<cfparam name="url.rtn" default="assessment_form" />
<cfparam name='url.na' default='' />
 <cfif url.na eq 'y'>
  <cfset session.cs.AssessmentId = 0 />
 </cfif>
<cfquery name="AssForm" datasource="#Application.DataSrc#">
SELECT *
FROM #Request.prefix_db_agency#.Assessment_New
WHERE Assessment_New.Assessment_ID='#session.cs.AssessmentId#'
</cfquery>
<cfquery name="Createdby" datasource="#Application.DataSrc#">
	select Last_Name,First_Name from #Request.prefix_db_lookup#.Employee where Employee_ID = '#AssForm.Record_Created_By#'
</cfquery>

<cfscript>
		pat = CreateObject("Component", "patientadmin_new.patient.assessment");
		get_ques = pat.get_all_ques_ans('6 - Transferred to an inpatient facility - patient not discharged from agency','#DateFormat(AssForm.Assessment_Completed_M0090,'yyyy-mm-dd')#');
	</cfscript>
	
<!-- BEGIN DEFAULT FORM PORTLET -->
<div class="portlet box blue">
    <div class="portlet-title">
        <div class="caption">
            <i class="fa fa-gear"></i> <cfoutput>#DateFormat(AssForm.Start_of_Care_M0030,'mm/dd/yyyy')# - Transfer Not Discharge </cfoutput>
            
        </div>
		<div class="tools">
		  <a href="javascript:;" class="collapse"></a>
		</div>
    </div>
    <div class="portlet-body form">
        <cfform name="transForm" method="post" action="index.cfm?a=1&a=1&px=y&page=patient&px=y&cat=TransferNotDischargeUpdateForm">
            <div class="form-body">
			    <div class="well">
					  <input type="hidden" name="assessmentcompleted" id="assessmentcompleted" value="<cfoutput>#DateFormat(AssForm.Assessment_Completed_M0090,'yyyy-mm-dd')#</cfoutput>"/>
					  <input type="hidden" name="txtAssId" id="txtAssId" value="<cfoutput>#DateFormat(AssForm.Assessment_Completed_M0090,'yyyy-mm-dd')#</cfoutput>"/>
					     <cfoutput query="get_ques" group="questions">
									  <div class="form-group">
											<div class="label-stable">
												<label>#questions#</label>
													<input type="hidden" name="hdn_#answer_label#" id="hdn_#answer_label#" />
												  <cfset  cheked_value = "AssForm."&answer_label />
													   <cfif answer_type EQ 'text' >
																  <br />
																	  <label> <input type="#answer_type#" name="#answer_label#" id="#answer_label#" value="#Evaluate(Variables.cheked_value)#" 
																	  class="form-control"> </label>
														<cfelseif answer_type EQ 'textarea' >
																	   <br />
																	  <label><textarea class="form-control" name="#answer_label#" id="#answer_label#"  rows="3" style="width:700px;max-width:100%;height:90px;display:block;">#Evaluate(Variables.cheked_value)#</textarea></label>
														<cfelseif answer_type EQ 'radio'>
																	  <cfoutput>
																	   <div class="radio-list">
																			   <label> <input type="#answer_type#" name="#answer_label#" id="#answer_label#" value="#answer#" <cfif #Evaluate(Variables.cheked_value)#  EQ  "#answer#">checked </cfif>><span>#answer#</span></label>
																		</div>
																		</cfoutput>
														<cfelseif answer_type EQ 'checkbox'>
																	 <cfoutput>
																		   <div class="checkbox-list">
																			  <label><input type="#answer_type#"  name="#answer_label#" id="#answer_label#" value="#answer#" <cfif #Evaluate(Variables.cheked_value)#  Contains  #answer#>checked</cfif>  <cfif show_text eq 1 > onclick="showTextArea('#answer_label#');" </cfif>>#answer#
																			 </label>
																			 <cfif show_text eq 1 and answer eq 'Other'>
																			 <textarea  <cfif #Evaluate(Variables.cheked_value)# neq '' and  #Evaluate(Variables.cheked_value)# neq '$' >style="width:900px;max-width:100%;height:90px;display:block;"<cfelse>style="width:900px;max-width:100%;height:90px;display:none;"</cfif>  class="form-control" name="txt_#answer_label#" id="txt_#answer_label#"><cfoutput>#Evaluate(Variables.cheked_value)#</cfoutput></textarea>
																			</cfif> 
																			</div>
																			</cfoutput>
													
