patientconsentform.ascx

医疗决策支持系统

<%@ Control Language="c#" AutoEventWireup="false" Codebehind="PatientConsentForm.ascx.cs" Inherits="Caisis.UI.Modules.All.DataEntryForms.PatientConsentForm" TargetSchema="http://schemas.microsoft.com/intellisense/ie5" %>
<%@ Register TagPrefix="uc1" TagName="helpToolTip" Src="../../../Core/Help/helpToolTip.ascx" %>
<%@ Register TagPrefix="val" TagName="DataEntryCommonFields" Src="../../../Core/DataEntryForms/DataEntryCommonFields.ascx" %>
<%@ Register TagPrefix="val" Namespace="Caisis.UI.Core.Classes" Assembly="Caisis.UI" %>
<val:dataentrycommonfields id="commonFields" runat="server"></val:dataentrycommonfields><input id="ConsentId" type="hidden" name="ConsentId" runat=server>
<table class="pdFormTable" width="440" align="left" cellpadding="3" cellspacing="3">
		<tr>
			<td class="pdFormFieldLabel" width="145"><val:PDLabel id="PtPatientConsent_drop_PdLabel" runat="server" Text="PHI Research Consent Status:" Required="No" Field="DBConsented" runat=server></val:PDLabel></td>
			<td><select class="pdFormField" id="PtPatientConsent_drop" name="PtPatientConsent_drop" runat="server"></select></td>
		</tr>
		<tr>
			<td class="pdFormFieldLabel"><val:PDLabel id="FutureConsent_Drop_PdLabel" runat="server" Text="Future Contact Status:" Required="No" Field="ResearchConsented" runat=server></val:PDLabel></td>
			<td><select class="pdFormField" id="FutureConsent_Drop" name="FutureConsent_Drop"	runat="server"></select></td>
		</tr>
		<tr>
			<td class="pdFormFieldLabel" style="HEIGHT: 21px"><val:PDLabel id="ConsentDate_PdLabel" runat="server" Text="Consent Date:" Required="No" Field="ConsentDate" runat=server></val:PDLabel></td>
			<td style="HEIGHT: 21px"><input class="pdFormField" id="ConsentDate" type="text" maxLength="50" onblur="isDate(this.value);" name="ConsentDate" runat="server"><img id="ConsentDateCal" runat="server"  src="../../../images/Calendar/cal.gif" width="16" height="16" border="0" alt="select date" align="absMiddle" onClick="showCal(this);"></td>
		</tr>
		<tr>
			<td class="pdFormFieldLabel"><val:PDLabel id="AuthorizedPerson_PdLabel" runat="server" Text="Authorized Person:" Required="No" Field="AuthorizedPerson" runat=server></val:PDLabel></td>
			<td><input class="pdFormField" id="AuthorizedPerson" type="text" maxLength="50" name="AuthorizedPerson" runat="server"></td>
		</tr>
		<tr>
			<td class="pdFormFieldLabel"><val:PDLabel id="PtRelationship_drop_PdLabel" runat="server" Text="Relationship:" Required="No" Field="ConsentRelationship" runat=server></val:PDLabel></td>
			<td><SELECT class="pdFormField" id="PtRelationship_drop" name="PtRelationship_drop" runat="server"></SELECT></td>
		</tr>
		<tr>
			<td class="pdFormFieldLabel"><val:PDLabel id="PtConsentVersion_Drop_PdLabel" runat="server" Text="Consent Version:" Required="No" Field="ConsentVer" runat=server></val:PDLabel></td>
			<td><select class="pdFormField" id="PtConsentVersion_Drop" name="PtConsentVersion_Drop" runat="server"></select></td>
		</tr>
		<tr>
			<td class="pdFormFieldLabel"><val:PDLabel id="PtCopyGiven_Drop_PdLabel" runat="server" Text="Copy given to patient:" Required="No" Field="CopyToPatient" runat=server></val:PDLabel></td>
			<td><select class="pdFormField" id="PtCopyGiven_Drop" name="PtCopyGiven_Drop" runat="server"></select></td>
		</tr>
		<tr>
			<td class="pdFormFieldLabel"><val:PDLabel id="PersonGiven_PdLabel" runat="server" Text="Person obtaining consent:" Required="No" Field="ObtainPerson" runat=server></val:PDLabel></td>
			<td><input class="pdFormField" id="PersonGiven" type="text" maxLength="50" name="PersonGiven" runat="server"></td>
		</tr>
		<tr>
			<td class="pdFormFieldLabel"><val:PDLabel id="DateObtained_PdLabel" runat="server" Text="Date obtained:" Required="No" Field="ObtainDate" runat=server></val:PDLabel></td>
			<td><input class="pdFormField" id="DateObtained" type="text" maxLength="50" onblur="isDate(this.value);" name="DateObtained" runat="server"><img id="DateObtainedCal" runat="server"  src="../../../images/Calendar/cal.gif" width="16" height="16" border="0" alt="select date" align="absMiddle" onClick="showCal(this);"></td>
		</tr>
		<tr>
			<td class="pdFormFieldLabel"><val:PDLabel id="Protocol_Drop_PdLabel" runat="server" Text="Protocol:" Required="No" Field="ConsentProtocol" runat=server></val:PDLabel></td>
			<td><select class="pdFormField" id="Protocol_Drop" name="Protocol_Drop" runat="server"></select></td>
		</tr>
</table>