API tools faq
paste
Advertisement
Guest User

Untitled

a guest
Mar 19th, 2019
55
0
Never
Add comment
Not a member of Pastebin yet? Sign Up, it unlocks many cool features!
text 28.67 KB | None | 0 0
raw download clone embed print report
  1. <form action="" method="post" name="vm.medication" id="vm.medication" viewtype="dataentry" fhform="" class="text-left medication-form" autocomplete="off" novalidate="true" reset-directive="formData" submit-valid>
  2. <!-- Row 1: No known, Name, Specify, Strength -->
  3. <div class="row">
  4. <element-container ng-if="!vm.hasHistory && !vm.hasMedicationRecords" el="vm.medication.noknown" class="medium-4 columns">
  5. <element change="vm.updateNoKnown" tpl="toggle" label="No Known" model="noknown" form-data="vm.formData"></element>
  6. </element-container>
  7. </div>
  8. <div class="row">
  9. <div field-container="" class="medium-4 columns" ng-class="{'error':vm.medication.name.$isInvalid}" ng-if="(!vm.cfgMedicationList || vm.cfgMedicationList.length == 0 || vm.mode != 'edit')">
  10. <label ng-class="{ 'required': !vm.formData.noknown }">
  11. <span class="formlabel">Name</span>
  12. <input name="name"
  13. type="text"
  14. field
  15. ng-required="!vm.formData.noknown"
  16. ng-model="vm.formData.name"
  17. fh-disabled="{{vm.noEditable || vm.formData.noknown}}"/>
  18. <validation-message for="name"></validation-message>
  19. </label>
  20. </div>
  21. <element-container ng-if="vm.cfgMedicationList && vm.cfgMedicationList.length !== 0 && vm.mode == 'edit'" el="vm.medication.name" class="medium-4 columns">
  22. <element tpl="select" custom-order="vm.customOrder" label="Name" select-options="vm.cfgMedicationList" model="name" form-data="vm.formData" fh-disabled="vm.noDrxRecord" req="!vm.formData.noknown"></element>
  23. </element-container>
  24. <div class="medium-4 columns" ng-if="vm.formData.name == 'Other' && vm.cfgMedicationList.length !== 0" ng-class="{'error':vm.medication.n.$isInvalid}" field-container="">
  25. <label ng-class="{ 'required': !vm.formData.noknown }">
  26. <span class="formlabel">Specify</span>
  27. <input name="specify"
  28. type="text"
  29. field
  30. ng-required="!vm.formData.noknown"
  31. ng-model="vm.formData.specify"
  32. fh-disabled="{{vm.noEditable || vm.formData.noknown}}"/>
  33. <validation-message for="specify"></validation-message>
  34. </label>
  35. </div>
  36. <div class="medium-4 columns" field-container="" ng-class="{'error':vm.medication.n.$isInvalid}">
  37. <label ng-class="{ 'required': (vm.formData.strengthUnit || vm.requiredStrengthUnit) && !vm.formData.noknown }">
  38. <span class="formlabel">Strength</span>
  39. <div class="medication-form-row">
  40. <input name="strengthQuantity"
  41. class="medium-3 small-2 inline-column strength-quantity columns"
  42. type="text"
  43. field
  44. ng-pattern="/^[0-9 \&\(\)\%\^\#\+\.\-\/]{0,10}$/"
  45. fh-disabled="{{vm.noEditable || vm.formData.noknown}}"
  46. ng-required="(vm.formData.strengthUnit || vm.requiredStrengthUnit) && !vm.formData.noknown"
  47. ng-model="vm.formData.strength"/>
  48. <input name="strengthUnit"
  49. class="medium-8 strength-unit small-9 inline-column column"
  50. type="text"
  51. field
  52. placeholder="Unit"
