--covid 19 screening Form in Assessment tab


INSERT INTO `forms` (`id`, `form_name`, `form_data`) VALUES
(73, 'covid_19_screening', '{\"formSections\":[{\"id\":\"user-form-settings\",\"componentType\":\"form\",\"component\":{\"ajax\":\"false\",\"attr\":\"novalidate\",\"framework\":\"bs4\",\"iconFont\":\"fontawesome5\",\"iconFontUrl\":\"//cdnjs.cloudflare.com/ajax/libs/font-awesome/5.3.1/css/all.min.css\",\"id\":\"covid_19_screening\",\"layout\":\"horizontal\",\"plugins\":[],\"aftervalidation\":\"\",\"redirectUrl\":\"\",\"senderEmail\":\"\",\"recipientEmail\":\"\",\"subject\":\"\",\"senderName\":\"\",\"replyToEmail\":\"\",\"sentMessage\":\"\",\"dbTable\":\"\",\"dbPrimary\":\"\",\"dbFilter\":\"\"}},{\"id\":\"xwfkr7srcevbryy12mya\",\"componentType\":\"radio\",\"component\":{\"componentType\":\"radio\",\"helper\":\"\",\"plugins\":[],\"radioButtons\":[{\"index\":1,\"text\":\"90-97\",\"value\":\"90-97\"},{\"index\":2,\"text\":\"97 - 98.9\",\"value\":\"97 - 98.9\"},{\"index\":3,\"text\":\"> 99\",\"value\":\"> 99\"}],\"attr\":[],\"clazz\":\"\",\"index\":1,\"inline\":\"true\",\"label\":\"Temperature\",\"name\":\"temperature\",\"value\":\"\",\"width\":\"100%\"}},{\"id\":\"1i873u6ue56kpvexryfmbc\",\"componentType\":\"radio\",\"component\":{\"componentType\":\"radio\",\"helper\":\"\",\"plugins\":[],\"radioButtons\":[{\"index\":1,\"text\":\"Yes\",\"value\":\"Yes\"},{\"index\":2,\"text\":\"No\",\"value\":\"No\"}],\"attr\":[{\"name\":\"class\",\"value\":\"fstfdt6tsrt\"}],\"clazz\":\"fstfdt6tsrt\",\"index\":2,\"inline\":\"true\",\"label\":\"Was Symptoms Screening as per screening Covid tool (attached) done?\",\"name\":\"Was_symptoms_screening_as_per_screening_covid_tool_donew\",\"value\":\"\",\"width\":\"100%\"}},{\"id\":\"zjbokwyupari3yu5ic2p\",\"componentType\":\"radio\",\"component\":{\"componentType\":\"radio\",\"helper\":\"\",\"plugins\":[],\"radioButtons\":[{\"index\":1,\"text\":\"Yes\",\"value\":\"Yes\"},{\"index\":2,\"text\":\"No\",\"value\":\"No\"}],\"attr\":[],\"clazz\":\"\",\"index\":3,\"inline\":\"true\",\"label\":\"Symptoms\",\"name\":\"symptoms\",\"value\":\"\",\"width\":\"100%\"}},{\"id\":\"4tbjs84gqyfz9scw8sfih\",\"componentType\":\"textarea\",\"component\":{\"componentType\":\"textarea\",\"helper\":\"\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":1,\"label\":\"Additional Comments\",\"name\":\"additional_comments\",\"placeholder\":\"\",\"value\":\"\",\"width\":\"100%\"}},{\"id\":\"ptnw0q4fzgl452pj70ez5a\",\"componentType\":\"radio\",\"component\":{\"componentType\":\"radio\",\"helper\":\"\",\"plugins\":[],\"radioButtons\":[{\"index\":1,\"text\":\"Yes\",\"value\":\"Yes\"},{\"index\":2,\"text\":\"No\",\"value\":\"No\"}],\"attr\":[{\"name\":\"class\",\"value\":\"fstfdt6tsrt\"}],\"clazz\":\"fstfdt6tsrt\",\"index\":4,\"inline\":\"true\",\"label\":\"1. Have you traveled outside of the United States in the last 5 days?\",\"name\":\"have_you_traveled_outside_of_the_united_states_in_the_last_5_days\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"icmkdqslljono21u9brav\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":1,\"label\":\"Where\",\"name\":\"where_you_traveled_outside_of_the_united_states_in_the_last_5_days\",\"placeholder\":\"\",\"type\":\"text\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"7c8zak1akxyij2mj2tn5nk\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":2,\"label\":\"A. Date