn btn-light btn-circle disabled">2</a>
 367                     <p><?php echo xlt('Profile') ?></p>
 368                 </div>
 369                 <div class="stepwiz-step">
 370                     <a href="#step-3" type="button" class="btn btn-light btn-circle disabled">3</a>
 371                     <p><?php echo xlt('Insurance') ?></p>
 372                 </div>
 373                 <div class="stepwiz-step">
 374                     <a href="#step-4" type="button" class="btn btn-light btn-circle disabled">4</a>
 375                     <p><?php echo xlt('Register') ?></p>
 376                 </div>
 377             </div>
 378         </div>
 379         <!-- // Start Forms // -->
 380         <form id="startForm" role="form">
 381             <div class="text-center setup-content" id="step-1">
 382                 <div class="jumbotron">
 383                     <input type="hidden" name="languageChoice" value="<?php echo attr($languageRegistration); ?>" />
 384                     <input type="hidden" id="fname" name="fname" value="<?php echo attr($fnameRegistration); ?>" />
 385                     <input type="hidden" id="mname" name="mname" value="<?php echo attr($mnameRegistration); ?>" />
 386                     <input type="hidden" id="lname" name="lname" value="<?php echo attr($lnameRegistration); ?>" />
 387                     <input type="hidden" id="dob" name="dob" value="<?php echo attr($dobRegistration); ?>" />
 388                     <input type="hidden" id="emailInput" name="email" value="<?php echo attr($emailRegistration); ?>" />
 389                     <div class="alert alert-success" role="alert"><?php echo xlt("Your email has been verified. Click Next."); ?></div>
 390                 </div>
 391                 <button class="btn btn-primary nextBtn pull-right" type="button"><?php echo xlt('Next') ?></button>
 392             </div>
 393         </form>
 394         <!-- Profile Form -->
 395         <form id="profileForm" role="form" action="account/account.php" method="post">
 396             <div class="text-center setup-content" id="step-2" style="display: none">
 397                 <legend class="bg-primary text-white"><?php echo xlt('Profile') ?></legend>
 398                 <div class="jumbotron">
 399                     <iframe class="embedded-content" src="patient/patientdata?pid=0&register=true" id="profileFrame" name="Profile Info"></iframe>
 400                 </div>
 401                 <button class="btn btn-primary pull-right" type="button" id="profileNext"><?php echo xlt('Next') ?></button>
 402             </div>
 403         </form>
 404         <!-- Insurance Form -->
 405         <form id="insuranceForm" role="form" action="" method="post">
 406             <div class="text-center setup-content" id="step-3" style="display: none">
 407                 <legend class='bg-primary text-white'><?php echo xlt('Insurance') ?></legend>
 408                 <div class="jumbotron">
 409                     <div class="form-row">
 410                         <div class="col-12 col-md-6 col-lg-3 form-group">
 411                             <label for="provider"><?php echo xlt('Insurance Company') ?></label>
 412                             <div class="controls inline-inputs">
 413                                 <input type="text" class="form-control" name="provider" id="inscompany" required placeholder="<?php echo xla('Enter Self if None'); ?>">
 414                             </div>
 415                         </div>
 416                         <div class="col-12 col-md-6 col-lg-3 form-group">
 417                             <label for="plan_name"><?php echo xlt('Plan Name') ?></label>
 418                             <div class="controls inline-inputs">
 419                                 <input type="text" class="form-control" name="plan_name" required placeholder="<?php echo xla('required'); ?>">
 420                             </div>
 421                         </div>
 422                         <div class="col-12 col-md-6 col-lg-3 form-group">
 423                             <label for="policy_number"><?php echo xlt('Policy Number') ?></label>
 424                             <div class="controls inline-inputs">
 425                                 <input type="text" class="form-control" name="policy_number" required placeholder="<?php echo xla('required'); ?>">
 426                             </div>
 427                         </div>
 428                     </div>
 429                     <div class="form-row">
 430                         <div class="col-12 col-md-6 col-lg-3 form-group">
 431                             <label for="group_number"><?php echo xlt('Group Number') ?></label>
 432                             <div class="controls inline-inputs">
 433                                 <input type="text" class="form-control" name="group_number" required placeholder="<?php echo xla('required'); ?>">
 434                             </div>
 435                         </div>
 436                         <div class="col-12 col-md-6 col-lg-3 form-group">
 437                             <label for="date"><?php echo xlt('Policy Begin Date') ?></label>
 438                             <div class="controls inline-inputs">
 439                                 <input type="text" class="form-control datepicker" name="date" placeholder="<?php echo xla('Policy effective date'); ?>">
 440                             </div>
 441                         </div>
 442                         <div class="col-12 col-md-6 col-lg-3 form-group">
 443                             <label for="copay"><?php echo xlt('Co-Payment') ?></label>
 444                             <div class="controls inline-inputs">
 445                                 <input type="number" class="form-control" name="copay" placeholder="<?php echo xla('Plan copay if known'); ?>">
 446                             </div>
 447                         </div>
 448                     </div>
 449                 </div>
 450                 <button class="btn btn-primary prevBtn btn-sm pull-left" type="button"><?php echo xlt('Previous') ?></button>
 451                 <button class="btn btn-primary nextBtn btn-sm pull-right" type="button"><?php echo xlt('Next') ?></button>
 452             </div>
 453         </form>
 454         <!-- End Insurance. Next what we've been striving towards..the end-->
 455         <div class="text-center setup-content" id="step-4" style="display: none">
 456             <legend class='bg-success text-white'><?php echo xlt('Register') ?></legend>
 457             <div class="jumbotron">
 458                 <h4 class='bg-success'><?php echo xlt("All set. Click Send Request below to finish registration.") ?></h4>
 459                 <hr />
 460                 <p>
 461                     <?php echo xlt("An e-mail with your new account credentials will be sent to the e-mail address supplied earlier. You may still review or edit any part of your information by using the top step buttons to go to the appropriate panels. If after receiving credentials and you have trouble with access to the portal, please contact administration.") ?>
 462                 </p>
 463             </div>
 464             <hr />
 465             <button class="btn btn-primary prevBtn float-left" type="button"><?php echo xlt('Previous') ?></button>
 466             <button class="btn btn-success float-right" type="button" id="submitPatient"><?php echo xlt('Send Request') ?></button>
 467         </div>
 468     </div>
 469 </body>
 470 </html>