Injury details and design changes
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sonika
parent
d172573539
commit
6cfc963130
@ -7,6 +7,7 @@
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.collapsable-form-style .MuiInputBase-root {
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width: 300px !important;
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margin: 5%;
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height: 50px
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}
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.collapsable-form-style label {
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@ -164,7 +164,7 @@ export default function MedicalHistoryForm(){
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</FormControl>
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</Grid>
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<Grid item xs={12} sx={{paddingLeft:"14px",marginTop:2}} className='collapsable-form-style-radioButtons-fullwidth'>
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<Grid item xs={12} className='collapsable-form-style-radioButtons-fullwidth'>
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<FormControl>
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<FormLabel>Who can we thank for referring you to our office:</FormLabel>
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<RadioGroup
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@ -4,26 +4,32 @@ import { useFormik } from 'formik';
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import * as Yup from 'yup';
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interface FormValues {
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chiefComplaint:string;
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painQuality: string[];
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painDuration: string;
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currentTreatment: string;
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treatmentResults: string;
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treatmentGoal: string;
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}
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const validationSchema = Yup.object({
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chiefComplaint:Yup.array().required('Required'),
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painQuality: Yup.array().required('Required'),
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painDuration: Yup.string().required('Required'),
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currentTreatment: Yup.string().required('Required'),
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treatmentResults: Yup.string().required('Required'),
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treatmentGoal: Yup.string().required('Required'),
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});
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export default function PainAnalysisSection4(){
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const formik = useFormik<FormValues>({
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initialValues:{
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chiefComplaint:'',
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painQuality:[],
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painDuration:'',
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currentTreatment:'',
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treatmentResults:''
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treatmentResults:'',
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treatmentGoal:'',
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},
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validationSchema,
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onSubmit:(values)=>{
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@ -41,26 +47,44 @@ export default function PainAnalysisSection4(){
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return(
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<>
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<form onSubmit={formik.handleSubmit}>
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<Grid item xs={12} className='collapsable-form-style '>
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<FormLabel sx={{fontWeight:600}}>Issue Details:</FormLabel>
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</Grid>
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<Grid container direction="row">
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<Grid item xs={12}>
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<Grid item xs={4} className='collapsable-form-style'>
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<TextField
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variant="outlined"
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label="How did your Chief complaint start?(ex-fell on ice)"
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name='familyphysician'
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onChange={formik.handleChange}
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value={formik.values.chiefComplaint}
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onBlur={formik.handleBlur}
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/>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style-radioButtons-fullwidth'>
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<FormControl>
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<FormLabel>Pain Quality</FormLabel>
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<FormGroup>
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<FormLabel>What makes your pain worse?</FormLabel>
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<FormGroup sx={{display:'flex', flexDirection:'row'}}>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="sharp" />}
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label="Sharp"
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label="Bending"
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/>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="dull" />}
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label="Dull"
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label="Standing"
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/>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="burning" />}
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label="Burning"
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label="Sitting"
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/>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="aching" />}
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label="Aching"
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label="Walking"
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/>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="aching" />}
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label="Others"
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/>
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</FormGroup>
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{formik.touched.painQuality && formik.errors.painQuality ? (
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@ -68,25 +92,181 @@ export default function PainAnalysisSection4(){
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) : null}
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</FormControl>
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</Grid>
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<Grid item xs={12}>
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<Grid item xs={12} className='collapsable-form-style-radioButtons-fullwidth'>
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<FormControl>
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<FormLabel>Pain Duration</FormLabel>
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<FormLabel>What makes your pain better?</FormLabel>
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<FormGroup sx={{display:'flex', flexDirection:'row'}}>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="sharp" />}
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label="laying down"
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/>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="dull" />}
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label="Standing"
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/>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="burning" />}
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label="Sitting"
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/>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="aching" />}
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label="Walking"
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/>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="aching" />}
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label="Others"
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/>
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</FormGroup>
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{formik.touched.painQuality && formik.errors.painQuality ? (
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<div>{formik.errors.painQuality}</div>
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) : null}
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</FormControl>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style-radioButtons-fullwidth'>
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<FormControl>
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<FormLabel>What is the quality of your pain?</FormLabel>
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<FormGroup sx={{display:'flex', flexDirection:'row'}}>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="sharp" />}
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label="Sharp"
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/>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="dull" />}
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label="Dull/Ache"