Departed\",\"name\":\"date_departed\",\"placeholder\":\"\",\"type\":\"date\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"xs20j6jf5bno12hrbgfdg\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":3,\"label\":\"Date Arrived into the US\",\"name\":\"date_arrived_into_the_us\",\"placeholder\":\"\",\"type\":\"text\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"v6rq8508b8tqenh7x0phh\",\"componentType\":\"radio\",\"component\":{\"componentType\":\"radio\",\"helper\":\"\",\"plugins\":[],\"radioButtons\":[{\"index\":1,\"text\":\"Yes\",\"value\":\"Yes\"},{\"index\":2,\"text\":\"No\",\"value\":\"No\"}],\"attr\":[],\"clazz\":\"\",\"index\":5,\"inline\":\"true\",\"label\":\"B. Have you visited any facilities with confirmed COVID-19 cases (i.e. grocery store, bank)?\",\"name\":\"have_you_visited_any_facilities_with_confirmed_covid_19_cases\",\"value\":\"\",\"width\":\"100%\"}},{\"id\":\"k5ur5n26crtu5xdrdmpgo\",\"componentType\":\"radio\",\"component\":{\"componentType\":\"radio\",\"helper\":\"\",\"plugins\":[],\"radioButtons\":[{\"index\":1,\"text\":\"Yes\",\"value\":\"Yes\"},{\"index\":2,\"text\":\"No\",\"value\":\"No\"}],\"attr\":[{\"name\":\"class\",\"value\":\"fstfdt6tsrt\"}],\"clazz\":\"fstfdt6tsrt\",\"index\":6,\"inline\":\"true\",\"label\":\"2. Does someone you are in close contact with have COVID-19 (household, daycare, etc.)?\",\"name\":\"does_someone_you_are_in_close_contact_with_have_covid_19\",\"value\":\"\",\"width\":\"100%\"}},{\"id\":\"hugl8kdx1svvec7yrthm7\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":4,\"label\":\"A. Who?\",\"name\":\"who_you_are_in_close_contact_with_have_covid_19\",\"placeholder\":\"\",\"type\":\"text\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"3th8ai7yhfviu366xzw3rg\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":5,\"label\":\"Date Diagnosed\",\"name\":\"date_diagnosed_you_are_in_close_contact_with_have_covid_19\",\"placeholder\":\"\",\"type\":\"date\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"huyck7bpay63o1q5248wpb\",\"componentType\":\"radio\",\"component\":{\"componentType\":\"radio\",\"helper\":\"\",\"plugins\":[],\"radioButtons\":[{\"index\":1,\"text\":\"Yes\",\"value\":\"Yes\"},{\"index\":2,\"text\":\"No\",\"value\":\"No\"}],\"attr\":[],\"clazz\":\"\",\"index\":7,\"inline\":\"true\",\"label\":\"3. Are you in close contact with someone who is sick with respiratory symptoms?\",\"name\":\"are_you_in_close_contact_with_someone_who_is_sick_with_respiratory_symptom\",\"value\":\"\",\"width\":\"100%\"}},{\"id\":\"h3lpk6ktsn7jfmu836uz7\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":6,\"label\":\"A. Who?\",\"name\":\"who_you_in_close_contact_with_someone_who_is_sick_with_respiratory_symptom\",\"placeholder\":\"\",\"type\":\"text\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"qm7voz0zuacouux0lmj2go\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":7,\"label\":\"Date symptoms began\",\"name\":\"date_symptoms_began_you_in_close_contact_with_someone_who_is_sick_with_respiratory_symptom\",\"placeholder\":\"\",\"type\":\"date\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"fe12gxtnb1g6osmtuf08c3\",\"componentType\":\"radio\",\"component\":{\"componentType\":\"radio\",\"helper\":\"\",\"plugins\":[],\"radioButtons\":[{\"index\":1,\"text\":\"Yes\",\"value\":\"Yes\"},{\"index\":2,\"text\":\"No\",\"value\":\"No\"}],\"attr\":[{\"name\":\"class\",\"value\":\"fstfdt6tsrt\"}],\"clazz\":\"fstfdt6tsrt\",\"index\":8,\"inline\":\"true\",\"label\":\"4. Screening for respiratory: Do you feel any of the following symptoms\",\"name\":\"screening_for_respiratory_do_you_feel_any_of_the_following_symptoms\",\"value\":\"\",\"width\":\"100%\"}},{\"id\":\"150xa1z312ks4ml45vzso\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":8,\"label\":\"A. Fever?