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@@ -133,12 +133,12 @@ if (!!@$point->data) {
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}
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?>
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+
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<div visit-moe close-on-save close-on-cancel class="d-block p-3">
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<form show url="/api/visitPoint/<?= $endPoint ?>" class="mcp-theme-1">
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<input type="hidden" name="segmentUid" value="<?= $segment->uid ?>">
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<input type="hidden" name="category" value="<?= $category ?>">
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<input type="hidden" name="data" value="{{json_encode($contentData)}}">
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-
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<p class="mb-2">Hi {{strtolower($patient->sex) === 'M' ? 'Mr.' : 'Mrs.'}} {{$patient->displayName()}}, My name is {{$pro->displayName()}}. I'm a board-certified nurse practitioner.</p>
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<div class="mb-2">
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@@ -152,7 +152,7 @@ if (!!@$point->data) {
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<?php
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$mailingAddress = implode(' ', [$patient->mailing_address_line1, $patient->mailing_address_line2, $patient->mailing_address_city, $patient->mailing_address_state, $patient->mailing_address_zip]);
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?>
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- <label class="mb-1">Let me confirm your mailing address for delivery of the self-monitoring kit: {{$mailingAddress}}</label>
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+ <label class="mb-1">Let me confirm your mailing address: {{$mailingAddress}}</label>
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<div class="d-inline-flex ml-2 align-items-baseline pt-1">
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<label class="my-0 mr-3 d-flex align-items-center">
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<input type="radio" data-name="ans_is_address_correct" name="ans_is_address_correct" {{@$contentData['ans_is_address_correct'] && @$contentData['ans_is_address_correct'] === 'yes' ? 'checked' : ''}} value="yes">
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@@ -172,10 +172,14 @@ if (!!@$point->data) {
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<hr class="my-3">
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- <div class="mb-2">
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+ <div class="mb-2 d-none">
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So it'll be my responsibility to ensure that you know exactly how to use the kit once you get it.
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</div>
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+ <div class="mb-2>
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+ DialMD
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+ </div>
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+
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<div class="mb-2">
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<label class="mb-1">Have you ever worked with a nurse practitioner before?</label>
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<div class="d-inline-flex ml-2 align-items-baseline pt-1">
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@@ -192,6 +196,8 @@ if (!!@$point->data) {
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<div class="mb-2 ml-3">
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<ul>
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+ <li><strong>I'M NOT HERE TO REPLACE YOUR CURRENT DOCTORS.</strong></li>
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+ <li>This is a telehealth service that you can rely on in addition to your existing care team if you ever need support after hours or have a question about one of your vital signs.</li>
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<li>Like medical doctors, we have the authority to write prescriptions and order labs.</li>
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<li>So if you ever need anything (medical advice, prescriptions, labs, etc.), you can always call me via phone.</li>
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<li>Or we can do video calls over Zoom if that's ever helpful.</li>
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@@ -725,41 +731,49 @@ if (!!@$point->data) {
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<hr class="my-3">
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- <p><b>Vaccine Status:</b></p>
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-
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- <div class="ml-3 mb-3">
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+ <div class="ml-3 mb-3">
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<label class="mb-2 d-flex align-items-center">
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- <input type="checkbox" data-name="ans_vaccine_status_not_enough_rapport" {{@$contentData['ans_vaccine_status_not_enough_rapport'] ? 'checked' : ''}} class="mr-2">
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- <span class="ml-2">Not enough rapport right now to ask</span>
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+ <input type="checkbox" data-name="ans_cdc_push" {{@$contentData['ans_vaccine_push'] ? 'checked' : ''}} class="mr-2">
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+ <span class="ml-2">Educated patient that self-monitoring is not a replacement for following CDC guidelines re: vaccines, mask-wearing, and social distancing; <strong>CDC guidelines re: vaccines, masks, and social distancing are the most effective strategy to reduce COVID-19 risk.</strong>.</span>
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</label>
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+ </div>
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+
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+ <p><b>Vaccine Status:</b></p>
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+
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+ <div class="ml-3 mb-3">
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<label class="mb-2 d-flex align-items-center">
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<input type="checkbox" data-name="ans_vaccine_status_declined_to_answer" {{@$contentData['ans_vaccine_status_declined_to_answer'] ? 'checked' : ''}} class="mr-2">
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<span class="ml-2">Declined to answer</span>
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</label>
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<div>
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- <input type="text" data-name="ans_vaccine_status" value="{{@$contentData['ans_vaccine_status']}}" class="form-control form-control-sm d-inline-block w-auto">
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+ Status: <input type="text" data-name="ans_vaccine_status" value="{{@$contentData['ans_vaccine_status']}}" class="form-control form-control-sm d-inline-block w-auto">
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+ </div>
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+ <div class="mt-2">
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+ Support needed? <input type="text" data-name="ans_vaccine_status" value="{{@$contentData['ans_vaccine_status']}}" class="form-control form-control-sm d-inline-block w-auto">
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</div>
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</div>
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<p><b>Booster Status:</b></p>
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<div class="ml-3 mb-3">
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- <label class="mb-2 d-flex align-items-center">
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- <input type="checkbox" data-name="ans_booster_status_not_enough_rapport" {{@$contentData['ans_booster_status_not_enough_rapport'] ? 'checked' : ''}} class="mr-2">
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- <span class="ml-2">Not enough rapport right now to ask</span>
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- </label>
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<label class="mb-2 d-flex align-items-center">
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<input type="checkbox" data-name="ans_booster_status_declined_to_answer" {{@$contentData['ans_booster_status_declined_to_answer'] ? 'checked' : ''}} class="mr-2">
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<span class="ml-2">Declined to answer</span>
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</label>
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<div>
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- <input type="text" data-name="ans_booster_status" value="{{@$contentData['ans_booster_status']}}" class="form-control form-control-sm d-inline-block w-auto">
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+ Status: <input type="text" data-name="ans_booster_status" value="{{@$contentData['ans_booster_status']}}" class="form-control form-control-sm d-inline-block w-auto">
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+ </div>
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+ <div class="mt-2">
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+ Support needed? <input type="text" data-name="ans_vaccine_status" value="{{@$contentData['ans_vaccine_status']}}" class="form-control form-control-sm d-inline-block w-auto">
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</div>
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</div>
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<div class="mb-3">
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- <label class="mb-1">Current Behaviors to Stay Safe:</label>
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+ <label class="mb-1"><strong>Current Behaviors to Stay Safe:</strong></label>
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<input type="text" data-name="ans_current_behaviors_to_stay_safe" value="{{@$contentData['ans_current_behaviors_to_stay_safe']}}" class="form-control form-control-sm">
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+ <div class="mt-2">
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+ Support needed? <input type="text" data-name="ans_vaccine_status" value="{{@$contentData['ans_vaccine_status']}}" class="form-control form-control-sm d-inline-block w-auto">
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+ </div>
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</div>
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<p><b>Education Provided:</b></p>
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root