Eform Instance

HTTP 200 OK
Allow: GET, HEAD, OPTIONS
Content-Type: application/json
Vary: Accept

{
    "url": "https://testing.clinic-frontend.dc.gompels.com/api/public/eforms/28/?format=api",
    "is_deleted": false,
    "deleted_at": null,
    "name": "Flu Vaccination NHS - Patient Info",
    "title": "Flu Vaccination - Patient Info",
    "description": "Details required for NHS/Private Flu Vaccinations",
    "version": 1,
    "subversion": 3,
    "formDefinition": [
        {
            "id": "header-fbfc8f56-d102-4b8c-b7a7-a7952f980219",
            "type": "header",
            "label": "Patient Emergency Contact ",
            "access": false,
            "subtype": "h1"
        },
        {
            "id": "text-f567f754-8868-40f6-9233-a0e0801ce8f0",
            "name": "emergencycontactname",
            "type": "text",
            "label": "Emergency Contact Name",
            "access": false,
            "subtype": "text",
            "required": false,
            "className": "form-control"
        },
        {
            "id": "number-d142e82f-bf3b-43eb-9a24-608758402202",
            "name": "emergencycontactnumber",
            "type": "number",
            "label": "Emergency Contact Number",
            "access": false,
            "required": false,
            "className": "form-control"
        },
        {
            "id": "text-4982572e-3c32-43d5-ad4c-8e60991447b1",
            "name": "emergencycontactrelationship",
            "type": "text",
            "label": "Emergency Contact Relationship to Patient",
            "access": false,
            "subtype": "text",
            "required": false,
            "className": "form-control"
        },
        {
            "id": "textarea-9839fe8d-b493-4135-8e8f-3d753a6365b9",
            "name": "allergies",
            "type": "textarea",
            "label": "Allergies",
            "access": false,
            "subtype": "textarea",
            "required": false,
            "className": "form-control",
            "description": "Please detail any allergies below"
        },
        {
            "id": "radio-group-b8305637-abec-46f4-80b6-2dcedd95e9f8",
            "name": "eligiblegroup",
            "type": "radio-group",
            "label": "Eligible Group",
            "other": false,
            "access": false,
            "inline": false,
            "values": [
                {
                    "label": "65 Years or Over",
                    "value": "option-1",
                    "selected": false
                },
                {
                    "label": "Chronic Heart Disease",
                    "value": "option-2",
                    "selected": false
                },
                {
                    "label": "Chronic Liver Disease",
                    "value": "option-3",
                    "selected": false
                },
                {
                    "label": "Diabetes",
                    "value": "option-4",
                    "selected": false
                },
                {
                    "label": "Asplenia/Splenic dysfunction",
                    "value": "option-5",
                    "selected": false
                },
                {
                    "label": "Person in long-stay residential care home or care facility",
                    "value": "option-6",
                    "selected": false
                },
                {
                    "label": "Household contact of immunocompromised individual",
                    "value": "option-7",
                    "selected": false
                },
                {
                    "label": "Frontline health and Social Care worker",
                    "value": "option-10",
                    "selected": false
                },
                {
                    "label": "Chronic Respiratory Disease",
                    "value": "option-11",
                    "selected": false
                },
                {
                    "label": "Chronic Kidney Disease",
                    "value": "option-12",
                    "selected": false
                },
                {
                    "label": "Chronic Neurological disease",
                    "value": "option-13",
                    "selected": false
                },
                {
                    "label": "Immunosuppression",
                    "value": "option-14",
                    "selected": false
                },
                {
                    "label": "Pregnant Woman",
                    "value": "option-15",
                    "selected": false
                },
                {
                    "label": "Carer",
                    "value": "option-16",
                    "selected": false
                },
                {
                    "label": "Morbid Obesity (BMI ≥ 40) ",
                    "value": "option-17",
                    "selected": false
                },
                {
                    "label": "Learning Disability",
                    "value": "option-18",
                    "selected": false
                },
                {
                    "label": "Employed through Direct Payment of Personal Health Budget",
                    "value": "option-19",
                    "selected": false
                },
                {
                    "label": "Hospice Worker ",
                    "value": "option-20",
                    "selected": false
                },
                {
                    "label": "None",
                    "value": "option-21",
                    "selected": false
                }
            ],
            "required": true
        }
    ],
    "created": "2024-02-14T07:37:25.948470Z",
    "modified": "2024-08-27T16:16:45.331721+01:00",
    "archived": true,
    "is_vaccination_form": false
}