romelloskuggs-8.x-1.1/config/install/webform.webform.template_medical_appointment.yml
config/install/webform.webform.template_medical_appointment.yml
uuid: a878bf35-8561-45d3-ab7c-fd80a069ea1d
langcode: en
status: closed
dependencies:
enforced:
module:
- webform_templates
_core:
default_config_hash: x9os7ywN36tnJBHE0V7aVK84BZ_53qT86DmpkCB00Uw
open: null
close: null
weight: 0
uid: null
template: true
archive: false
id: template_medical_appointment
title: 'Request a Medical Appointment'
description: 'A medical appointment request webform template.'
category: ''
elements: "introduction:\n '#markup': 'After you submit the form, a care specialist will call you back within XX hours to schedule an appointment.'\nh2:\n '#type': webform_horizontal_rule\ncall:\n '#markup': 'You may also speak with a care specialist directly by calling <a href=\"tel:XXX-XXX-XXXX\">XXX-XXX-XXXX</a> on Monday–Friday between 8:30 am to 5:00 pm EST.'\ngeneral:\n '#type': fieldset\n '#title': 'General Information'\n '#title_display': invisible\n '#attributes':\n style: 'background-color: #efefef'\n type:\n '#type': radios\n '#title': 'Who are you?'\n '#options':\n Patient: Patient\n Caregiver: Caregiver\n '#options_display': buttons\n '#required': true\n relationship:\n '#type': webform_select_other\n '#title': 'What is your relationship to the patient?'\n '#options': relationship\n '#states':\n visible:\n ':input[name=\"type\"]':\n value: Caregiver\n required:\n ':input[name=\"type\"]':\n value: Caregiver\ncaregiver:\n '#type': fieldset\n '#title': 'Your Information'\n '#states':\n visible:\n ':input[name=\"type\"]':\n value: Caregiver\n caregiver_name:\n '#type': webform_flexbox\n caregiver_first_name:\n '#title': 'Your First Name'\n '#type': textfield\n '#states':\n required:\n ':input[name=\"type\"]':\n value: Caregiver\n caregiver_last_name:\n '#title': 'Your Last Name'\n '#type': textfield\n '#states':\n required:\n ':input[name=\"type\"]':\n value: Caregiver\n '#title': 'Your Name'\n caregiver_contact:\n '#type': webform_flexbox\n caregiver_email:\n '#title': 'Your Email'\n '#type': email\n '#states':\n required:\n ':input[name=\"type\"]':\n value: Caregiver\n caregiver_phone:\n '#title': 'Your Phone'\n '#type': tel\n '#placeholder': 000-000-0000\n '#states':\n required:\n ':input[name=\"type\"]':\n value: Caregiver\n caregiver_phone_preferences:\n '#type': webform_custom_composite\n '#title': 'Your Phone Preferences'\n '#description': |\n Please select the best days and times for us to call you.<br/>\n <em>Leave blank if you have no preferences.</em>\n '#description_display': 'before'\n '#multiple__min_items': '3'\n '#multiple__sorting': false\n '#multiple__operations': false\n '#multiple__add_more': false\n '#element':\n day:\n '#type': select\n '#options':\n Monday: Monday\n Tuesday: Tuesday\n Wednesday: Wednesday\n Thursday: Thursday\n Friday: Fridate\n '#title': 'Day of the Week'\n '#empty_option': 'Any day of the week'\n time:\n '#type': select\n '#options':\n '8am-10am EST': '8am-10am EST'\n '10am-12pm EST': '10am-12pm EST'\n '12pm-2pm EST': '12pm-2pm EST'\n '2pm-4pm EST': '2pm-4pm EST'\n '#title': 'Time of Day'\n '#empty_option': 'Any time of the day'\npatient:\n '#type': fieldset\n '#title': 'Patient Information'\n patient_name:\n '#type': webform_flexbox\n patient_first_name:\n '#title': 'Patient First Name'\n '#type': textfield\n '#required': true\n patient_last_name:\n '#title': 'Patient Last Name'\n '#type': textfield\n '#required': true\n patient_contact:\n '#type': webform_flexbox\n patient_email:\n '#title': 'Patient Email'\n '#type': email\n '#states':\n required:\n ':input[name=\"type\"]':\n '!value': Caregiver\n patient_phone:\n '#title': 'Patient Phone'\n '#type': tel\n '#required': true\n '#placeholder': 000-000-0000\n '#states':\n required:\n ':input[name=\"type\"]':\n '!value': Caregiver\n patient_phone_preferences:\n '#type': webform_custom_composite\n '#title': 'Patient Phone Preferences'\n '#description': |\n Please select the best days and times for us to call the patient.<br/>\n <em>Leave blank if the patient has no preferences.</em>'\n '#description_display': 'before'\n '#multiple__min_items': '3'\n '#multiple__sorting': false\n '#multiple__operations': false\n '#multiple__add_more': false\n '#element':\n day:\n '#type': select\n '#options':\n Monday: Monday\n Tuesday: Tuesday\n Wednesday: Wednesday\n Thursday: Thursday\n Friday: Fridate\n '#title': 'Day of the Week'\n '#empty_option': 'Any day of the week'\n time:\n '#type': select\n '#options':\n '8am-10am EST': '8am-10am EST'\n '10am-12pm EST': '10am-12pm EST'\n '12pm-2pm EST': '12pm-2pm EST'\n '2pm-4pm EST': '2pm-4pm EST'\n '#title': 'Time of Day'\n '#empty_option': 'Any time of the day'\nappointment:\n '#type': fieldset\n '#title': 'Appointment Information (optional)'\n medical:\n '#type': textarea\n '#title': 'Please provide information about your medical needs'\n '#rows': 3\n insurance:\n '#type': textfield\n '#title': 'Please provide insurance plan name information'''\n referral:\n '#type': checkbox\n '#title': 'Have you been referred by a physician?'\n physician:\n '#type': textarea\n '#title': 'Please provide information about the referring physician'\n '#rows': 3\n '#states':\n visible:\n ':input[name=\"referral\"]':\n checked: true\nactions:\n '#type': webform_actions\n '#title': 'Submit button(s)'\n '#submit__label': 'Send Request'\n"
