Snap to grid (0 is off) 0 4 5 6 7 8 9 10
Image Name: for Page
- Please include the extension of the image file(.gif's, .jpg's, or .png's) - Make sure the image file is in the same folder as this html file.
Orientation of form: Portrait (image width should be 1500 pixels, resized to 750 pixels on screen) Landscape (image width should be 2000 pixels, resized to 1000 pixels on screen) Custom (enter an integer)
If the eForm image extends past the red outline, you've cropped the image too long and it won't fit on a letter-sized printout. Try typing a number smaller than 750 in the "Custom" field.
Enter a name for the eForm here
Gender checkboxes used in this eForm? If yes, click here Add Gender Checkboxes Add Gender Xboxes
Radioboxes used in this eform? If yes, click here Add Radio Checkboxes Add Radio Xboxes
Parent-Child Checkboxes used in this eform? If yes, click here AddParent Checkbox
consult_sig_xxx.png
Single-line text input Multi-line text input Checkbox Xbox
Measurement Type
---NONE--- HT WT BP BMI WAIS (waist) WC (waist circ.) Gravida Para LMP Smoking HbAi A1C FBS TG LDL HDL TCHD TCHL EGFR SCR (Cr) ACR
or custom
Field Value Date Observed Comment
Measurement Type ---NONE--- HT WT BP BMI WAIS (waist) WC (waist circ.) Gravida Para LMP Smoking HbAi A1C FBS TG LDL HDL TCHD TCHL EGFR SCR (Cr) ACR
Maximize window when eForm loads. Useful for lower resolution monitors.
Hide Headers/Footers on Print Removes headers/footers on print (so your OSCAR link isn't displayed on the printed eForm...)
Date Validation Add calander date picker for fields labeled date or day.
Emphasize Checkmarks Blackbox changes an X box into an entirely black mark. Very high visibility even when using small Xbox. Scaling up checkbox. (Works for Firefox 3.5 or newer, Safari (or similar WebKit) 3.1 or newer, IE 5-7 or IE 8 running compatibility mode, Opera 10.5) "Drawing" in checkmarks during printing. Works for Firefox older than 3.5, longer code, and may not work for IE.
Fax Include options for faxing to this eForm. Corresponding default fax number xxx-xxx-xxxx:
PDF Print Include options for PDF printing this eForm. Works with stamped signatures
Tickler Options Include automatic ticklers (requires PDF print) Priority Normal High Low Assign to Patients MRP Current User Due in 6 weeks 1 week 2 weeks 3 weeks 4 weeks 2 months 3 months 4 months 6 months 9 months 1 year allow end user to adjust Tickler message (leave blank to have the message read "Check for results of [subject] ordered [today]")
Generating the code: The html code should open up in a new window. Now you got two options: 1. Highlight everything and copy and paste it into a text editor (ex. Notepad), then save it as filename.html. 2. In the new window (in Firefox), select "File", then "Save Page As...", then select "Text Files" as the file type, then type in a filename.html.
Uploading the files: Go to Admin -> Eforms -> "Upload a Form", and upload the newly generated html file. Go to Admin -> Eforms -> "Upload an Image", and upload: - the eform background image - "jSignature.min.js"for signing signatures if you have not already done so