<form action="import-hma.php" method="post" name="formex" id="formex" enctype="multipart/form-data">
<input type="hidden" name="MAX_FILE_SIZE" value="6553600" />
<p>Select Import type:
<br>
<input name="extype" type="radio" id="exfile" value="X"> HMA XML File:
<input type="file" name="userfile" size="40"><br>
<?php
if ($ACCESS >= 200) {
// cust serv - was admin
?>
<input name="extype" type="radio" id="exlink" value="K"> HMA XML Link
URL: <input name="filename" type="text" id="filename" size="40" value="http://www.practicewithhealthmanagement.com/opportunities/pullForMDSearch"><br>
<hr />
<input name="extype" type="radio" id="exfile" value="M"> Map an HMA specialty to ours: <input type="text" name="hmaspec" value="">
to <?php
echo showSpecList($db);
}
?>
<hr />
<input type="radio" checked name="testrun" value="1"> TEST RUN: To Validate Input
<?php
if (!$testonly) {
?>
<input type="radio" name="testrun" value="0"> DATA RUN: To Import<br>
<?php
}
?>
<input type="submit" name="submit" value="Import">
</p>
</form>
</div>
<td class="tborderDR"><input name="lna2" type="text" id="lna2" maxlength="30"></td>
<td class="tborderL">OR:</td>
<td colspan="2" class="tborderR"><?php
echo showSpecList($resdb, $spec2, 'spec2');
?>
</td>
</tr>
<tr>
<td class="tborderUL">State Codes From: </td>
<td class="tborderUR"><?php
echo showStateList($resdb, $state);
?>
</td>
<td class="tborderDL">OR:</td>
<td colspan="2" class="tborderDR"><?php
echo showSpecList($resdb, $spec3, 'spec3');
?>
</td>
</tr>
<tr>
<td class="tborderDL">State Codes To: </td>
<td class="tborderDR"><?php
echo showStateList($resdb, $state2, 'state2');
?>
</td>
<td><a href="editprog.php?y=2010" target="_blank">Res.Program</a>:</td>
<td colspan="2"><input name="program" type="text" id="program"></td>
</tr>
<tr>
<td>Modified from:</td>
<td title="Year 2000 means 'From the beginning'"><script language="javascript">DateInput('mofrom2', false, 'YYYY-MM-DD', '<?php
?>
>Fellow</option>
<!--<option value="4" <?php
echo $status == 4 ? 'selected' : '';
?>
>Future Fellow</option>-->
<option value="3" <?php
echo $status == 3 ? 'selected' : '';
?>
>In Practice</option>
</select></td>
</tr>
<tr>
<td>2<sup>nd</sup> specialty:</td>
<td colspan="3"><?php
echo showSpecList($resdb, $spec_add, 'spec_add');
?>
</td>
<td> </td>
<td> </td>
</tr>
<tr>
<td>Specialty Interest:</td>
<td colspan="2"><input name="spec_2nd" type="text" id="spec_2nd" value="<?php
echo $spec_2nd;
?>
" size="35" maxlength="50" title="Secondary specialty or subspecialty"></td>
<td colspan="3">Med School*:
<input name="school" type="text" id="school" value="<?php
echo $school;
?>
<td colspan="2"> </td>
<td> </td>
<td class="tdborder3399"><label>
ID#:
<input name="res_id" type="text" id="res_id" size="15" maxlength="10">
</label></td>
</tr>
<tr>
<td class="tborderUL">Last name: </td>
<td class="tborderUR"><input name="lname" type="text" id="lname" value="<?php
echo stripslashes($lname);
?>
" maxlength="30"></td>
<td>Specialty:</td>
<td colspan="2"><?php
echo showSpecList($resdb, $spec);
?>
</td>
</tr>
<tr>
<td class="tborderDL">First name: </td>
<td class="tborderDR"><input name="fname" type="text" id="fname" value="<?php
echo stripslashes($fname);
?>
" maxlength="50"></td>
<td class="tborderUL">City:</td>
