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  1. <!DOCTYPE html>
  2. <html>
  3. <head>
  4. <title>Hospice HR</title>
  5. <meta charset="utf-8">
  6. <meta name="viewport" content="width=device-width, initial-scale=1">
  7. <link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/4.0.0-beta.2/css/bootstrap.min.css">
  8. </head>
  9. <body>
  10. <header><div class="jumbotron text-center">
  11.  
  12. <h5>Update Employees</h5>
  13. <p><?php echo date("F j, Y");?></p>
  14. </div>
  15.  
  16. <div class="container-fluid">
  17. <legend>Personal Information</legend>
  18. <nav class="navbar navbar-expand-sm bg-primary navbar-dark">
  19. <!-- Brand/logo -->
  20. <a class="navbar-brand" href="index.php">Employees</a>
  21.  
  22. <!-- Links -->
  23. <ul class="navbar-nav">
  24. <li class="nav-item">
  25. <a class="nav-link" href="logout">Log Out</a>
  26. </li>
  27.  
  28. </ul>
  29. </nav>
  30.  
  31. <?php
  32. require("qwe.php");
  33. $db = new dbconn();
  34.  
  35. $get_id = $db->safe($_GET["id"]);
  36.  
  37. $idc = $db->con->query("SELECT * FROM hospicestaff WHERE id='{$get_id}'");
  38.  
  39. $data = $idc->fetch_assoc();
  40.  
  41. if($idc->num_rows<1)
  42. {
  43. header("refresh:1; url=employer.php");
  44.  
  45. }
  46.  
  47.  
  48. if(isset($_POST["update"]))
  49. {
  50. $line = $_POST["line"];
  51. $fname = rtrim($_POST["fname"]);
  52. $lname = $_POST["lname"];
  53. $phone = $_POST["phone"];
  54. $email = $_POST["email"];
  55.  
  56. $db->updateEmploy($get_id,$line,$fname,$lname,$phone,$email);
  57.  
  58.  
  59. }
  60.  
  61. if(isset($_POST["delete"]))
  62.  
  63. {
  64.  
  65. $db->removeEmploy($get_id);
  66. echo $db->response;
  67.  
  68. }
  69.  
  70.  
  71.  
  72. ?>
  73.  
  74.  
  75. <div class='row'>
  76. <div class='col-sm-3'>
  77. <form method="post" class="form-horizontal">
  78. Status: <select name="status">
  79. <option><i><?php echo $data['status'];?></i></option>
  80. <option value="active">active</option>
  81. <option value="inactive">inactive</option>
  82. </select><br>
  83. Role :
  84. <div class="form-group">
  85.  
  86. <select name="line" class="btn btn-warning dropdown-toggle">
  87. <option value="MD">Phycician</option>
  88. <option value="NP">Nurse Practitioner</option>
  89. <option value="RN">Registered Nurse</option>
  90. <option value="LVN">Licensed Vocational Nurse</option>
  91. <option value="OF">Office Staff</option>
  92. <option value="HA">Health Aide</option>
  93. <option value="PT">Physical Therapist</option>
  94. <option value="PTA">Physical Therapy Assistant</option>
  95. <option value="OT">Occupational Therapist</option>
  96. <option value="MSW">Medical Social Worker</option>
  97. <option value="SC">Chaplain</option>
  98. <option value="ST">Speech Therapist</option>
  99. </select>
  100. </select>
  101. </div>
  102. Firstname
  103. <div class="form-group">
  104.  
  105. <input type="text" name="fname" value="<?php echo $data['firstname']; ?>">
  106. </div>
  107. LastName
  108. <div class="form-group">
  109.  
  110. <input type="text" name="lname" value="<?php echo $data['lastname']; ?>">
  111. </div>
  112. Phone
  113. <div class="form-group">
  114.  
  115. <input type="text" name="phone" value="<?php echo $data['phone']; ?>">
  116. </div>
  117. Email
  118. <div class="form-group">
  119.  
  120. <input type="text" name="email" value="<?php echo $data['email']; ?>">
  121. </div>
  122. <input type="submit" name="update" class="btn btn-sm btn-danger" value="Update">
  123. <input type="submit" name="delete" class="btn btn-sm btn-danger" value="Delete">
  124.  
  125. </div>
  126.  
  127.  
  128.  
  129.  
  130.  
  131.  
  132. <fieldset>
  133. <legend>Hotspice Pay Rate</legend>
  134.  
  135. <div class='row'>
  136. <div class='col-sm-4'>
  137. <div class="form-group" >
  138. Hourly: <input type="text" name="phone" value="<?php echo $data['phone']; ?>">
  139.  
  140. </div>
  141. <div class="form-group" >
  142. SOC/Eval: <input type="text" name="phone" value="<?php echo $data['phone']; ?>">
  143.  
  144. </div>
  145. <div class="form-group" >
  146. Missed Visit: <input type="text" name="phone" value="<?php echo $data['phone']; ?>">
  147.  
