Skip to content

Commit

Permalink
Have form field names match API
Browse files Browse the repository at this point in the history
  • Loading branch information
@dmethvin-gov
dmethvin-gov committed Feb 29, 2024
1 parent fd43569 commit 04b7dc9
Showing 1 changed file with 36 additions and 37 deletions.
73 changes: 36 additions & 37 deletions index.html
View file
Original file line number Diff line number Diff line change
Expand Up @@ -38,7 +38,7 @@ <h2 class="ds-h2">
type="radio"
class="ds-c-choice"
id="anon-no-input"
name="file_anonymously"
name="isAnonymous"
value="no"
data-reveal=".relationship-to-patient"
/>
Expand All @@ -59,7 +59,7 @@ <h2 class="ds-h2">
type="radio"
class="ds-c-choice"
id="anon-yes-input"
name="file_anonymously"
name="isAnonymous"
value="yes"
data-reveal=".relationship-to-patient"
/>
Expand Down Expand Up @@ -87,7 +87,7 @@ <h2 class="ds-h2">
<input
id="id-contact-firstname"
class="ds-c-field"
name="contact_firstname"
name="firstname"
autocomplete="given-name"
maxlength="50"
/>
Expand All @@ -99,7 +99,7 @@ <h2 class="ds-h2">
<input
id="id-contact-lastname"
class="ds-c-field"
name="contact_lastname"
name="lastname"
autocomplete="family-name"
maxlength="50"
/>
Expand All @@ -110,7 +110,7 @@ <h2 class="ds-h2">
type="text"
id="id-contact-phone"
class="ds-c-field"
name="contact_phone"
name="phone"
autocomplete="tel"
maxlength="30"
/>
Expand All @@ -121,7 +121,7 @@ <h2 class="ds-h2">
type="text"
id="id-contact-email"
class="ds-c-field"
name="contact_email"
name="email"
autocomplete="email"
maxlength="50"
/>
Expand All @@ -137,7 +137,7 @@ <h2 class="ds-h2">
type="radio"
class="ds-c-choice"
id="id-relationship-patient"
name="relationship"
name="relationToPatient"
value="self"
data-reveal=".hospital-location"
/>
Expand All @@ -150,7 +150,7 @@ <h2 class="ds-h2">
type="radio"
class="ds-c-choice"
id="id-relationship-helper"
name="relationship"
name="relationToPatient"
value="helper"
data-reveal=".hospital-location"
/>
Expand All @@ -163,7 +163,7 @@ <h2 class="ds-h2">
type="radio"
class="ds-c-choice"
id="id-relationship-worker"
name="relationship"
name="relationToPatient"
value="worker"
data-reveal=".hospital-location"
/>
Expand All @@ -176,7 +176,7 @@ <h2 class="ds-h2">
type="radio"
class="ds-c-choice"
id="id-relationship-anon"
name="relationship"
name="relationToPatient"
value="anonymous"
data-reveal=".hospital-location"
/>
Expand All @@ -200,7 +200,7 @@ <h2 class="ds-h2">
>Select a U.S. state or territory</label
>
<select
name="incident_state"
name="state"
id="id-incident-state"
class="ds-c-field"
required
Expand Down Expand Up @@ -266,11 +266,12 @@ <h2 class="ds-h2">
</div>

<div class="hospital-dropdown ds-u-clearfix" hidden>
<label class="ds-c-label"> Hospital name</label>
<label for="id-facility" class="ds-c-label"> Hospital name</label>
<input
class="ds-c-field"
id="id-facility"
type="text"
name="hospital_ccn"
name="facilityCCN"
data-reveal=".date-of-incident"
/>
<div class="hospital-details" hidden>
Expand Down Expand Up @@ -310,7 +311,7 @@ <h3 class="ds-text-heading--md">
type="date"
id="incident-date"
class="ds-c-field"
name="incident_date"
name="dateOfIncident"
required
data-reveal=".description-of-incident"
/>
Expand Down Expand Up @@ -349,7 +350,7 @@ <h2 class="ds-h2">
Please enter at least 250 characters here.
</span>
</label>
<textarea name="incident_description" class="ds-c-field"></textarea>
<textarea name="description" class="ds-c-field"></textarea>
<div class="text-counter">(Up to 3,000 characters)</div>
</div>

Expand All @@ -360,7 +361,7 @@ <h2 class="ds-h2">
>If so, what office did you report this problem to?</span
></label
>
<textarea name="previously_reported" class="ds-c-field"></textarea>
<textarea name="previouslyReported" class="ds-c-field"></textarea>
<div class="text-counter">(Up to 200 characters)</div>
</div>

