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KHP3-3756 Add program enrollment and county in vmmc entrollment form (#…
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@CynthiaKamau
CynthiaKamau authored Jul 12, 2023
1 parent 7613395 commit 0862aae
Showing 1 changed file with 190 additions and 174 deletions.
364 changes: 190 additions & 174 deletions configuration/ampathforms/VMMC_Enrollment.json
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@@ -1,176 +1,192 @@
{
"name": "VMMC Enrollment Form",
"description": "VMMC Enrollment Form",
"version": "1",
"published": true,
"uuid": "a74e3e4a-9e2a-41fb-8e64-4ba8a71ff984",
"retired": false,
"encounter": "VMMC Enrollment",
"pages": [
{
"label": "POC VMMC Enrollment Form",
"sections": [
{
"label": "Visit Details",
"isExpanded": "true",
"questions": [
{
"label": "Date:",
"type": "encounterDatetime",
"questionOptions": {
"rendering": "ui-select-extended"
},
"validators": [
{
"type": "date",
"allowFutureDates": "false"
}
],
"id": "encDate"
},
{
"label": "Provider:",
"type": "encounterProvider",
"questionOptions": {
"rendering": "ui-select-extended"
},
"id": "encProvider "
},
{
"label": "Location:",
"type": "encounterLocation",
"questionOptions": {
"rendering": "ui-select-extended"
},
"id": "encLocation"
}
]
},
{
"label": "Client Enrollment",
"isExpanded": "true",
"questions": [
{
"label": "Referred by:",
"type": "obs",
"questionOptions": {
"rendering": "select",
"concept": "160482AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"answers": [
{
"concept": "165650AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Self referral"
},
{
"concept": "163488AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Community Health Volunteer"
},
{
"concept": "5619AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Health Care Worker"
},
{
"concept": "1370AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HTS Counsellors"
},
{
"concept": "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Other"
}
]
},
"id": "referralBy",
"required": "true"
},
{
"label": "Specify :",
"type": "obs",
"questionOptions": {
"rendering": "text",
"concept": "b7f19768-bb0e-4bd4-b24b-e53b566b6af9"
},
"id": "otherReferral",
"hide": {
"hideWhenExpression": "referralBy !== '5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
}
},
{
"label": "Client type:",
"type": "obs",
"questionOptions": {
"rendering": "select",
"concept": "162728AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"answers": [
{
"concept": "159833AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Re-enrollment(Re-activation)"
},
{
"concept": "164144AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "New Patient"
}
]
},
"id": "clientType",
"required": "true"
},
{
"label": "Main source of VMMC Information:",
"type": "obs",
"questionOptions": {
"rendering": "select",
"concept": "167094AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"answers": [
{
"concept": "167096AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Print Media"
},
{
"concept": "160542AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "OPD/MCH/HT"
},
{
"concept": "1555AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Mobilizer CHW"
},
{
"concept": "167097AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Social Media"
},
{
"concept": "167098AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Road Show"
},
{
"concept": "167095AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Radio/Tv"
},
{
"concept": "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Other"
}
]
},
"id": "informationSource",
"required": "true"
},
{
"label": "Specify :",
"type": "obs",
"questionOptions": {
"rendering": "text",
"concept": "160632AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA"
},
"id": "otherinformationSource",
"hide": {
"hideWhenExpression": "informationSource !== '5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
}
}
]
}
]
"name": "VMMC Enrollment Form",
"description": "VMMC Enrollment Form",
"version": "1",
"published": true,
"uuid": "a74e3e4a-9e2a-41fb-8e64-4ba8a71ff984",
"retired": false,
"encounter": "VMMC Enrollment",
"meta": {
"programs": {
"uuid": "228538f4-cad9-476b-84c3-ab0086150bcc",
"isEnrollment": true,
"discontinuationDateQuestionId": ""
}
],
"processor": "EncounterFormProcessor",
"referencedForms": []
}
},
"pages": [
{
"label": "VMMC Enrollment Form",
"sections": [
{
"label": "Visit Details",
"isExpanded": "true",
"questions": [
{
"label": "Date:",
"type": "encounterDatetime",
"questionOptions": {
"rendering": "ui-select-extended"
},
"validators": [
{
"type": "date",
"allowFutureDates": "false"
}
],
"id": "encDate"
},
{
"label": "Provider:",
"type": "encounterProvider",
"questionOptions": {
"rendering": "ui-select-extended"
},
"id": "encProvider "
},
{
"label": "Location:",
"type": "encounterLocation",
"questionOptions": {
"rendering": "ui-select-extended"
},
"id": "encLocation"
}
]
},
{
"label": "Client Enrollment",
"isExpanded": "true",
"questions": [
{
"label": "Referred by:",
"type": "obs",
"questionOptions": {
"rendering": "select",
"concept": "160482AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"answers": [
{
"concept": "165650AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Self referral"
},
{
"concept": "163488AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Community Health Volunteer"
},
{
"concept": "5619AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Health Care Worker"
},
{
"concept": "1370AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HTS Counsellors"
},
{
"concept": "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Other"
}
]
},
"id": "referralBy",
"required": "true"
},
{
"label": "Specify :",
"type": "obs",
"questionOptions": {
"rendering": "text",
"concept": "b7f19768-bb0e-4bd4-b24b-e53b566b6af9"
},
"id": "otherReferral",
"hide": {
"hideWhenExpression": "referralBy !== '5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
}
},
{
"label": "Client type:",
"type": "obs",
"questionOptions": {
"rendering": "select",
"concept": "162728AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"answers": [
{
"concept": "159833AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Re-enrollment(Re-activation)"
},
{
"concept": "164144AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "New Patient"
}
]
},
"id": "clientType",
"required": "true"
},
{
"label": "Main source of VMMC Information:",
"type": "obs",
"questionOptions": {
"rendering": "select",
"concept": "167094AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"answers": [
{
"concept": "167096AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Print Media"
},
{
"concept": "160542AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "OPD/MCH/HT"
},
{
"concept": "1555AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Mobilizer CHW"
},
{
"concept": "167097AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Social Media"
},
{
"concept": "167098AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Road Show"
},
{
"concept": "167095AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Radio/Tv"
},
{
"concept": "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Other"
}
]
},
"id": "informationSource",
"required": "true"
},
{
"label": "Specify :",
"type": "obs",
"questionOptions": {
"rendering": "text",
"concept": "160632AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA"
},
"id": "otherinformationSource",
"hide": {
"hideWhenExpression": "informationSource !== '5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
}
},
{
"label": "County :",
"type": "obs",
"questionOptions": {
"rendering": "text",
"concept": "167131AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA"
},
"id": "county"
}
]
}
]
}
],
"processor": "EncounterFormProcessor",
"referencedForms": []
}

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