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/31/?format=api",
    "is_deleted": false,
    "deleted_at": null,
    "name": "Microsuction Clinician Forms",
    "title": "Microsuction Clinician Forms",
    "description": "Microsuction Clinican form for in appointment",
    "version": 1,
    "subversion": 1,
    "formDefinition": [
        {
            "id": "checkbox-group-5fc5e7f2-7365-44e2-ab10-b161f123ed06",
            "name": "microsuction_ear_treated",
            "type": "checkbox-group",
            "label": "Ear Treated",
            "other": false,
            "access": false,
            "inline": false,
            "toggle": false,
            "values": [
                {
                    "label": "Left",
                    "value": "option-1",
                    "selected": false
                },
                {
                    "label": "Right",
                    "value": "option-2",
                    "selected": false
                }
            ],
            "required": true
        },
        {
            "id": "text-db6804fb-3de9-4d27-8c13-a1f27702e317",
            "name": "microsuction_findings_description_left_ear",
            "type": "text",
            "label": "Microsuction Description of findings Left Ear",
            "access": false,
            "subtype": "text",
            "required": false
        },
        {
            "id": "text-53035e52-b13d-4fcf-ba7b-7319fdf365cb",
            "name": "microsuction_findings_description_right_ear",
            "type": "text",
            "label": "Microsuction Description of findings Right Ear",
            "access": false,
            "subtype": "text",
            "required": false
        },
        {
            "id": "checkbox-group-96000649-eb7f-41a2-8db0-1b2eed41746a",
            "name": "microsuction_performed",
            "type": "checkbox-group",
            "label": "Microsuction Performed?",
            "other": false,
            "access": false,
            "inline": false,
            "toggle": false,
            "values": [
                {
                    "label": "Yes - Left",
                    "value": "option-1",
                    "selected": false
                },
                {
                    "label": "No - Left",
                    "value": "option-2",
                    "selected": false
                },
                {
                    "label": "Yes - right",
                    "value": "option-3",
                    "selected": false
                },
                {
                    "label": "No - right",
                    "value": "option-4",
                    "selected": false
                }
            ],
            "required": true
        },
        {
            "id": "text-a7d2363c-779a-40a3-8552-527af672aff6",
            "name": "microsuction_performed_general_comments",
            "type": "text",
            "label": "General Comments ",
            "access": false,
            "subtype": "text",
            "required": false
        },
        {
            "id": "checkbox-group-67b41d7a-eedc-4b46-b159-5118d400fece",
            "name": "irrigation_performed",
            "type": "checkbox-group",
            "label": "Irrigation Performed?",
            "other": false,
            "access": false,
            "inline": false,
            "toggle": false,
            "values": [
                {
                    "label": "Yes - Left",
                    "value": "option-1",
                    "selected": false
                },
                {
                    "label": "No - Left",
                    "value": "option-2",
                    "selected": false
                },
                {
                    "label": "Yes - right",
                    "value": "option-3",
                    "selected": false
                },
                {
                    "label": "No - right",
                    "value": "option-4",
                    "selected": false
                }
            ],
            "required": true
        },
        {
            "id": "text-076fc700-e374-4e43-a663-882e601112ea",
            "name": "irrigation_performed_general_comments",
            "type": "text",
            "label": "General Comments ",
            "access": false,
            "subtype": "text",
            "required": false
        },
        {
            "id": "checkbox-group-028faa51-3f68-4780-ae74-fe48572b1f6c",
            "name": "microsuction_treatment_during_procedure",
            "type": "checkbox-group",
            "label": "Treatment During Procedure? ",
            "other": false,
            "access": false,
            "inline": false,
            "toggle": false,
            "values": [
                {
                    "label": "Olive Oil - Left",
                    "value": "option-1",
                    "selected": false
                },
                {
                    "label": "Na+Bicarb - Left",
                    "value": "option-2",
                    "selected": false
                },
                {
                    "label": "Olive Oil- right",
                    "value": "option-3",
                    "selected": false
                },
                {
                    "label": "Na+Bicarb - right",
                    "value": "option-4",
                    "selected": false
                }
            ],
            "required": true
        },
        {
            "id": "text-a9c44b66-f515-4cea-9829-3182dfa32ab1",
            "name": "microsuction_treatment_in_procedure_general_comments",
            "type": "text",
            "label": "General Comments ",
            "access": false,
            "subtype": "text",
            "required": false
        },
        {
            "id": "checkbox-group-62e7890a-7520-426a-b7d3-15e767dc05de",
            "name": "microsuction_wax_removed",
            "type": "checkbox-group",
            "label": "Wax Removed?",
            "other": false,
            "access": false,
            "inline": false,
            "toggle": false,
            "values": [
                {
                    "label": "Yes - Left",
                    "value": "option-1",
                    "selected": false
                },
                {
                    "label": "No - Left",
                    "value": "option-2",
                    "selected": false
                },
                {
                    "label": "Yes - right",
                    "value": "option-3",
                    "selected": false
                },
                {
                    "label": "No - right",
                    "value": "option-4",
                    "selected": false
                }
            ],
            "required": true
        },
        {
            "id": "text-c1e384da-8bb9-4b72-8bb2-116f5c051551",
            "name": "microsuction_wax_removed_general_comments",
            "type": "text",
            "label": "General Comments ",
            "access": false,
            "subtype": "text",
            "required": false
        },
        {
            "id": "checkbox-group-3474862d-c546-49fb-868c-0c1be9f30c59",
            "name": "microsuction_further_treatment_required",
            "type": "checkbox-group",