\",\"name\":\"screening_for_respiratory_do_you_feel_fever\",\"placeholder\":\"\",\"type\":\"text\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"4ktkealjvxtw26si52u61\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":9,\"label\":\"Date symptom began\",\"name\":\"screening_for_respiratory_do_you_feel_fever_date_symptom_began\",\"placeholder\":\"\",\"type\":\"date\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"cs273yof65pgvwklgv8rcf\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":10,\"label\":\"B. Cough?\",\"name\":\"screening_for_respiratory_do_you_feel_cough\",\"placeholder\":\"\",\"type\":\"text\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"95ecd1utxpkm7qohgjc7j\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":11,\"label\":\"Date symptom began\",\"name\":\"screening_for_respiratory_do_you_feel_cough_date_symptom_began\",\"placeholder\":\"\",\"type\":\"date\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"05vczl9t1d0qc7070zya8at\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":12,\"label\":\"C. Difficulty breathing?\",\"name\":\"screening_for_respiratory_do_you_feel_difficulty_breathing\",\"placeholder\":\"\",\"type\":\"text\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"ttqxl4armkj1fc34dq2c09\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":13,\"label\":\"Date symptom began\",\"name\":\"screening_for_respiratory_do_you_feel_difficulty_breathing_date_symptom_began\",\"placeholder\":\"\",\"type\":\"date\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"yzcbck7qcu76m2x3chb43a\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":14,\"label\":\"D. Muscle aches?\",\"name\":\"screening_for_respiratory_do_you_feel_muscle_aches\",\"placeholder\":\"\",\"type\":\"text\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"k8acj1cqzyp8xjjj4du65d\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":15,\"label\":\"Date symptom began\",\"name\":\"screening_for_respiratory_do_you_feel_muscle_aches_date_symptom_began\",\"placeholder\":\"\",\"type\":\"date\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"19gwo3sc8ok6y3pij7l24\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":16,\"label\":\"E. Fatigue?\",\"name\":\"screening_for_respiratory_do_you_feel_fatigue\",\"placeholder\":\"\",\"type\":\"text\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"bs6ht8gk4e5mxbyh0ue5f\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":17,\"label\":\"Date symptom began\",\"name\":\"screening_for_respiratory_do_you_feel_fatigue_date_symptom_began\",\"placeholder\":\"\",\"type\":\"date\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"jwql52u496or5hf8ls3fi\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":18,\"label\":\"F. Headaches?\",\"name\":\"screening_for_respiratory_do_you_feel_headaches\",\"placeholder\":\"\",\"type\":\"text\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"f4fzcgcqryasty9g9muy5e\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":19,\"label\":\"Date symptom began\",\"name\":\"screening_for_respiratory_do_you_headaches_date_symptom_began\",\"placeholder\":\"\",\"type\":\"date\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"prwdj0x2pc0zvgjxqp4vlb\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":20,\"label\":\"G. Sore throat?