  53. style="width: 100%;float: none;margin-left: 10px;display: inline-block;"
  54. fh-disabled="{{vm.noEditable || vm.formData.noknown}}"
  55. ng-required="(vm.formData.strength || vm.requiredStrengthUnit) && !vm.formData.noknown"
  56. ng-model="vm.formData.strengthUnit"/>
  57. </div>
  58. <validation-message for="strengthQuantity" pattern="Invalid strength, please enter numeric measures only"></validation-message>
  59. <validation-message for="strengthUnit"></validation-message>
  60. </label>
  61. </div>
  62. </div>
  63. <!-- Row 2: Start date, start time, selfadministering -->
  64. <div class="row">
  65. <div class="medium-4 columns" ng-class="{'error':vm.formData.startDate.$isInvalid}" field-container="">
  66. <label class="required">
  67. <span class="formlabel">Start Date</span>
  68. <input name="startDate"
  69. type="date"
  70. ng-required="!vm.formData.noknown"
  71. ng-model="vm.formData.startDate"
  72. fh-max="vm.maxStartDate"
  73. fh-disabled="{{vm.noDrxRecord || vm.formData.noknown}}"
  74. placeholder="MM/DD/YYYY"
  75. ng-change="vm.updateMinEndDate()"
  76. field/>
  77. <validation-message
  78. for="startDate"
  79. fhmax="Medication Start date cannot be more than 30 days in the future"
  80. ></validation-message>
  81. </label>
  82. </div>
  83. <div class="medium-4 columns" ng-class="{'error':vm.formData.startTime.$isInvalid}" field-container="">
  84. <label>
  85. <span class="formlabel">Start Time</span>
  86. <input name="startTime"
  87. type="time"
  88. field
  89. ng-model="vm.formData.startTime"
  90. fh-disabled="{{vm.formData.noknown}}"
  91. placeholder="HH:MM AM/PM"/>
  92. <validation-message
  93. for="startTime"
  94. ></validation-message>
  95. </label>
  96. </div>
  97. <element-container ng-if="vm.displaySelfAdministering" el="vm.medication.selfadministering" class="medium-2 columns">
  98. <element tpl="toggle" label="Self-Administering" model="selfadministering" form-data="vm.formData" fh-disabled="vm.formData.noknown"></element>
  99. </element-container>
  100.  
  101. </div>
  102. <div class="row">
  103. <div class="medium-4 columns" ng-class="{'error':vm.formData.endDate.$isInvalid}" field-container="">
  104. <label>
  105. <span class="formlabel">End Date</span>
  106. <input name="endDate"
  107. type="date"
  108. field
  109. ng-model="vm.formData.endDate"
  110. fh-disabled="{{vm.noEditable || vm.formData.noknown}}"
  111. placeholder="MM/DD/YYYY"
  112. fh-min="vm.minEndDate"/>
  113. <validation-message
  114. for="endDate"
  115. fhmin="{{ 'Date must be on or after ' + (vm.minEndDate | fhdate) }}"
  116. ></validation-message>
  117. </label>
  118. </div>
  119. <div ng-if="vm.isOnPrescriptFields('endtime') && vm.formData.endDate" class="medium-4 columns" ng-class="{'error':vm.formData.endTime.$isInvalid}" field-container="">
  120. <label>
  121. <span class="formlabel">End Time</span>
  122. <input name="endTime"
  123. type="time"
  124. field
  125. ng-model="vm.formData.endTime"
  126. fh-disabled="{{vm.formData.noknown || !vm.formData.endDate}}"
  127. placeholder="HH:MM AM/PM"/>
  128. <validation-message
  129. for="endTime"
  130. ></validation-message>
  131. </label>
  132. </div>
  133.  
