<?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>