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Off Site Clinic Log
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Outline
Configuration
Form components
Webform Settings
Title:
*
Description:
<p>Form to enter your off-site clinic log patients. Please make sure that you log in to the site before submiting the form. Once logged in, a courtesy copy of the results entered at each form submission will be emailed to you.</p>
Text to be shown as teaser and before the form.
Confirmation message or redirect URL:
<p>Your clinic log DATA has successfully been submitted!</p>
Message to be shown upon successful submission or a path to a redirect page. Preface message with
message:
for a simple message that does not require a page refresh. Redirect pages must start with
http://
for external sites or
internal:
for an internal path. i.e.
http://www.example.com
or
internal:node/10
Input format
Filtered HTML
Web page addresses and e-mail addresses turn into links automatically.
Lines and paragraphs break automatically.
Rich-text editing
Lines and paragraphs break automatically.
Web page addresses and e-mail addresses turn into links automatically.
More information about formatting options
Webform access control
These permissions affect which roles can submit this webform. It does not prevent access to the webform page. If needing to prevent access to the webform page entirely, use a content access module such as
Taxonomy Access
or
Node Privacy by Role
.
Roles that can submit this webform:
admins
alumni
anonymous user
authenticated user
HO 1
HO 2
HO 3
HO 4
Resident 2
staff
Uncheck all roles to prevent new submissions. The
authenticated user
role applies to any user signed into the site, regardless of other assigned roles.
Webform mail settings
E-mail to address:
Form submissions will be e-mailed to this address. Leave blank for none. Multiple e-mail addresses may be separated by commas.
Conditional e-mail recipients
The settings below allow you to send e-mails to multiple recipients based off the value of a component.
To
Name
Type
Billing Provider(Staff)
select
Performing Provider(Resident)
select
your email address
email
E-mail from name:
Default:
lsumedpeds.com:
Custom:
Component:
Last Name
First Name
Birthdate
Diagnosis
Pat MRN
Billing Provider(Staff)
Performing Provider(Resident)
After adding components to this form any email, select, or hidden form element may be selected as the sender's name for e-mails.
E-mail from address:
Default:
ssa5@hotmail.com
Custom:
Component:
Billing Provider(Staff)
Performing Provider(Resident)
your email address
After adding components to this form any textfield, select, or hidden form element may be selected as the sender's e-mail address.
E-mail subject:
Default:
Form submission from: %title
Custom:
Component:
Last Name
First Name
Birthdate
Diagnosis
Pat MRN
Billing Provider(Staff)
Performing Provider(Resident)
After adding components to this form any textfield, select, or hidden form element may be selected as the subject for e-mails.
Webform advanced settings
Show complete form in teaser
Display the entire form in the teaser display of this node.
Limit the number of submissions a user may send within a specified time period
Unlimited
Limit to
submission(s)
ever
every hour
every day
every week
Submit button text:
By default the submit button on this form will have the label
Submit
. Enter a new title here to override the default.
Log message:
An explanation of the additions or updates being made to help other authors understand your motivations.
Authoring information
Authored by:
Leave blank for
Anonymous
.
Authored on:
Format:
2009-05-17 00:45:53 -0600
. Leave blank to use the time of form submission.
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