interface/usergroup/facilities_add.php

   1 <?php
   2 require_once("../globals.php");
   3 require_once("../../library/acl.inc");
   4 require_once("$srcdir/sql.inc");
   5 require_once("$srcdir/formdata.inc.php");
   6 require_once("$srcdir/classes/POSRef.class.php");
   7 require_once("$srcdir/options.inc.php");
   8 require_once("$srcdir/erx_javascript.inc.php");
   9
  10 $alertmsg = '';
  11 ?>
  12 <html>
  13 <head>
  14 <link rel="stylesheet" href="<?php echo $css_header;?>" type="text/css">
  15 <link rel="stylesheet" type="text/css" href="<?php echo $GLOBALS['webroot'] ?>/library/js/fancybox/jquery.fancybox-1.2.6.css" media="screen" />
  16 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/dialog.js?v=<?php echo $v_js_includes; ?>"></script>
  17 <script type="text/javascript" src="<?php echo $GLOBALS['assets_static_relative'] ?>/jquery-min-1-9-1/index.js"></script>
  18 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/js/common.js"></script>
  19 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/js/fancybox/jquery.fancybox-1.2.6.js"></script>
  20 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/js/jquery-ui.js"></script>
  21 <script type="text/javascript" src="../main/calendar/modules/PostCalendar/pnincludes/AnchorPosition.js"></script>
  22 <script type="text/javascript" src="../main/calendar/modules/PostCalendar/pnincludes/PopupWindow.js"></script>
  23 <script type="text/javascript" src="../main/calendar/modules/PostCalendar/pnincludes/ColorPicker2.js"></script>
  24
  25 <!-- validation library -->
  26 <!--//Not lbf forms use the new validation, please make sure you have the corresponding values in the list Page validation-->
  27 <?php    $use_validate_js = 1;?>
  28 <?php  require_once($GLOBALS['srcdir'] . "/validation/validation_script.js.php"); ?>
  29 <?php  require_once($GLOBALS['srcdir'] . "/validation/validate_core.php"); ?>
  30 <?php
  31 //Gets validation rules from Page Validation list.
  32 //Note that for technical reasons, we are bypassing the standard validateUsingPageRules() call.
  33 $collectthis = collectValidationPageRules("/interface/usergroup/facilities_add.php");
  34 if (empty($collectthis)) {
  35     $collectthis = "undefined";
  36 }
  37 else {
  38     $collectthis = $collectthis["facility-add"]["rules"];
  39 }
  40
  41 // Old Browser comp trigger on js
  42
  43 if (isset($_POST["mode"]) && $_POST["mode"] == "facility") {
  44         echo '
  45 <script type="text/javascript">
  46 <!--
  47 parent.$.fn.fancybox.close();
  48 //-->
  49 </script>
  50
  51         ';
  52 }
  53 ?>
  54 <script type="text/javascript">
  55 /// todo, move this to a common library
  56
  57 var collectvalidation = <?php echo($collectthis); ?>;
  58
  59 function submitform() {
  60
  61     var valid = submitme(1, undefined, 'facility-add', collectvalidation);
  62     if (!valid) return;
  63
  64         <?php if($GLOBALS['erx_enable']){ ?>
  65         alertMsg='';
  66         f=document.forms[0];
  67         for(i=0;i<f.length;i++){
  68                 if(f[i].type=='text' && f[i].value)
  69                 {
  70                         if(f[i].name == 'facility' || f[i].name == 'Washington')
  71                         {
  72                                 alertMsg += checkLength(f[i].name,f[i].value,35);
  73                                 alertMsg += checkFacilityName(f[i].name,f[i].value);
  74                         }
  75                         else if(f[i].name == 'street')
  76                         {
  77                                 alertMsg += checkLength(f[i].name,f[i].value,35);
  78                                 alertMsg += checkAlphaNumeric(f[i].name,f[i].value);
  79                         }
  80                         else if(f[i].name == 'phone' || f[i].name == 'fax')
  81                         {
  82                                 alertMsg += checkPhone(f[i].name,f[i].value);
  83                         }
  84                         else if(f[i].name == 'federal_ein')
  85                         {
  86                                 alertMsg += checkLength(f[i].name,f[i].value,10);
  87                                 alertMsg += checkFederalEin(f[i].name,f[i].value);
  88                         }
  89                 }
  90         }
  91         if(alertMsg)
  92         {
  93                 alert(alertMsg);
  94                 return false;
  95         }
  96         <?php } ?>
  97
  98     document.forms[0].submit();
  99     top.restoreSession();