css: ''
javascript: ''
settings:
ajax: false
ajax_scroll_top: form
ajax_progress_type: ''
ajax_effect: ''
ajax_speed: null
page: true
page_submit_path: ''
page_confirm_path: ''
page_admin_theme: false
form_title: source_entity_webform
form_submit_once: false
form_exception_message: ''
form_open_message: ''
form_close_message: ''
form_previous_submissions: true
form_confidential: false
form_confidential_message: ''
form_remote_addr: true
form_convert_anonymous: false
form_prepopulate: false
form_prepopulate_source_entity: false
form_prepopulate_source_entity_required: false
form_prepopulate_source_entity_type: ''
form_reset: false
form_disable_autocomplete: false
form_novalidate: false
form_disable_inline_errors: false
form_required: true
form_unsaved: true
form_disable_back: false
form_submit_back: false
form_autofocus: false
form_details_toggle: false
form_access_denied: default
form_access_denied_title: ''
form_access_denied_message: ''
form_access_denied_attributes: { }
form_file_limit: ''
submission_label: ''
submission_log: false
submission_views: { }
submission_views_replace: { }
submission_user_columns: { }
submission_user_duplicate: false
submission_access_denied: default
submission_access_denied_title: ''
submission_access_denied_message: ''
submission_access_denied_attributes: { }
submission_exception_message: ''
submission_locked_message: ''
submission_excluded_elements: { }
submission_exclude_empty: false
submission_exclude_empty_checkbox: false
previous_submission_message: ''
previous_submissions_message: ''
autofill: false
autofill_message: ''
autofill_excluded_elements: { }
wizard_progress_bar: true
wizard_progress_pages: false
wizard_progress_percentage: false
wizard_progress_link: false
wizard_start_label: ''
wizard_preview_link: false
wizard_confirmation: true
wizard_confirmation_label: ''
wizard_track: ''
preview: 0
preview_label: ''
preview_title: ''
preview_message: ''
preview_attributes: { }
preview_excluded_elements: { }
preview_exclude_empty: true
preview_exclude_empty_checkbox: false
draft: none
draft_multiple: false
draft_auto_save: false
draft_saved_message: ''
draft_loaded_message: ''
draft_pending_single_message: ''
draft_pending_multiple_message: ''
confirmation_type: page
confirmation_title: 'Thank You'
confirmation_message: 'Your request has been sent. A care specialist will call you back within XX hours to schedule an appointment.'
confirmation_url: '<front>'
confirmation_attributes: { }
confirmation_back: false
confirmation_back_label: ''
confirmation_back_attributes: { }
confirmation_exclude_query: false
confirmation_exclude_token: false
confirmation_update: false
limit_total: null
limit_total_interval: null
limit_total_message: ''
limit_total_unique: false
limit_user: null
limit_user_interval: null
limit_user_message: ''
limit_user_unique: false
entity_limit_total: null
entity_limit_total_interval: null
entity_limit_user: null
entity_limit_user_interval: null
purge: none
purge_days: null
results_disabled: false
results_disabled_ignore: false
token_update: false
access:
create:
roles:
- anonymous
- authenticated
users: { }
permissions: { }
view_any:
roles: { }
users: { }
permissions: { }
update_any:
roles: { }
users: { }
permissions: { }
delete_any:
roles: { }
users: { }
permissions: { }
purge_any:
roles: { }
users: { }
permissions: { }
view_own:
roles: { }
users: { }
permissions: { }
update_own:
roles: { }
users: { }
permissions: { }
delete_own:
roles: { }
users: { }
permissions: { }
administer:
roles: { }
users: { }
permissions: { }
test:
roles: { }
users: { }
permissions: { }
configuration:
roles: { }
users: { }
permissions: { }
handlers:
email_notification:
id: email
label: 'Email notification'
handler_id: email_notification
status: true
conditions: { }
weight: 0
settings:
states:
- completed
to_mail: _default
to_options: { }
cc_mail: ''
cc_options: { }
bcc_mail: ''
bcc_options: { }
from_mail: '[webform_submission:values:email:raw]'
from_options: { }
from_name: '[webform_submission:values:name:raw]'
subject: '[webform_submission:values:subject:raw]'
body: '[webform_submission:values:message:value]'
excluded_elements: { }
ignore_access: false
exclude_empty: true
exclude_empty_checkbox: false
html: true
attachments: false
twig: false
theme_name: ''
debug: false
reply_to: ''
return_path: ''
sender_mail: ''
sender_name: ''