  134. <element-container ng-if="vm.isOnPrescriptFields('estimated-end-date') && vm.formData.endDate" el="vm.medication.endDateIsEstimate" class="medium-2 columns">
  135. <element fh-disabled="vm.formData.noknown || !vm.formData.endDate" tpl="toggle" label="Estimated End Date" model="endDateIsEstimate" form-data="vm.formData"></element>
  136. </element-container>
  137. </div>
  138. <p ng-if="vm.mode != 'view' && vm.mode != 'print'" style="text-align: center; margin-top: 10px; margin-bottom: 5px;">Dosage and Frequency are not required if sig is entered.</p>
  139. <div class="row">
  140. <div ng-if="!(vm.mode != 'edit' && vm.formData.sig && !vm.formData.doseUnitQuantity && !vm.formData.dosage)" class="medium-4 columns" field-container="" ng-class="{'error':vm.medication.n.$isInvalid}">
  141. <label ng-class="{'required': ((!vm.formData.dosage && !!vm.formData.doseUnitQuantity) || (!!vm.formData.dosage && !vm.formData.doseUnitQuantity) || !vm.formData.sig) && !vm.formData.noknown }">
  142. <span class="formlabel">Dosage</span>
  143. <div class="medication-form-row">
  144. <input name="doseUnitQuantity"
  145. class="medium-3 small-2 inline-column strength-quantity columns"
  146. field=""
  147. type="number"
  148. min="1"
  149. ng-min="1"
  150. fh-disabled="{{vm.noEditable || vm.formData.noknown}}"
  151. ng-required="(vm.formData.dosage || !vm.formData.sig) && !vm.formData.noknown"
  152. ng-model="vm.formData.doseUnitQuantity"/>
  153. <select name="dosage"
  154. field
  155. style="float: none; margin-left: 19px;"
  156. fh-blankoption="true"
  157. ng-options="o as o for o in vm.cfgdoseunitqtys"
  158. class="medium-8 strength-unit small-9 inline-column column"
  159. fh-disabled="{{vm.noEditable || vm.formData.noknown}}"
  160. ng-required="(vm.formData.doseUnitQuantity || !vm.formData.sig) && !vm.formData.noknown"
  161. ng-model="vm.formData.dosage">
  162. <option value=""></option>
  163. </select>
  164. </div>
  165. <validation-message for="dosage"></validation-message>
  166. <validation-message min="Enter a number equal to or greater than 1." for="doseUnitQuantity"></validation-message>
  167. </label>
  168. </div>
  169. <div ng-if="!(vm.mode != 'edit' && vm.formData.sig && !vm.formData.frequency && !vm.formData.frequencyInterval) " class="medium-4 columns" field-container="" ng-class="{'error':vm.medication.n.$isInvalid}">
  170. <label ng-class="{'required': ((!vm.formData.frequency && !!vm.formData.frequencyInterval) || (!!vm.formData.frequency && !vm.formData.frequencyInterval) || !vm.formData.sig) && !vm.formData.noknown }">
  171. <span class="formlabel">Frequency</span>
  172. <div class="row medication-form-row" style="display: flex;flex-direction: row">
  173. <select name="frequency"
  174. field
  175. ng-if="vm.formData.frequencyInterval !== 'As Needed'"
  176. class="8 medium-8 strength-unit small-9 inline-column columns right ng-scope"
  177. fh-disabled="{{vm.noEditable || vm.formData.noknown}}"
  178. ng-required="(vm.formData.frequencyInterval || !vm.formData.sig) && !vm.formData.noknown"
  179. ng-model="vm.formData.frequency">
  180. <option value=""></option>
  181. <option label="{{i}}" value="{{i}}" ng-repeat="i in vm.frequencyIntervalOptions">{{i}}</option>
  182. </select>
  183. <span ng-if="vm.formData.frequencyInterval !== 'As Needed'" style="display: inline-block;width: 70px;padding: 0 10px;vertical-align: middle;line-height: 30px;">x per</span>
  184. <select name="frequencyInterval"
  185. field=""
  186. ng-options="o as o for o in vm.frequencyIntervalConfig"
  187. class="8 medium-8 strength-unit small-9 inline-column columns right ng-scope"
