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enroll:adding the enrollment form
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@gitcliff
gitcliff committed Jun 23, 2022
1 parent 3a3b6ae commit cc386ba
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9 changes: 9 additions & 0 deletions config/forms/app/enroll.properties.json
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{
"title": "Enrollment Form",
"icon": "assessment",
"context": {
"person": true,
"place": false,
"expression": "contact.type === 'person'"
}
}
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216 changes: 216 additions & 0 deletions config/forms/app/enroll.xml
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<?xml version="1.0"?>
<h:html xmlns="http://www.w3.org/2002/xforms" xmlns:h="http://www.w3.org/1999/xhtml" xmlns:ev="http://www.w3.org/2001/xml-events" xmlns:xsd="http://www.w3.org/2001/XMLSchema" xmlns:jr="http://openrosa.org/javarosa" xmlns:orx="http://openrosa.org/xforms">
<h:head>
<h:title>Enrollment Form</h:title>
<model>
<instance>
<enroll id="enroll" prefix="J1!enroll!" delimiter="#" version="2022-06-22_23-32">
<inputs>
<meta>
<location>
<lat/>
<long/>
<error/>
<message/>
</location>
</meta>
<source/>
<source_id/>
<contact>
<_id/>
<patient_id/>
<name/>
<date_of_birth/>
<sex/>
<parent>
<contact>
<phone/>
<name/>
</contact>
</parent>
</contact>
</inputs>
<patient_id/>
<patient_name/>
<enroll>
<name/>
<aka/>
<docket/>
<telephone/>
<type/>
<cell/>
<birth/>
<digital/>
<at/>
<genda/>
<stat/>
<not/>
</enroll>
<meta tag="hidden">
<instanceID/>
</meta>
</enroll>
</instance>
<instance id="contact-summary"/>
<bind nodeset="/enroll/inputs" relevant="./source = 'user'"/>
<bind nodeset="/enroll/inputs/source" type="string"/>
<bind nodeset="/enroll/inputs/source_id" type="string"/>
<bind nodeset="/enroll/inputs/contact/_id" type="db:person"/>
<bind nodeset="/enroll/inputs/contact/patient_id" type="string"/>
<bind nodeset="/enroll/inputs/contact/name" type="string"/>
<bind nodeset="/enroll/inputs/contact/date_of_birth" type="string"/>
<bind nodeset="/enroll/inputs/contact/sex" type="string"/>
<bind nodeset="/enroll/inputs/contact/parent/contact/phone" type="string"/>
<bind nodeset="/enroll/inputs/contact/parent/contact/name" type="string"/>
<bind nodeset="/enroll/patient_id" type="string" calculate="../inputs/contact/patient_id"/>
<bind nodeset="/enroll/patient_name" type="string" calculate="../inputs/contact/name"/>
<bind nodeset="/enroll/enroll/name" type="string" required="true()"/>
<bind nodeset="/enroll/enroll/aka" type="string"/>
<bind nodeset="/enroll/enroll/docket" type="int"/>
<bind nodeset="/enroll/enroll/telephone" type="tel" jr:constraintMsg="Please enter a valid local number, or use the standard international format, which includes a plus sign (+) and country code. For example: +254712345678" constraint="true()"/>
<bind nodeset="/enroll/enroll/type" type="select1"/>
<bind nodeset="/enroll/enroll/cell" type="select1"/>
<bind nodeset="/enroll/enroll/birth" type="date"/>
<bind nodeset="/enroll/enroll/digital" type="int"/>
<bind nodeset="/enroll/enroll/at" type="select1"/>
<bind nodeset="/enroll/enroll/genda" type="select1"/>
<bind nodeset="/enroll/enroll/stat" type="select1"/>
<bind nodeset="/enroll/enroll/not" readonly="true()" type="string"/>
<bind nodeset="/enroll/meta/instanceID" type="string" readonly="true()" calculate="concat('uuid:', uuid())"/>
</model>
</h:head>
<h:body class="pages">
<group appearance="field-list" ref="/enroll/inputs">
<label>Enrollment Form v1</label>
<group ref="/enroll/inputs/contact">
<label></label>
<input appearance="db-object" ref="/enroll/inputs/contact/_id">
<label>What is the patient's name?</label>
</input>
<input appearance="hidden" ref="/enroll/inputs/contact/patient_id">
<label></label>
</input>
<input appearance="hidden" ref="/enroll/inputs/contact/name">
<label></label>
</input>
<input appearance="hidden" ref="/enroll/inputs/contact/date_of_birth">
<label></label>
</input>
<input appearance="hidden" ref="/enroll/inputs/contact/sex">
<label></label>
</input>
<group ref="/enroll/inputs/contact/parent">
<label></label>
<group ref="/enroll/inputs/contact/parent/contact">
<label></label>
<input appearance="hidden" ref="/enroll/inputs/contact/parent/contact/phone">
<label></label>
</input>
<input appearance="hidden" ref="/enroll/inputs/contact/parent/contact/name">
<label></label>
</input>
</group>
</group>
</group>
</group>
<group appearance="field-list" ref="/enroll/enroll">
<label></label>
<input ref="/enroll/enroll/name">
<label>Name</label>
</input>
<input ref="/enroll/enroll/aka">
<label>Also Known As:</label>
</input>
<input ref="/enroll/enroll/docket">
<label>Docket Number</label>
</input>
<input ref="/enroll/enroll/telephone">
<label>Cell number</label>
</input>
<select1 ref="/enroll/enroll/type">
<label>Type of phone</label>
<item>
<label>Banger Phone</label>
<value>banger</value>
</item>
<item>
<label>SmartPhone</label>
<value>smart</value>
</item>
</select1>
<select1 ref="/enroll/enroll/cell">
<label>Is it okay to leave a message on your cell phone?</label>
<item>
<label>Yes</label>
<value>yes</value>
</item>
<item>
<label>No</label>
<value>no</value>
</item>
</select1>
<input ref="/enroll/enroll/birth">
<label>Date of Birth</label>
</input>
<input ref="/enroll/enroll/digital">
<label>Age in years at today's Enrollment in the digital device:</label>
</input>
<select1 ref="/enroll/enroll/at">
<label>Sex at birth</label>
<item>
<label>Male</label>
<value>male</value>
</item>
<item>
<label>Female</label>
<value>female</value>
</item>
<item>
<label>Intersex</label>
<value>inter</value>
</item>
</select1>
<select1 ref="/enroll/enroll/genda">
<label>Gender Identity</label>
<item>
<label>Male</label>
<value>gender_male</value>
</item>
<item>
<label>Female</label>
<value>gender_female</value>
</item>
</select1>
<select1 ref="/enroll/enroll/stat">
<label>Marital Status</label>
<item>
<label>Single</label>
<value>single</value>
</item>
<item>
<label>Married</label>
<value>married</value>
</item>
<item>
<label>Separated</label>
<value>separated</value>
</item>
<item>
<label>Divorced</label>
<value>divorced</value>
</item>
<item>
<label>Widowed</label>
<value>widowed</value>
</item>
<item>
<label>Common-Law</label>
<value>common</value>
</item>
</select1>
<input ref="/enroll/enroll/not">
<label>We'd like you to choose a secret word that will become a passcode. We will ask you to text us this word before we can call you to chat with you. What word would you like to select?</label>
</input>
</group>
</h:body>
</h:html>

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