14.3.73. crate_anon/crateweb/consent/templates/contact_request_submit.html

{# crate_anon/crateweb/consent/templates/contact_request_submit.html #}
{% extends "base.html" %}

{% comment %}
    template parameters:
        form: Form
{% endcomment %}

{% block content %}

    <h1>Submit patient contact request</h1>

    <div>Using database: <b>{{ db_description }}</b></div>

    <p>You can submit contact requests for studies for which all of the following are true:</p>
    <ul>
        <li>You are the lead or other designated researcher (or you are the RDBM)</li>
        <li>Title/forename/surname information is available for the lead researcher</li>
        <li>The study has been approved for patient contact</li>
        <li>A patient information leaflet has been uploaded by the RDBM</li>
    </ul>
    <p><b>The RDBM can submit contact requests using NHS numbers or research
        IDs; researchers are restricted to research ID lookup.</b></p>

    <form action="{% url 'submit_contact_request' %}" method="post">
        {% csrf_token %}
        <table class="formtable">
            {{ form }}
        </table>
        <input type="submit" value="Submit" />
    </form>

{% endblock %}

{% block helpurl %}{{ HelpUrl.submit_contact_request }}{% endblock %}