  188. fh-disabled="{{vm.noEditable || vm.formData.noknown}}"
  189. ng-required="(vm.formData.frequency || !vm.formData.sig) && !vm.formData.noknown"
  190. ng-model="vm.formData.frequencyInterval">
  191. <option value=""></option>
  192. </select>
  193. </div>
  194. <validation-message ng-if="vm.formData.frequencyInterval !== 'As Needed'" for="frequency"></validation-message>
  195. <validation-message for="frequencyInterval"></validation-message>
  196. </label>
  197. </div>
  198. <div class="medium-4 columns" field-container="">
  199. <label ng-class="{'required': vm.requiredSig }">
  200. <span class="formlabel">SIG</span>
  201. <input name="sig"
  202. type="text"
  203. field=""
  204. ng-required="vm.requiredSig && !vm.formData.noknown"
  205. ng-model="vm.formData.sig"
  206. fh-disabled="{{vm.noEditable || vm.formData.noknown}}"/>
  207. <validation-message for="sig"></validation-message>
  208. </label>
  209. </div>
  210. </div>
  211. <div class="row">
  212. <div class="large-12 medium-12 columns" field-container="">
  213. <label ng-class="{ 'required': vm.requiredInstructions }">
  214. <span class="formlabel">Instructions</span>
  215. <textarea name="specialInstructions"
  216. type="text"
  217. field=""
  218. ng-required="vm.requiredInstructions && !vm.formData.noknown"
  219. ng-model="vm.formData.specialInstructions"
  220. fh-disabled="{{vm.formData.noknown}}"></textarea>
  221. <validation-message for="specialInstructions"></validation-message>
  222. </label>
  223. </div>
  224. </div>
  225. <div class="row">
  226. <div ng-if="vm.isOnPrescriptFields('clock-times')" class="medium-4 columns" ng-class="{'error':vm.formData['clock-times'].$isInvalid}" field-container="">
  227. <label ng-class="{'required': vm.requiredScheduledTimes }">
  228. <span class="formlabel">Scheduled Times <span ng-if="vm.mode !== 'view'">(Press Tab to add multiple)</span></span>
  229. <ui-select name="clockTimes" field multiple tagging tagging-label="false" type="time" ng-model="vm.formData.clockTimes" theme="bootstrap" sortable="true" close-on-select="false">
  230. <ui-select-match placeholder="hh:mm (AM|PM)">{{$item | timeFormat}}</ui-select-match>
  231. <ui-select-choices position="down" repeat="date in [] | filter: {name: $select.search}">
  232. {{date}}
  233. </ui-select-choices>
  234. </ui-select>
  235. <validation-message for="clock-times"></validation-message>
  236. </label>
  237. </div>
  238. <div class="medium-4 columns" ng-class="{'error':vm.formData.details.$isInvalid}">
  239. <label class="no-search" ng-class="{'required':vm.formData.details.$required}">
  240. <span class="formlabel">Medication Details</span>
  241. <ui-select field multiple class="multiple-select-wrapper"
  242. ng-disabled="vm.noEditable || vm.formData.noknown"
  243. ng-model="vm.formData.details"
  244. theme="bootstrap"
  245. sortable="true"
  246. close-on-select="false">
  247. <ui-select-match>{{$item}}</ui-select-match>
  248. <ui-select-choices position="down" repeat="item in vm.medicationDetetailsConf">
  249. {{item}}
  250. </ui-select-choices>
  251. </ui-select>
  252. <validation-message for="details"></validation-message>
  253. </label>
  254. </div>
  255.  
  256. <element-container ng-if="vm.isOnPrescriptFields('medsroute')" el="vm.medication.medsroute" class="medium-4 columns">
  257. <element fh-blankoption="true" fh-disabled="vm.noEditable || vm.formData.noknown" tpl="select" label="Route" select-options="vm.routeOptions" model="medsroute" form-data="vm.formData" req="!vm.formData.noknown && vm.requiredRoute">
  258. </element>
  259. </element-container>
  260. </div>
  261. <div class="row">
  262.  
  263.  