 100 }
 101
 102 function toggle( target, div ) {
 103
 104     $mode = $(target).find(".indicator").text();
 105     if ( $mode == "collapse" ) {
 106         $(target).find(".indicator").text( "expand" );
 107         $(div).hide();
 108     } else {
 109         $(target).find(".indicator").text( "collapse" );
 110         $(div).show();
 111     }
 112
 113 }
 114
 115 $(document).ready(function(){
 116
 117     $("#dem_view").click( function() {
 118         toggle( $(this), "#DEM" );
 119     });
 120
 121     // fancy box
 122     enable_modals();
 123
 124     tabbify();
 125
 126     // special size for
 127         $(".large_modal").fancybox( {
 128                 'overlayOpacity' : 0.0,
 129                 'showCloseButton' : true,
 130                 'frameHeight' : 600,
 131                 'frameWidth' : 1000
 132         });
 133
 134     // special size for
 135         $(".medium_modal").fancybox( {
 136                 'overlayOpacity' : 0.0,
 137                 'showCloseButton' : true,
 138                 'frameHeight' : 260,
 139                 'frameWidth' : 510
 140         });
 141
 142 });
 143
 144 $(document).ready(function(){
 145     $("#cancel").click(function() {
 146                   parent.$.fn.fancybox.close();
 147          });
 148 });
 149 var cp = new ColorPicker('window');
 150   // Runs when a color is clicked
 151 function pickColor(color) {
 152         document.getElementById('ncolor').value = color;
 153 }
 154 var field;
 155 function pick(anchorname,target) {
 156         var cp = new ColorPicker('window');
 157         field=target;
 158         cp.show(anchorname);
 159 }
 160 function displayAlert()
 161 {
 162         if(document.getElementById('primary_business_entity').checked==false)
 163         alert("<?php echo addslashes(xl('Primary Business Entity tax id is used as account id for NewCrop ePrescription. Changing the facility will affect the working in NewCrop.'));?>");
 164         else if(document.getElementById('primary_business_entity').checked==true)
 165         alert("<?php echo addslashes(xl('Once the Primary Business Facility is set, it should not be changed. Changing the facility will affect the working in NewCrop ePrescription.'));?>");
 166 }
 167 </script>
 168 <link rel="stylesheet" href="<?php echo $css_header;?>" type="text/css">
 169
 170 </head>
 171 <body class="body_top">
 172 <table>
 173 <tr><td>
 174     <span class="title"><?php xl('Add Facility','e'); ?></span>&nbsp;&nbsp;&nbsp;</td>
 175     <td colspan=5 align=center style="padding-left:2px;">
 176         <a onclick="submitform();" class="css_button large_button" name='form_save' id='form_save' href='#'>
 177             <span class='css_button_span large_button_span'><?php xl('Save','e');?></span>
 178         </a>
 179         <a class="css_button large_button" id='cancel' href='#' >
 180             <span class='css_button_span large_button_span'><?php xl('Cancel','e');?></span>
 181         </a>
 182 </td></tr>
 183 </table>
 184
 185 <br>
 186
 187 <form name='facility-add' id='facility-add' method='post' action="facilities.php" target='_parent'>
 188     <input type=hidden name=mode value="facility">
 189     <table border=0 cellpadding=0 cellspacing=0>
 190         <tr>
 191         <td><span class="text"><?php xl('Name','e'); ?>: </span></td><td><input type=entry name=facility size=20 value=""><span class="mandatory">&nbsp;*</span></td>
 192         <td width=20>&nbsp;</td>
 193         <td><span class="text"><?php xl('Phone','e'); ?>: </span></td><td><input type=entry name=phone size=20 value=""></td>
 194         </tr>
 195         <tr>
 196         <td><span class="text"><?php xl('Address','e'); ?>: </span></td><td><input type=entry size=20 name=street value=""></td>
 197         <td>&nbsp;</td>
 198         <td><span class="text"><?php xl('Fax','e'); ?>: </span></td><td><input type=entry name=fax size=20 value=""></td>
 199         </tr>
 200         <tr>
 201         <td><span class="text"><?php xl('City','e'); ?>: </span></td><td><input type=entry size=20 name=city value=""></td>
 202         <td>&nbsp;</td>
 203         <td><span class="text"><?php xl('Zip Code','e'); ?>: </span></td><td><input type=entry size=20 name=postal_code value=""></td>
 204         </tr>
 205         <tr>
 206         <td><span class="text"><?php xl('State','e'); ?>: </span></td><td><input type=entry size=20 name=state value=""></td>
 207         <td>&nbsp;</td>