Expand All @@ -384,11 +385,9 @@ <h2 class="ds-h2">
<h3 class="ds-h3">${".filing-choice legend"}</h3>
<p>${".filing-choice input:checked + label :first-child"}</p>
<ul class="contact-info-review">
<li>
Name: ${"![name=contact_firstname]"} ${"![name=contact_lastname]"}
</li>
<li>Phone: ${"![name=contact_phone]"}</li>
<li>Email: ${"![name=contact_email]"}</li>
<li>Name: ${"![name=firstname]"} ${"![name=lastname]"}</li>
<li>Phone: ${"![name=phone]"}</li>
<li>Email: ${"![name=email]"}</li>
</ul>
<h3 class="ds-h3">${".relationship-to-patient legend"}</h3>
<p>
Expand All @@ -414,12 +413,12 @@ <h3 class="ds-h3">${".date-of-incident label :first-child"}</h3>
<h3 class="ds-h3">
${".description-of-incident label :first-child"}
</h3>
<p>${"!textarea[name=incident_description]"}</p>
<p>${"!textarea[name=description]"}</p>

<h3 class="ds-h3">
${".reported-problem-before label :first-child"}
</h3>
<p>${"!textarea[name=previously_reported]"}</p>
<p>${"!textarea[name=previouslyReported]"}</p>
</template>

<h1 class="ds-h1">Review your EMTALA complaint</h1>
Expand Down Expand Up @@ -528,7 +527,7 @@ <h2 class="ds-h2">About CMS</h2>
select {
width: auto;
}
textarea[name="incident_description"] {
textarea[name="description"] {
height: 20ex;
}
.ds-c-field__hint ul {
Expand Down Expand Up @@ -693,12 +692,12 @@ <h2 class="ds-h2">About CMS</h2>
return;
}
// If anonymous, ensure contact fields are emptied
const anon = qs("input[name=file_anonymously][value=yes]").checked;
const anon = qs("input[name=isAnonymous][value=yes]").checked;
if (anon) {
qs("input[name=contact_firstname]").value = "";
qs("input[name=contact_lastname]").value = "";
qs("input[name=contact_phone]").value = "";
qs("input[name=contact_email]").value = "";
qs("input[name=firstname]").value = "";
qs("input[name=lastname]").value = "";
qs("input[name=phone]").value = "";
qs("input[name=email]").value = "";
}

const tpl = qs(".review-complaint template").innerHTML;
Expand Down Expand Up @@ -731,14 +730,14 @@ <h2 class="ds-h2">About CMS</h2>
const { name, value } = e.target;
const field = e.target;

if (name === "file_anonymously") {
if (name === "isAnonymous") {
if (value === "yes") {
hide(".contact-information");
} else {
show(".contact-information");
}
}
if (name === "contact_phone") {
if (name === "phone") {
const digits = value.replace(/\D/g, "");
const [, one, ac, ex, ln] =
digits.match(/^(1?)([2-9]\d\d)(\d\d\d)(\d\d\d\d)$/) ?? [];
Expand All @@ -749,11 +748,11 @@ <h2 class="ds-h2">About CMS</h2>
field.value = formatted;
}
// State may have been autofilled but no onchange
const state = qs("select[name=incident_state]").value;
if (name === "incident_state" || (name === "relationship" && state)) {
const state = qs("select[name=state]").value;
if (name === "state" || (name === "relationToPatient" && state)) {
hide(".hospital-details");
hospitals = allHospitals.filter((h) => h.state === state);
const input = qs("input[name=hospital_ccn]");
const input = qs("input[name=facilityCCN]");
input.ariaAutocomplete?.destroy();
AriaAutocomplete(input, {
source: hospitals.map((h) => ({
Expand All @@ -762,7 +761,7 @@ <h2 class="ds-h2">About CMS</h2>
})),
});
}
if (name === "hospital_ccn") {
if (name === "facilityCCN") {
const info = hospitals.find((h) => h.ccn == value);
if (!info || value === "") {
hide(".hospital-details");
Expand All @@ -777,7 +776,7 @@ <h2 class="ds-h2">About CMS</h2>
show(".hospital-details");
}
}
if (name === "incident_date") {
if (name === "dateOfIncident") {
const idate = new Date(value);
// Convert from UTC to local time
idate.setMinutes(idate.getMinutes() + idate.getTimezoneOffset());
Expand All @@ -802,7 +801,7 @@ <h2 class="ds-h2">About CMS</h2>
})
);
}
if (name === "incident_description") {
if (name === "description") {
if (value.length < 10) {
field.classList.add("ds-c-field-error");
show(".incident-description-error");
Expand Down

0 comments on commit 04b7dc9

Please sign in to comment.