  264. <element-container ng-if="vm.isOnPrescriptFields('drug_type')" el="vm.medication.drugType" class="medium-4 columns">
  265. <element fh-blankoption="true" tpl="select" req="!vm.formData.noknown && vm.requiredDrugType" fh-disabled="vm.noEditable || vm.formData.noknown" label="Drug Type" select-options="vm.drugTypeOptions" model="drugType" form-data="vm.formData"></element>
  266. </element-container>
  267.  
  268.  
  269. <element-container el="vm.medication.type" class="medium-4 columns">
  270. <element fh-blankoption="true" req="vm.requiredRxOtc" tpl="select" label="Rx/OTC" fh-disabled="vm.noEditable || vm.formData.noknown" select-options="vm.rxOTCOptions" model="type" form-data="vm.formData"></element>
  271. </element-container>
  272. </div>
  273. <div class="row">
  274. <div ng-if="vm.isOnPrescriptFields('scriptnum')" class="medium-4 columns" field-container="">
  275. <label>
  276. <span class="formlabel">Rx #</span>
  277. <input name="scriptNumber"
  278. type="text"
  279. field=""
  280. ng-model="vm.formData.scriptNumber"
  281. fh-disabled="{{vm.noDrxRecord || vm.formData.noknown}}"/>
  282. <validation-message for="scriptNumber"></validation-message>
  283. </label>
  284. </div>
  285. <div ng-if="vm.isOnPrescriptFields('expirationdate')" class="medium-4 columns" ng-class="{'error':vm.formData.expirationDate.$isInvalid}" field-container="">
  286. <label ng-class="{ 'required': vm.requiredExpirationDate && !vm.formData.noknown }">
  287. <span class="formlabel">Medication Expiration Date</span>
  288. <input name="expirationDate"
  289. type="date"
  290. ng-required="vm.requiredExpirationDate && !vm.formData.noknown"
  291. ng-model="vm.formData.expirationDate"
  292. fh-disabled="{{vm.formData.noknown}}"
  293. placeholder="MM/DD/YYYY"
  294. fh-min="vm.formData.startDate"
  295. field=""/>
  296. <validation-message
  297. for="expirationDate"
  298. fhmin="{{ 'Date must be on or after ' + (vm.formData.startDate | fhdate) }}"
  299. ></validation-message>
  300. </label>
  301. </div>
  302. </div>
  303. <div class="row">
  304. <div class="medium-4 columns" field-container="">
  305. <label>
  306. <span class="formlabel"># Refills</span>
  307. <input name="scriptRefills"
  308. class="medium-4 small-2 columns"
  309. type="number"
  310. ng-max="999"
  311. ng-min="0"
  312. field=""
  313. fh-disabled="{{vm.noEditable || vm.formData.noknown}}"
  314. ng-model="vm.formData.scriptRefills"/>
  315.  
  316. <validation-message for="scriptRefills"
  317. min="Please enter a valid number (0-999)"
  318. max="Please enter a number less than 999"
  319. number="">
  320. </validation-message> </label>
  321. </div>
  322. <div class="medium-4 columns" field-container="" ng-class="{'error':vm.medication.scriptQty.$isInvalid}">
  323. <label>
  324. <span class="formlabel">Quantity</span>
  325. <input name="scriptQty"
  326. class="medium-4 small-2 columns"
  327. type="number"
  328. field
  329. fh-disabled="{{vm.noEditable || vm.formData.noknown}}"
  330. ng-model="vm.formData.scriptQty"/>
  331. <validation-message for="scriptQty"></validation-message>
  332. </label>
  333. </div>
  334. </div>
  335.  
  336. <div class="row">
  337.  