 208         <td><span class="text"><?php xl('Tax ID','e'); ?>: </span></td><td><select name=tax_id_type><option value="EI"><?php xl('EIN','e'); ?></option><option value="SY"><?php xl('SSN','e'); ?></option></select><input type=entry size=11 name=federal_ein value=""></td>
 209         </tr>
 210         <tr>
 211         <td height="22"><span class="text"><?php xl('Country','e'); ?>: </span></td><td><input type=entry size=20 name=country_code value=""></td>
 212         <td>&nbsp;</td>
 213         <td><span class="text"><?php ($GLOBALS['simplified_demographics'] ? xl('Facility Code','e') : xl('Facility NPI','e')); ?>:
 214         </span></td><td><input type=entry size=20 name=facility_npi value=""></td>
 215         </tr>
 216                 <tr>
 217         <td><span class="text"><?php xl('Website','e'); ?>: </span></td><td><input type=entry size=20 name=website value=""></td>
 218         <td>&nbsp;</td>
 219         <td><span class="text"><?php xl('Email','e'); ?>: </span></td><td><input type=entry size=20 name=email value=""></td>
 220         </tr>
 221
 222         <tr>
 223           <td><span class='text'><?php xl('Billing Location','e'); ?>: </span></td><td><input type='checkbox' name='billing_location' value = '1'></td>
 224           <td>&nbsp;</td>
 225           <td><span class='text'><?php xl('Accepts Assignment','e'); ?><br>(<?php xl('only if billing location','e'); ?>): </span></td> <td><input type='checkbox' name='accepts_assignment' value = '1'></td>
 226         </tr>
 227         <tr>
 228           <td><span class='text'><?php xl('Service Location','e'); ?>: </span></td> <td><input type='checkbox' name='service_location' value = '1'></td>
 229           <td>&nbsp;</td>
 230           <td><span class='text'><?php echo htmlspecialchars(xl('Color'),ENT_QUOTES); ?>: </span><span class="mandatory">&nbsp;*</span></td> <td><input type=entry name=ncolor id=ncolor size=20 value=""><span>[<a href="javascript:void(0);" onClick="pick('pick','newcolor');return false;" NAME="pick" ID="pick"><?php echo htmlspecialchars(xl('Pick'),ENT_QUOTES); ?></a>]</span></td>
 231         </tr>
 232         <?php
 233          $disabled='';
 234          $resPBE=sqlStatement("select * from facility where primary_business_entity='1' and id!='".$my_fid."'");
 235          if(sqlNumRows($resPBE)>0)
 236          $disabled='disabled';
 237          ?>
 238          <tr>
 239           <td><span class='text'><?php xl('Primary Business Entity','e'); ?>: </span></td>
 240           <td><input type='checkbox' name='primary_business_entity' id='primary_business_entity' value='1' <?php if ($facility['primary_business_entity'] == 1) echo 'checked'; ?> <?php if($GLOBALS['erx_enable']){ ?> onchange='return displayAlert()' <?php } ?> <?php echo $disabled;?>></td>
 241           <td>&nbsp;</td>
 242          </tr>
 243         <tr>
 244             <td><span class=text><?php xl('POS Code','e'); ?>: </span></td>
 245             <td colspan="6">
 246                 <select name="pos_code">
 247                 <?php
 248                 $pc = new POSRef();
 249
 250                 foreach ($pc->get_pos_ref() as $pos) {
 251                     echo "<option value=\"" . $pos["code"] . "\" ";
 252                     echo ">" . $pos['code']  . ": ". text($pos['title']);
 253                     echo "</option>\n";
 254                 }
 255
 256                 ?>
 257                 </select>
 258             </td>
 259         </tr>
 260         <tr>
 261             <td><span class="text"><?php xl('Billing Attn','e'); ?>:</span></td>
 262             <td colspan="4"><input type="text" name="attn" size="45"></td>
 263         </tr>
 264         <tr>
 265             <td><span class="text"><?php xl('CLIA Number','e'); ?>:</span></td>
 266             <td colspan="4"><input type="text" name="domain_identifier" size="45"></td>
 267         </tr>
 268         <tr>
 269             <td><span class="text"><?php xl('Facility ID','e'); ?>:</span></td>
 270             <td colspan="4"><input type="text" name="facility_id" size="20"></td>
 271         </tr>
 272         <tr height="25" style="valign:bottom;">
 273         <td><font class="mandatory">*</font><span class="text"> <?php echo xl('Required','e'); ?></span></td><td>&nbsp;</td><td>&nbsp;</td>
 274         <td>&nbsp;</td><td>&nbsp;</td>
 275         </tr>
 276     </table>
 277 </form>
 278
 279 <script language="JavaScript">
 280 <?php
 281   if ($alertmsg = trim($alertmsg)) {
 282     echo "alert('$alertmsg');\n";
 283   }
 284 ?>
 285 </script>
 286
 287 </body>
 288 </html>