            "label": "Does the patient have to return for further treatment? ",
            "other": false,
            "access": false,
            "inline": false,
            "toggle": false,
            "values": [
                {
                    "label": "Yes - Left",
                    "value": "option-1",
                    "selected": false
                },
                {
                    "label": "No - Left",
                    "value": "option-2",
                    "selected": false
                },
                {
                    "label": "Yes - right",
                    "value": "option-3",
                    "selected": false
                },
                {
                    "label": "No - right",
                    "value": "option-4",
                    "selected": false
                }
            ],
            "required": true
        },
        {
            "id": "text-4820da85-4694-4748-8278-cdb42932b423",
            "name": "microsuction_further_treatment_general_comments",
            "type": "text",
            "label": "General Comments ",
            "access": false,
            "subtype": "text",
            "required": false
        },
        {
            "id": "checkbox-group-a1514e7c-5153-4671-a7a1-fc871b91dff4",
            "name": "microsuction_trauma_caused",
            "type": "checkbox-group",
            "label": "Trauma Caused",
            "other": false,
            "access": false,
            "inline": false,
            "toggle": false,
            "values": [
                {
                    "label": "Yes - Left",
                    "value": "option-1",
                    "selected": false
                },
                {
                    "label": "No - Left",
                    "value": "option-2",
                    "selected": false
                },
                {
                    "label": "Yes - right",
                    "value": "option-3",
                    "selected": false
                },
                {
                    "label": "No - right",
                    "value": "option-4",
                    "selected": false
                }
            ],
            "required": true
        },
        {
            "id": "text-b2c60e43-d7fb-4ab3-bdd0-403e1edbf90e",
            "name": "microsuction_trauma_caused_general_comments",
            "type": "text",
            "label": "General Comments ",
            "access": false,
            "subtype": "text",
            "required": false
        },
        {
            "id": "checkbox-group-264f5b68-c957-4a5d-bd78-8a1549c01e39",
            "name": "microsuction_ear_calm_applied",
            "type": "checkbox-group",
            "label": "Ear Calm Applied? ",
            "other": false,
            "access": false,
            "inline": false,
            "toggle": false,
            "values": [
                {
                    "label": "Yes - Left",
                    "value": "option-1",
                    "selected": false
                },
                {
                    "label": "No - Left",
                    "value": "option-2",
                    "selected": false
                },
                {
                    "label": "Yes - right",
                    "value": "option-3",
                    "selected": false
                },
                {
                    "label": "No - right",
                    "value": "option-4",
                    "selected": false
                }
            ],
            "required": true
        },
        {
            "id": "text-8d392892-eb2a-452c-981a-54cc068823af",
            "name": "microsuction_ear_calm_applied_general_comments",
            "type": "text",
            "label": "General Comments ",
            "access": false,
            "subtype": "text",
            "required": false
        },
        {
            "id": "checkbox-group-38455218-84ed-472f-a924-22686f6202d6",
            "name": "microsuction_gp_referral",
            "type": "checkbox-group",
            "label": "Referral to GP required? ",
            "other": false,
            "access": false,
            "inline": false,
            "toggle": false,
            "values": [
                {
                    "label": "Yes",
                    "value": "option-1",
                    "selected": false
                },
                {
                    "label": "No",
                    "value": "option-2",
                    "selected": false
                }
            ],
            "required": true
        },
        {
            "id": "text-e32201ca-4760-4e95-a4cd-30fabb4500fd",
            "name": "microsuction_gp_referral_general_comments",
            "type": "text",
            "label": "General Comments ",
            "access": false,
            "subtype": "text",
            "required": false
        },
        {
            "id": "checkbox-group-f64b1d0c-584f-4d04-aef7-cefb8b714a31",
            "name": "microsuction_hearing_test_referral",
            "type": "checkbox-group",
            "label": "Referral for hearing test? ",
            "other": false,
            "access": false,
            "inline": false,
            "toggle": false,
            "values": [
                {
                    "label": "Yes",
                    "value": "option-1",
                    "selected": false
                },
                {
                    "label": "No",
                    "value": "option-2",
                    "selected": false
                }
            ],
            "required": true
        },
        {
            "id": "text-12342b02-7712-492a-99cf-cf2ae485e199",
            "name": "microsuction_clinician_name",
            "type": "text",
            "label": "Clinician Name",
            "access": false,
            "subtype": "text",
            "required": true
        },
        {
            "id": "date-36ef94f9-40bc-46f3-81dc-5ae20f821e29",
            "name": "treatment_date",
            "type": "date",
            "label": "Treatment Date",
            "access": false,
            "required": true
        },
        {
            "id": "checkbox-group-a236e436-99d6-46d4-a853-340fb8cb402a",
            "name": "microsuction_clinician_form_confirmation",
            "type": "checkbox-group",
            "label": "Confirm Data Correct",
            "other": false,
            "access": false,
            "inline": false,
            "toggle": false,
            "values": [
                {
                    "label": "Yes",
                    "value": "option-1",
                    "selected": false
                }
            ],
            "required": true
        },
        {
            "id": "file-f0f8fc6a-688d-4987-90f1-e87001979181",
            "name": "Image_of_ears",
            "type": "file",
            "label": "Image Of Ear ",
            "access": false,
            "subtype": "file",
            "multiple": true,
            "required": false,
            "description": "For clinician to upload image of Ear "
        }
    ],
    "created": "2024-02-14T07:41:50.035559Z",
    "modified": "2024-02-14T07:41:50.035573Z",
    "archived": false,
    "is_vaccination_form": false
}