  338. <div field-container="" class="medium-4 columns" ng-class="{'error':vm.medication.doctor.$isInvalid}" ng-if="!vm.cfgPhysicianlistPref">
  339. <label>
  340. <span class="formlabel">Prescribing Physician</span>
  341. <input name="doctor"
  342. type="text"
  343. field
  344. ng-model="vm.formData.doctor"
  345. fh-disabled="{{vm.noEditable || vm.formData.noknown}}"/>
  346. <validation-message for="name"></validation-message>
  347. </label>
  348. </div>
  349. <element-container ng-if="vm.cfgPhysicianlistPref" el="vm.medication.doctor" class="medium-4 columns">
  350. <element tpl="select" fh-disabled="vm.noEditable || vm.formData.noknown" custom-order="vm.customOrder" label="Prescribing Physician" select-options="vm.cfgPhysicianList" model="doctor" form-data="vm.formData"></element>
  351. </element-container>
  352. <div class="medium-4 columns" ng-if="vm.formData.doctor == 'Other' && vm.cfgMedicationList.length !== 0" ng-class="{'error':vm.medication.doctor.$isInvalid}" field-container="">
  353. <label>
  354. <span class="formlabel">Specify Physician</span>
  355. <input name="specifyPhysician"
  356. type="text"
  357. field
  358. ng-required="!vm.formData.noknown"
  359. ng-model="vm.formData.specifyPhysician"
  360. fh-disabled="{{vm.noEditable || vm.formData.noknown}}"/>
  361. <validation-message for="specifyPhysician"></validation-message>
  362. </label>
  363. </label>
  364. </div>
  365.  
  366. <div class="medium-4 columns" ng-class="{'error':vm.medication.doctorPhone.$isInvalid}" field-container="">
  367. <label>
  368. <span class="formlabel">Phone</span>
  369. <input name="doctorPhone"
  370. type="text"
  371. field=""
  372. ng-model="vm.formData.doctorPhone"
  373. fh-disabled="{{vm.formData.noknown}}"/>
  374. </label>
  375. </div>
  376. </div>
  377. <div class="row" ng-if="vm.showConsent">
  378.  
  379. <element-container el="vm.medication.consent" class="medium-4 columns">
  380. <element tpl="toggle" fh-disabled="vm.noDrxRecord" label="Consent" model="consent" form-data="vm.formData"></element>
  381. </element-container>
  382.  
  383.  
  384. <div ng-if="vm.formData.consent && vm.cfgConsentDates" class="medium-4 columns" ng-class="{'error':vm.formData.consentStartDate.$isInvalid}" field-container="">
  385. <label class="required">
  386. <span class="formlabel">Consent Start Date</span>
  387. <input name="consentEffectiveDate"
  388. type="date"
  389. ng-required="!vm.formData.noknown"
  390. ng-model="vm.formData.consentEffectiveDate"
  391. fh-disabled="{{vm.formData.noknown}}"
  392. placeholder="MM/DD/YYYY"
  393. field/>
  394. <validation-message
  395. for="consentEffectiveDate"
  396. ></validation-message>
  397. </label>
  398. </div>
  399. <div class="medium-4 columns" ng-if="vm.formData.consent && vm.cfgConsentDates" ng-class="{'error':vm.formData.consentExpirationDate.$isInvalid}" field-container="">
  400. <label class="required">
  401. <span class="formlabel">Consent End Date</span>
  402. <input name="consentExpirationDate"
  403. type="date"
  404. field
  405. ng-model="vm.formData.consentExpirationDate"
  406. ng-required="!vm.formData.noknown"
  407. fh-disabled="{{vm.formData.noknown}}"
  408. placeholder="MM/DD/YYYY"
  409. fh-min="vm.formData.consentEffectiveDate"/>
  410. <validation-message
  411. for="consentExpirationDate"
  412. fhmin="{{ 'Date must be on or after ' + (vm.formData.consentEffectiveDate | fhdate) }}"
  413. ></validation-message>
  414. </label>
  415. </div>
  416.  