														<cfelseif answer_type EQ 'spinner' >
																	 <div class="spinner1">
																		<div class="input-group input-small">
																			   <input type="#answer_type#" name="#answer_label#" id="#answer_label#" value="#Evaluate(Variables.cheked_value)#" 
																					   class="spinner-input form-control"> 
																			   <div class="spinner-buttons input-group-btn btn-group-vertical">
																					<button type="button" class="btn spinner-up btn-xs blue">
																					<i class="fa fa-angle-up"></i>
																					</button>
																					<button type="button" class="btn spinner-down btn-xs blue">
																					<i class="fa fa-angle-down"></i>
																					</button>
																				</div>		   
																			</div>
																		</div>
														<cfelseif answer_type EQ 'dropdown'>
																	  <div>
																		  <select class="form-control"  id="#answer_label#" name="#answer_label#" data-placeholder="Select...">
																						 <option value="" <cfif Evaluate(Variables.cheked_value) eq ''>selected</cfif>>-- Select option -- </option>
																							   <cfoutput>
																									   <option value="#answer#" <cfif Evaluate(Variables.cheked_value) eq #answer#   <!---OR  (Left(Evaluate(Variables.cheked_value),1) EQ Left(answer,1))---> OR  (Left(Evaluate(Variables.cheked_value),2) EQ Left(answer,2))>selected</cfif>>#answer#</option>
																								</cfoutput>
																					   </select>
																	 </div>
																	 
														<cfelseif answer_type EQ 'datepicker'>		
																	 <div>
																				<div class="input-group input-medium date date-picker" data-date-format="mm/dd/yyyy">
																					<input type="text" class="form-control" name="#answer_label#" id="#answer_label#" value='<cfoutput>#DateFormat(Evaluate(Variables.cheked_value),"mm/dd/yyyy")#</cfoutput>' placeholder="Select Date">
																					<span class="input-group-btn">
																						<button class="btn default" type="button">
																							<i class="fa fa-calendar">
																							</i>
																						</button>
																					</span>
																				</div>
																				<span class="help-block">Date Format: mm/dd/yyyy</span>
																			 </div>
														 </cfif>
											</div>
										</div>
						</cfoutput>
						</div>
			</div>
            <div class="form-actions">
                <input type="hidden" name="hdnM141Oxygen" />
                <input type="hidden" name="hdnM2030Value" />
                <input type="hidden" name="hdnM2020Value" />
                <input type="hidden" name="hdnM2300Value" />
                <input type="hidden" name="hdnM2310Value" />
                <input type="hidden" name="hdnM2430Value" />
                <input type="hidden" name="hdnM2440Value" />
                <input type="hidden" name="hdnM2420Value" />
                <input type="hidden" name="hdnM1510Value" />
				<cfoutput><input type="hidden" name="hdnAssId" value="#AssForm.Assessment_ID#" /></cfoutput>
                <cfset Transmission_status=AssForm.Transmission_status />
                <cfif 1 or #UCASE(Transmission_status)# neq "DATASET HAS BEEN TRANSMITTED." AND #UCASE(Transmission_status)# neq "READY TO TRANSMIT">
                	<input class="btn blue" type="button" name="Update" value="Update" onclick="return  transfer_update();" />
                </cfif>
                <input class="btn btn-default" type="button" value="Cancel" name="cancel" onclick="history.back();"  />
            </div>
        </cfform>
    </div>
</div>
<!-- END DEFAULT FORM PORTLET -->
<cfinclude template="/Scripts/assessments/TransferDischargeForm.cfm" />