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/>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="burning" />}
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label="Throbbing"
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/>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="aching" />}
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label="Tingling/Numbness/Burning"
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/>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="aching" />}
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label="Others"
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/>
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</FormGroup>
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{formik.touched.painQuality && formik.errors.painQuality ? (
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<div>{formik.errors.painQuality}</div>
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) : null}
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</FormControl>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style-radioButtons-fullwidth'>
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<FormControl>
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<FormLabel>What is the worst time for your pain?</FormLabel>
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<FormGroup sx={{display:'flex', flexDirection:'row'}}>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="sharp" />}
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label="Morning"
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/>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="dull" />}
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label="During day"
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/>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="burning" />}
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label="Evening"
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/>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="aching" />}
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label="Lying in bed"
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/>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="aching" />}
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label="Others"
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/>
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</FormGroup>
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{formik.touched.painQuality && formik.errors.painQuality ? (
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<div>{formik.errors.painQuality}</div>
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) : null}
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</FormControl>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style-radioButtons-fullwidth'>
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<FormControl>
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<FormLabel>How much of the day do you experience your chief complaint?</FormLabel>
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<RadioGroup
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name="painDuration"
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onChange={formik.handleChange}
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value={formik.values.painDuration}
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sx={{display:'flex', flexDirection:'row'}}
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>
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<FormControlLabel value="<1 week" control={<Radio />} label="<1 week" />
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<FormControlLabel value="1-4 weeks" control={<Radio />} label="1-4 weeks" />
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<FormControlLabel value="1-6 months" control={<Radio />} label="1-6 months" />
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<FormControlLabel value=">6 months" control={<Radio />} label=">6 months" />
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<FormControlLabel value="0-25%" control={<Radio />} label="0-25%" />
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<FormControlLabel value="25-50%" control={<Radio />} label="25-50%" />
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<FormControlLabel value="50-75%" control={<Radio />} label="50-75%" />
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<FormControlLabel value="75-100%" control={<Radio />} label="75-100%" />
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</RadioGroup>
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{formik.touched.painDuration && formik.errors.painDuration ? (
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<div>{formik.errors.painDuration}</div>
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) : null}
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</FormControl>
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</Grid>
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<Grid item xs={12}>
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<Grid item xs={12} className='collapsable-form-style-radioButtons-fullwidth'>
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<FormControl>
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<FormLabel>Has your current complaint caused any of the following?</FormLabel>
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<FormGroup sx={{display:'flex', flexDirection:'row'}}>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="sharp" />}
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label="Muscle weakness"
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/>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="dull" />}
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label="Bowel/Bladder problem"
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/>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="burning" />}
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label="Digestion"
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/>
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<FormControlLabel
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control={<Checkbox onChange={handlePainQualityChange} name="aching" />}
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label="Cardiac/Respiratory"
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/>
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</FormGroup>
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{formik.touched.painQuality && formik.errors.painQuality ? (
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<div>{formik.errors.painQuality}</div>
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) : null}
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</FormControl>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style-radioButtons-fullwidth'>
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<FormControl>
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<FormLabel>Have you tried any self treatment (ex-ice, heat, excercise) or taken any medication(over the counter or prescription)?</FormLabel>
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<RadioGroup
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name="painDuration"
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onChange={formik.handleChange}
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value={formik.values.painDuration}
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sx={{display:'flex', flexDirection:'row'}}
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>
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<FormControlLabel value="yes" control={<Radio />} label="Yes" />
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<FormControlLabel value="no" control={<Radio />} label="No" />
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</RadioGroup>
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{formik.touched.painDuration && formik.errors.painDuration ? (
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<div>{formik.errors.painDuration}</div>
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) : null}
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</FormControl>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style' sx={{marginTop:3 }}>
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<FormLabel sx={{fontWeight:600}}>Expected Treatment Result:</FormLabel>
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</Grid>
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<Grid item xs={4} className='collapsable-form-style'>
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<TextField
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variant="outlined"
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label="What is your goal from treatment?(ex-play golf without pain)"
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name='familyphysician'
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onChange={formik.handleChange}
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value={formik.values.chiefComplaint}
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onBlur={formik.handleBlur}
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/>
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</Grid>
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{/* <Grid item xs={12}>
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<TextField
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label="Current Treatment"
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name='currentTreatment'
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@ -109,7 +289,7 @@ export default function PainAnalysisSection4(){
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{formik.touched.treatmentResults && formik.errors.treatmentResults ? (
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<div>{formik.errors.treatmentResults}</div>
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) : null}
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</Grid>
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</Grid> */}
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</Grid>
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</form>
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