\",\"name\":\"screening_for_respiratory_do_you_feel_sore_throat\",\"placeholder\":\"\",\"type\":\"text\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"clj2nxe56qj0z7t3m1vpq4\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":21,\"label\":\"Date symptom began\",\"name\":\"screening_for_respiratory_do_you_sore_throat_symptom_began\",\"placeholder\":\"\",\"type\":\"date\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"6ex4smf24ahlksrx0c0iw\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":22,\"label\":\"H. Runny nose?\",\"name\":\"screening_for_respiratory_do_you_feel_runny_nose\",\"placeholder\":\"\",\"type\":\"text\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"snbqnlc1mejjuhyucn12nn\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":23,\"label\":\"Date symptom began\",\"name\":\"screening_for_respiratory_do_you_runny_nose_symptom_began\",\"placeholder\":\"\",\"type\":\"date\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"yw2kzlsef4rg4cdyzobr\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":24,\"label\":\"I. Diarrhea?\",\"name\":\"screening_for_respiratory_do_you_feel_diarrhea\",\"placeholder\":\"\",\"type\":\"text\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"11sg034vm17ddbeoda7ofep\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":25,\"label\":\"Date symptom began\",\"name\":\"screening_for_respiratory_do_you_diarrhea_symptom_began\",\"placeholder\":\"\",\"type\":\"date\",\"value\":\"\",\"width\":\"50%\"}},{\"id\":\"36ghucarpud6d65gvhaknb\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":26,\"label\":\"Employee Screening Patient Name\",\"name\":\"employee_screening_patient_name\",\"placeholder\":\"\",\"type\":\"text\",\"value\":\"\",\"width\":\"100%\"}},{\"id\":\"ffc9f4rudm4hfx6q3dtnq6\",\"componentType\":\"input\",\"component\":{\"componentType\":\"input\",\"helper\":\"\",\"icon\":\"\",\"iconPosition\":\"before\",\"plugins\":[],\"attr\":[],\"clazz\":\"\",\"index\":27,\"label\":\"Employee Screening Patient Title\",\"name\":\"employee_screening_patient_title\",\"placeholder\":\"\",\"type\":\"text\",\"value\":\"\",\"width\":\"100%\"}},{\"id\":\"user-form-settings\",\"componentType\":\"form\",\"component\":{\"ajax\":\"false\",\"attr\":\"novalidate\",\"framework\":\"bs4\",\"iconFont\":\"fontawesome5\",\"iconFontUrl\":\"//cdnjs.cloudflare.com/ajax/libs/font-awesome/5.3.1/css/all.min.css\",\"id\":\"fg-form\",\"layout\":\"horizontal\",\"plugins\":[],\"aftervalidation\":\"\",\"redirectUrl\":\"\",\"senderEmail\":\"\",\"recipientEmail\":\"\",\"subject\":\"\",\"senderName\":\"\",\"replyToEmail\":\"\",\"sentMessage\":\"\",\"dbTable\":\"\",\"dbPrimary\":\"\",\"dbFilter\":\"\"}}],\"uiForm\":{\"attr\":\"novalidate\",\"id\":\"fg-form\",\"layout\":\"horizontal\"},\"userForm\":{\"ajax\":\"false\",\"attr\":\"novalidate\",\"framework\":\"bs4\",\"iconFont\":\"fontawesome5\",\"iconFontUrl\":\"//cdnjs.cloudflare.com/ajax/libs/font-awesome/5.3.1/css/all.min.css\",\"id\":\"fg-form\",\"layout\":\"horizontal\",\"plugins\":[],\"aftervalidation\":\"\",\"redirectUrl\":\"\",\"senderEmail\":\"\",\"recipientEmail\":\"\",\"subject\":\"\",\"senderName\":\"\",\"replyToEmail\":\"\",\"sentMessage\":\"\",\"dbTable\":\"\",\"dbPrimary\":\"\",\"dbFilter\":\"\"}}');


INSERT INTO `form_template_mapping` (`id`, `form_name`, `template_id`) VALUES (NULL, 'covid_19_screening', '73');

ALTER TABLE `patient_report` ADD `covid19screening` TEXT NOT NULL AFTER `hhc_poc_record`;