<?php
}
?>
<?php
$this->renderPartial('//base/_messages');
?>
<?php
if (Yii::app()->user->checkAccess('Patient Merge')) {
?>
<div class="row">
<div class="large-5 column text-right large-offset-7">
<div class="row">
<div class="large-9 column text-right">
<label>
<?php
echo CHTML::checkBox('PatientMergeRequest[confirm]', false);
?>
I declare under penalty of perjury I reviewed the details and I would like to proceed to merge.
</label>
</div>
<div class="large-3 column text-right">
<input class="warning" type="submit" value="Merge">
</div>
</div>
<div class="row">
<div class="large-3 column text-right large-offset-9">
<?php
echo CHtml::link('cancel', array('patientMergeRequest/index'), array('class' => 'button primary'));
?>
</div>
<br>
<?php
$this->renderPartial('//base/_messages');
?>
<?php
if ($personalDetailsConflictConfirm && Yii::app()->user->checkAccess('Patient Merge')) {
?>
<div id="patientDataConflictConfirmation" class="row">
<div class="large-10 large-offset-1 column alert-box with-icon warning">
<h2> Personal details are conflicting. </h2>
Please confirm you selected the right patients. <br>
Note, the primary patient's personal details will <strong>NOT</strong> be overwritten.<br><br>
<label>
<?php
echo CHTML::checkBox('PatientMergeRequest[personalDetailsConflictConfirm]', false);
?>
I hereby confirm that I selected the right patients.</label>
</div>
</div>
<div class="row">
<div class="large-12 column text-left">
</div>
</div>
<?php
}
?>
<div class="row">
<div class="large-3 column text-right large-offset-9">
<?php
?>
</label>
</div>
<!-- Responses -->
<div class="form-group">
<br/>
<?php
echo CHTML::checkBox('converty', false, array('value' => 'Y', 'id' => 'converty'));
echo ' ' . CHTML::label(gT("Convert Y to:"), 'converty');
?>
<?php
echo CHTML::textField('convertyto', '1', array('id' => 'convertyto', 'size' => '3', 'maxlength' => '1'));
?>
<?php
echo CHTML::checkBox('convertn', false, array('value' => 'Y', 'id' => 'convertn'));
echo ' ' . CHTML::label(gT("Convert N to:"), 'convertn');
?>
<?php
echo CHTML::textField('convertnto', '2', array('id' => 'convertnto', 'size' => '3', 'maxlength' => '1'));
?>
</div>
</div>
</div>
</div>
<div class="col-sm-12 col-md-6">
<!-- Column control -->
<div class="panel panel-primary" id="pannel-6">
<fieldset>
<legend><?php eT("Responses");?></legend>
<ul class="list-unstyled">
<li>
<div class="radio">
<?php echo CHTML::radioButton('answers',false,array('value'=>'short','id'=>'answers-short'));
echo CHTML::label(gT("Answer codes"),'answers-short');?>
</div>
<ul class="list-unstyled">
<div class="checkbox">
<li> <?php echo CHTML::checkBox('converty',false,array('value'=>'Y','id'=>'converty'));
echo CHTML::label(gT("Convert Y to"),'converty');?>
<?php echo CHTML::textField('convertyto','1',array('id'=>'convertyto','size'=>'3','maxlength'=>'1')); ?>
</li>
<li> <?php echo CHTML::checkBox('convertn',false,array('value'=>'Y','id'=>'convertn'));
echo CHTML::label(gT("Convert N to"),'convertn');?>
<?php echo CHTML::textField('convertnto','2',array('id'=>'convertnto','size'=>'3','maxlength'=>'1')); ?>
</li>
</div>
</ul>
</li>
<li>
<div class="radio">
<?php echo CHTML::radioButton('answers',true,array('value'=>'long','id'=>'answers-long'));
echo CHTML::label(gT("Full answers"),'answers-long');?>
</div>
</ul></fieldset>
</div>
<div class='right'>
<fieldset>
