<%@taglib prefix="itrust" uri="/WEB-INF/tags.tld"%> <%@page errorPage="/auth/exceptionHandler.jsp"%> <%@page import="edu.ncsu.csc.itrust.action.AddPreRegisteredPatientAction"%> <%@page import="edu.ncsu.csc.itrust.BeanBuilder"%> <%@page import="edu.ncsu.csc.itrust.beans.PatientBean"%> <%@page import="edu.ncsu.csc.itrust.exception.FormValidationException"%> <%@page import="edu.ncsu.csc.itrust.exception.ITrustException"%> <%@include file="/global.jsp" %> <% pageTitle = "iTrust - PreRegister Patient"; %> <%@include file="/header.jsp" %> <% boolean formIsFilled = request.getParameter("formIsFilled") != null && request.getParameter("formIsFilled").equals("true"); if (formIsFilled) { //This page is not actually a "page", it just adds a user and forwards. PatientBean p = new BeanBuilder<PatientBean>().build(request.getParameterMap(), new PatientBean()); try { long newMID = 021700L; newMID = new AddPreRegisteredPatientAction(DAOFactory.getProductionInstance(), newMID).addPatient(p); session.setAttribute("pid", Long.toString(newMID)); String fullname; String password; password = p.getPassword(); fullname = p.getFullName(); loggingAction.logEvent(TransactionType.PATIENT_CREATE, newMID, newMID, ""); %> <div align=center> <span class="iTrustMessage">New Pre-registered Prepatient <%= StringEscapeUtils.escapeHtml("" + (fullname)) %> successfully added!</span> <br /><br /> <table class="fTable"> <tr> <th colspan=2>New Pre-registered Patient Information</th> </tr> <tr> <td class="subHeaderVertical">MID:</td> <td><%= StringEscapeUtils.escapeHtml("" + (newMID)) %></td> <td></td> </tr> <tr> <td class="subHeaderVertical">Temporary Password:</td> <td><%= StringEscapeUtils.escapeHtml("" + (password)) %></td> <td></td> </tr> </table> <br />Please get this information to <b><%= StringEscapeUtils.escapeHtml("" + (fullname)) %></b>! </div> <% } catch(FormValidationException e){ %> <div align=center> <span class="iTrustError"> <%= StringEscapeUtils.escapeHtml(e.getMessage()) %></span> <!-- StringEscapeUtils.escapeHtml(e.getMessage()) --> </div> <% } catch (ITrustException e) { %> <div align=center> <span class="iTrustError"> <%= StringEscapeUtils.escapeHtml(e.getMessage()) %></span> <!-- StringEscapeUtils.escapeHtml(e.getMessage()) --> </div> <% } } %> <div align=center> <form action="PreRegisterPatient.jsp" method="post"> <!-- Which page DIRECT to --> <input type="hidden" name="formIsFilled" value="true"> <br /> <br /> <div style="width: 50%; text-align:left;">Please enter in the name of the Pre-registered patient, with a valid email address. If the user does not have an email address, use the hospital's email address, [insert pre-defined email], to recover the password.</div> <br /> <br /> <table class="fTable"> <tr> <th colspan=2 style="text-align:center">Pre-registered Patient Information</th> </tr> <tr> <td class="subHeaderVertical">First name:</td> <td><input type="text" name="firstName" required> *</td> </tr> <tr> <td class="subHeaderVertical">Last Name:</td> <td><input type="text" name="lastName" required> *</td>> </tr> <tr> <td class="subHeaderVertical">Email:</td> <td><input type="text" name="email" required> *</td> </tr> <tr> <td class="subHeaderVertical">Password:</td> <td><input type="password" name="password" required> *</td> </tr> <tr> <td class="subHeaderVertical">Verify Password:</td> <td><input type="password" name="verifyPassword" required> *</td> </tr> <tr> <td class="subHeaderVertical">Address:</td> <td> <input name="streetAddress1" type="text"><br /> <input name="streetAddress2" type="text"></td> </tr> <tr> <td class="subHeaderVertical">City:</td> <td> <input name="city" type="text"></td> </tr> <tr> <td class="subHeaderVertical">State:</td> <td><itrust:state name="state" value="AK" /></td> </tr> <tr> <td class="subHeaderVertical">Zip:</td> <td> <input type="text" name="zip" maxlength="10" size="10"></td> </tr> <tr> <td class="subHeaderVertical">Phone:</td> <td> <input type="text" name="phone" size="12" maxlength="12"></td> </tr> <tr> <td class="subHeaderVertical">Height:</td> <td><input type="text" name="height"></td> </tr> <tr> <td class="subHeaderVertical">Weight:</td> <td><input type="text" name="weight"></td> </tr> <tr> <td class="subHeaderVertical">Smoker:</td> <td><input type="radio" id="smoker_yes" name="isSmoker" value="true"> <label for="smoker_yes">Yes</label> <br> <input type="radio" id="smoker_no" name="isSmoker" value="false"> <label for="smoker_no">No</label><br> </td> </tr> <br/> <tr> <th colspan=2 style="text-align:center">Insurance Information</th> </tr> <tr> <td class="subHeaderVertical">Insurance Provider Name:</td> <td> <input type="text" name="icName"></td> </tr> <tr> <td class="subHeaderVertical">Insurance Provider Address:</td> <td><input name="icAddress1" type="text"><br /> <input name="icAddress2" type="text"></td> </tr> <tr> <td class="subHeaderVertical">City:</td> <td> <input name="icCity" type="text"></td> </tr> <tr> <td class="subHeaderVertical">State:</td> <td><itrust:state name="icState" value="AK" /></td> </tr> <tr> <td class="subHeaderVertical">Zip:</td> <td> <input type="text" name="icZip" maxlength="10" size="10"></td> </tr> <tr> <td class="subHeaderVertical">Insurance Provider Phone:</td> <td><input type="text" name="icPhone"></td> </tr> </table> <br /> <input type="submit" style="font-size: 16pt; font-weight: bold;" value="Patient Pre-Register" id="submit_preregister"> </form> <br /> </div> <%@include file="/footer.jsp" %>