<td class="tborderU"><input name="city" type="text" id="city" value="<?php
echo stripslashes($city);
?>
" maxlength="50"></td>
<td class="tborderUR">Zip:
<h1>Custom Doc List </h1>
<p>Edit parameters below and submit to generate a list for clients.</p>
<?php
if ($mesg) {
echo "<p id='error_msg'>{$mesg}</p>";
}
?>
<style>
.customtbl { width: 90%; }
.customtbl td { border: 1px solid; padding: 2px; }
</style>
<form action="" method="post">
<label><strong>Specialty</strong></label><br/>
<?php
echo str_replace('name="spec"', 'name="spec" size="8" multiple', showSpecList($db, '', 'spec[]', 1));
?>
<br/><br/>
<label><strong>Region</strong></label><br/>
<select style="vertical-align:top" id="pcregion" name="pcregion">
<option value="">--Select Region--</option>
<option value="New England">New England</option>
<option value="Northeast">Northeast</option>
<option value="Midwest">Midwest</option>
<option value="Upper Midwest">Upper Midwest</option>
<option value="Mid Atlantic">Mid Atlantic</option>
<option value="South">South</option>
<option value="Southwest">Southwest</option>
<option value="Mountain">Mountain</option>
<option value="West/Pacific NW">West/Pacific NW</option>
</select>
}
?>
>
Office address</label></td>
<td> </td>
<td colspan="3"> </td>
</tr>
<tr>
<td>Phone</td>
<td><input name="phone" type="text" id="phone" value="<?php
echo $doc->phone;
?>
" maxlength="16" onChange="checkPhoEx(phone,'phone',state,'state')"> <img src="images/bquestion.png" alt="?" width="16" height="16" border="0" align="absmiddle" title="Check Area code/State match" onClick="checkPhoEx(phone,'phone',state,'state')"></td>
<td>Specialty:</td>
<td colspan="3"><?php
echo showSpecList($ama, $doc->spec);
?>
</td>
</tr>
<tr>
<td>Med school:</td>
<td colspan="3"><?php
echo $doc->sch_name;
?>
</td>
<td><?php
echo $doc->sch_amg ? 'AMG' : 'IMG';
?>
</td>
<td><?php
echo $doc->sch_loc;
<option value="<?php
echo $aloc->l_id;
?>
"><?php
echo "{$aloc->l_facility}, {$aloc->l_city}, {$aloc->l_state}";
if ($aloc->l_uid != $usid) {
echo '*';
}
?>
</option>
<?php
}
?>
</select></td></tr>
<tr><td>Specialty:</td><td><?php
echo showSpecList($db, $_POST['spec']);
?>
</td></tr>
<tr><td> </td><td><input name="submit" type="submit" value="Create"></td></tr>
</table>
</form>
</div>
<?php
} else {
echo "<p class='nodescript'>They have not entered any locations. You can enter one or more <a href=\"locationsadmin.php?cid={$usid}&acct={$uacct}&mas={$masid}\">locations</a> for them.</p>";
}
?>
<h3>Modify Opportunities</h3>
<?php
if ($opps && $opps->num_rows) {
?>
" maxlength="100"></td>
<td>Opp. State:</td>
<td><?php
echo showStateList($resdb, $state);
?>
</td>
</tr>
<tr>
<td>Company**:</td>
<td><input name="company" type="text" id="company" value="<?php
echo $company;
?>
" size="35" maxlength="120"></td>
<td>Specialty:</td>
<td><?php
echo showSpecList($resdb, $spec, 'spec');
?>
</td>
</tr>
<tr>
<td> </td>
<td>* partial email is accepted, too: user name part or domain part.<br>
** partial info is accepted, 3 symbols minimum</td>
<td> </td>
<td><input name="submitto" type="submit" id="submitto" value="Search">
<input type="reset" name="Reset" value="Reset"></td>
</tr>
</table>
</form>
</div>
?>
" size="20" maxlength="50"></td>
<td> </td>
</tr>
<tr>