  417. </div>
  418. <div class="row">
  419. <div class="medium-12 columns" field-container="">
  420. <label>
  421. <span class="formlabel">Reactions</span>
  422. <textarea name="reaction"
  423. type="text" field=""
  424. ng-model="vm.formData.reaction"
  425. fh-disabled="{{vm.formData.noknown}}"></textarea>
  426. </label>
  427. </div>
  428. </div>
  429. <div class="row">
  430. <div ng-if="vm.isOnPrescriptFields('purpose')" class="medium-4 columns" field-container="">
  431. <label ng-class="{'required': vm.requiredPurpose}">
  432. <span class="formlabel">Purpose</span>
  433. <input name="purpose"
  434. type="text"
  435. field
  436. ng-required="vm.requiredPurpose"
  437. ng-model="vm.formData.purpose"
  438. fh-disabled="{{vm.formData.noknown}}"/>
  439. <validation-message for="purpose"></validation-message>
  440. </label>
  441. </div>
  442. <div ng-if="vm.isOnPrescriptFields('source-knowledge')" class="medium-4 columns" field-container="">
  443. <label>
  444. <span class="formlabel">Source of Knowledge</span>
  445. <input name="sourceKnowledge"
  446. type="text"
  447. field
  448. ng-model="vm.formData.sourceKnowledge"
  449. fh-disabled="{{vm.formData.noknown}}"/>
  450. <validation-message for="sourceKnowledge"></validation-message>
  451. </label>
  452. </div>
  453. <div ng-if="vm.isOnPrescriptFields('rationale-change')" class="medium-4 columns" field-container="">
  454. <label>
  455. <span class="formlabel">Rationale for Change</span>
  456. <input name="rationaleChange"
  457. type="text"
  458. field
  459. ng-model="vm.formData.rationaleChange"
  460. fh-disabled="{{vm.formData.noknown}}"/>
  461. <validation-message for="rationaleChange"></validation-message>
  462. </label>
  463. </div>
  464. </div>
  465. <div class="row">
  466. <div ng-if="vm.cfgPrescriptions" class="large-4 medium-4 columns" ng-class="{'error':vm.formData.renewDate.$isInvalid}" field-container="">
  467. <label>
  468. <span class="formlabel">Renewal Date</span>
  469. <input name="renewDate"
  470. type="date"
  471. field
  472. ng-model="vm.formData.renewDate"
  473. fh-disabled="{{vm.formData.noknown}}"
  474. placeholder="MM/DD/YYYY"
  475. fh-min="vm.formData.startDate"/>
  476. <validation-message
  477. for="renewDate"
  478. fhmin="{{ 'Date must be on or after ' + (vm.formData.startDate | fhdate) }}"
  479. ></validation-message>
  480. </label>
  481. </div>
  482. <div ng-if="vm.cfgPrescriptions" class="large-4 medium-4 columns" ng-class="{'error':vm.formData.nextVisit.$isInvalid}" field-container="">
  483. <label>
  484. <span class="formlabel">Next Meds Review Appt Date</span>
  485. <input name="nextVisit"
  486. type="date"
  487. ng-model="vm.formData.nextVisit"
  488. fh-disabled="{{vm.formData.noknown}}"
  489. placeholder="MM/DD/YYYY"
  490. field=""
  491. fh-min="vm.formData.startDate"/>
  492. <validation-message
  493. for="nextVisit"
  494. fhmin="{{ 'Date must be on or after ' + (vm.formData.startDate | fhdate) }}"
  495. ></validation-message>
  496. </label>
  497. </div>
  498.  
  499. <element-container ng-if="vm.isOnPrescriptFields('negation_reason_code')" el="vm.medication.negationReasonCode" class="large-4 medium-4 columns">
  500. <element tpl="select" fh-disabled="vm.noDrxRecord || !vm.formData.endDate" label="Negation Reason" select-options="vm.negationReasonOptions" model="negationReasonCode" form-data="vm.formData"></element>
  501. </element-container>
  502.  
  503. </div>
  504. <form-buttons></form-buttons>
  505. <!-- end expandable sections -->
  506. </form>
Advertisement
Add Comment
Please, Sign In to add comment
Advertisement
Public Pastes
Advertisement
We use cookies for various purposes including analytics. By continuing to use Pastebin, you agree to our use of cookies as described in the Cookies Policy.  OK, I Understand
Not a member of Pastebin yet?
Sign Up, it unlocks many cool features!