  148. </div>
  149. <div class="form-group" >
  150. Death Visit: <input type="text" name="phone" value="<?php echo $data['phone']; ?>">
  151.  
  152. </div>
  153. <div class="form-group" >
  154. On-Call OOA: <input type="text" name="phone" value="<?php echo $data['phone']; ?>">
  155.  
  156. </div>
  157. <div class="form-group" >
  158. Trip Pay: <input type="text" name="phone" value="<?php echo $data['phone']; ?>">
  159.  
  160. </div>
  161. <div class="form-group" >
  162. Visit OOA: <input type="text" name="phone" value="<?php echo $data['phone']; ?>">
  163.  
  164. </div>
  165.  
  166. </div>
  167. <div class='row'>
  168. <div class='col-sm-4'>
  169.  
  170. <div class="form-group" >
  171. Over Time: <input type="text" name="phone" value="<?php echo $data['phone']; ?>">
  172.  
  173. </div>
  174. <div class="form-group" >
  175. SOC/Eval Out Of Area: <input type="text" name="phone" value="<?php echo $data['phone']; ?>">
  176.  
  177. </div>
  178. <div class="form-group" >
  179. Reassessment: <input type="text" name="phone" value="<?php echo $data['phone']; ?>">
  180.  
  181. </div>
  182. <div class="form-group" >
  183. Follow-Up: <input type="text" name="phone" value="<?php echo $data['phone']; ?>">
  184.  
  185. </div>
  186. <div class="form-group" >
  187. On-Call Week Night: <input type="text" name="phone" value="<?php echo $data['phone']; ?>">
  188.  
  189. </div>
  190.  
  191. <div class="form-group" >
  192. Trip Pay OOA: <input type="text" name="phone" value="<?php echo $data['phone']; ?>">
  193.  
  194. </div>
  195.  
  196.  
  197.  
  198. </div>
  199. </div>
  200.  
  201. </div>
  202. </fieldset>
  203. <fieldset>
  204. <legend>HOMEHEALTH PAY RATES</legend>
  205. <div class='row'>
  206. <div class='col-sm-4'>
  207. <div class="form-group" >
  208. HOME HEALTH Eval: <input type="text" name="phone" value="<?php echo $data['phone']; ?>">
  209.  
  210. </div>
  211.  
  212. <div class="form-group" >
  213. HOME HEALTH Follow-Up: <input type="text" name="phone" value="<?php echo $data['phone']; ?>">
  214.  
  215. </div>
  216.  
  217. </div>
  218. </div>
  219.  
  220. </fieldset>
  221.  
  222.  
  223. <fieldset>
  224. <legend>[TAB 1] Pre-Employment Documents (date received)</legend>
  225. <div class='col-sm-5'>
  226. <div class="form-group" >
  227.  
  228. <div class="form-group" >
  229. Resume/Application: <input type="date" name="date">
  230. </div>
  231. <div class="form-group" >
  232. Interview Summary: <input type="date" name="date">
  233. </div>
  234. <div class="form-group" >
  235. Tel. Reference: <input type="date" name="date">
  236. </div>
  237. <div class="form-group" >
  238. Background Check Auth: <input type="date" name="date">
  239. </div>
  240. <div class="form-group" >
  241. Background Check: <input type="date" name="date">
  242. </div>
  243. <div class="form-group" >
  244. Sex Offender Results: <input type="date" name="date">
  245. </div>
  246. <div class="form-group" >
  247. OIG Exclusion's List: <input type="date" name="date">
  248. </div>
  249. <div class="form-group" >
  250. Employment Verification Form: <input type="date" name="date">
  251. </div>
  252.  
  253. <div class="form-group" >
  254. Equal Employment Opportunity Data: <input type="date" name="date">
  255. </div>
  256. <div class="form-group" >
  257. Emergency Contact: <input type="date" name="date">
  258. </div>
  259. <div class="form-group" >
  260. Form I-9: <input type="date" name="date">
  261. </div>
  262. <div class="form-group" >
  263. Form W-4/W-9: <input type="date" name="date">
  264. </div>
  265. <div class="form-group" >
  266. Offer Letter: <input type="date" name="date">
  267. </div>
  268. <div class="form-group" >
  269. Employee Statements: <input type="date" name="date">
  270. </div>
  271. <div class="form-group" >
  272. Payroll Information Sheet: <input type="date" name="date">
  273. </div>
  274. <div class="form-group" >
  275. Authentication For Computer Key: <input type="date" name="date">
  276. </div>
  277.  
  278.  
  279. </div></div>
  280.  
  281. </fieldset>
  282.  
  283. <fieldset>
  284. <legend>[TAB 2] HR DOCUMENTS </legend>
  285. <div class='col-sm-5'>
  286. <div class="form-group" >
  287.  
  288.  
  289.  
  290. </div>
  291. </div>
  292. </fieldset>
  293.  
  294.  
  295.  
  296.  
  297.  
  298.  
  299.  
  300. </form>
  301. </div>
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