<td>Spouse's Profession:</td>
<td><input name="spouse_prof" type="text" id="spouse_prof" value="<?php
echo $doc->spouse_prof;
?>
" maxlength="50" title="Spouse profession" /></td>
<td> </td>
</tr>
<tr>
<td bgcolor="#E0E0FF" title="Spouse specialty, if physician">Spouse's Specialty, if physician:</td>
<td colspan="2" bgcolor="#E0E0FF" title="Spouse specialty, if physician"><?php
echo showSpecList($db, $doc->spouse_spec, 'spouse_spec');
?>
</td>
</tr>
<tr>
<td bgcolor="#E0E0FF" title="If born in the USA">Spouse's Home/Birth state:</td>
<td bgcolor="#E0E0FF"><?php
echo showStateList($db, $doc->spouse_state, 'spouse_state');
?>
</td>
<td bgcolor="#E0E0FF"> </td>
</tr>
<tr>
<td>Any Children?</td>
<td><label>
<input name="children" type="radio" value="1" <?php
<td><input name="cellphone" type="text" id="cellphone" value="<?php
echo $doc ? $doc->cellphone : '';
?>
" size="16" maxlength="16"></td>
</tr>
<tr>
<td><strong>Email</strong>*: </td>
<td><input name="email" type="text" id="email" value="<?php
echo $doc ? $doc->email : '';
?>
" size="30" maxlength="128" onChange="checkemail(1)">
<span id="chkemail" onClick="checkemail(1)" style="cursor:hand" title="Check for validity"> <img src="images/bquestion.png" alt="?" width="16" height="16" border="0" align="absmiddle"></span></td>
<td><strong>Specialty</strong>*:</td>
<td colspan="3">
<?php
echo showSpecList($resdb, $doc->spec);
?>
</td>
</tr>
<tr valign="bottom">
<td>Source:
</td>
<td><?php
$source = $doc ? $doc->source : 0;
?>
<select name="source" id="source" size="1">
<option value="0" <?php
echo $source ? '' : 'selected';
?>
> </option>
<option value="20" <?php
echo "<p id='error_msg'>{$mesg}</p>";
}
?>
<form action="hotdocs.php" method="get" name="datef">
<table><tr>
<td>From:</td><td> <script language="javascript">DateInput('d1', false, 'YYYY-MM-DD', '<?php
echo $d1;
?>
');</script></td>
<td>To:</td><td><script language="javascript">DateInput('d2', false, 'YYYY-MM-DD', '<?php
echo $d2;
?>
');</script></td>
</tr><tr>
<td>Specialty:</td><td colspan="2"><?php
echo $db ? showSpecList($db, $spec) : 'ERROR';
?>
</td>
<td align="center"><input type="submit" name="submit" value="Select"></td>
</tr>
</table>
</form>
<?php
if ($docs) {
?>
<p>Total results: <?php
echo $totalcount;
?>
. Results shown are from <?php
echo $page + 1;
?>
<td colspan="3"><input type="text" size="6" name="opplimit" value="<?php
echo isset($client) ? $client->opplimit : 0;
?>
"> (0 = unlimited)</td>
<tr>
<td colspan="2"> </td>
<td >Email limit: </td>
<td colspan="3"><input type="text" size="6" name="emaillimit" value="<?php
echo isset($client) ? $client->emaillimit : 0;
?>
"> (0 = unlimited)</td>
<tr>
<td>Specialty: <br>
(up to 5)</td>
<td colspan="3"><?php
echo showSpecList($db, $client->specs, 'specs', 3);
?>
</td>
<td align="center" colspan="2"><input name="add" type="button" id="add"
onClick="moveOptions(specs, speclist)" value=" Add " />
<br />
<br />
<input name="remove" type="button" id="remove"
onClick="moveOptions(speclist, specs)" value="Remove" />
<br><br>
Select specialties on the left and click Add.</td>
<tr>
<td align="center">Specialties<br>
Allowed:</td>
<td colspan="3" valign="left"><input type="hidden" name="cli_specs" id="cli_specs" value="<?php
echo $client->specs;
