749 lines
30 KiB
Vue
749 lines
30 KiB
Vue
<script setup>
|
|
import StartOverPupup from '@/views/pages/home/StartOverPupup.vue';
|
|
import cardiologyCategory from '@/views/pages/questionere/form-category';
|
|
import formview from '@/views/pages/questionere/form.vue';
|
|
import CustomNav from '../layouts/components/navbar-custom.vue';
|
|
import axios from '@axios';
|
|
import {
|
|
requiredValidator
|
|
} from '@validators';
|
|
import { onBeforeMount, onMounted } from 'vue';
|
|
import { useRoute, useRouter } from 'vue-router';
|
|
import { useStore } from 'vuex';
|
|
import Cart from '../layouts/components/cart.vue';
|
|
const store = useStore()
|
|
const router = useRouter()
|
|
const route = useRoute()
|
|
// const categoryName = 'doctor_intake_request';
|
|
// const currentForm = cardiologyCategory[categoryName.replace(/[\s_]/g, '')]
|
|
const planName = ref(null)
|
|
const planAmount = ref(null)
|
|
const list_one_title = ref(null)
|
|
const list_sub_title = ref(null)
|
|
const list_two_title = ref(null)
|
|
const prescription_required = ref(null)
|
|
const shipping_price = ref(null)
|
|
const categoryName = ref(null);
|
|
const currentForm = ref(null);
|
|
const isMobile = ref(window.innerWidth <= 768); // Assuming mobile width is less than or equal to 768px
|
|
const currentDialoagkey = ref('')
|
|
const isTonalSnackbarVisible = ref(false)
|
|
const patientResponse = ref(false)
|
|
const isLoadingVisible = ref(false)
|
|
const questionForm = ref()
|
|
const answers = ref([]);
|
|
const storeAnswers = ref();
|
|
const isDialogVisible = ref(false)
|
|
const patient_id = localStorage.getItem('patient_id')
|
|
const access_token = store.access_token;
|
|
const seetingPlanLogo = ref(null);
|
|
const redirectTo = '/thankyou'
|
|
const redirectBack = '/review-appointment'
|
|
const patientExist = localStorage.getItem('exist')
|
|
const products = JSON.parse(localStorage.getItem('cart_products'));
|
|
const productCategoryName = ref(null)
|
|
const questions = ref([
|
|
{
|
|
question_key: 'why_interested_hrt',
|
|
question: "What aspects of hormone replacement therapy (HRT) intrigue you?",
|
|
type: "text",
|
|
},
|
|
{
|
|
question_key: 'goal_loss_weight',
|
|
question: "Is your objective with the program to achieve weight loss?",
|
|
type: "radio",
|
|
options: ["Yes", "No"],
|
|
},
|
|
{
|
|
question_key: 'what_biological_sex',
|
|
question: "What is your assigned sex at birth?",
|
|
type: "radio",
|
|
options: ["Male", "Female"],
|
|
},
|
|
{
|
|
question_key: '3_years_physical_test',
|
|
question: "Have you undergone a comprehensive physical examination by a medical professional within the past three years, which included assessments of vital signs such as weight, blood pressure, and heart rate?",
|
|
type: "radio",
|
|
options: ["Yes", "No"],
|
|
},
|
|
{
|
|
question_key: 'medical_problems',
|
|
question: "Did you experience any medical issues? If so, could you please elaborate?",
|
|
type: "radio",
|
|
options: ["Yes", "No"],
|
|
},
|
|
{
|
|
question_key: 'have_prostate_cancer',
|
|
question: "Have you ever received a diagnosis of prostate cancer?",
|
|
type: "radio",
|
|
options: ["Yes", "No"],
|
|
},
|
|
// {
|
|
// question_key: 'what_height',
|
|
// question: "How tall are you?",
|
|
// type: "dropdown",
|
|
// options: ["5 ft 1 in",
|
|
// "5 ft 2 in",
|
|
// "5 ft 3 in",
|
|
// "5 ft 4 in",
|
|
// "5 ft 5 in",
|
|
// "5 ft 6 in",
|
|
// "5 ft 7 in",
|
|
// "5 ft 8 in",
|
|
// ],
|
|
// },
|
|
// {
|
|
// question_key: 'whight',
|
|
// question: "What is your weight?",
|
|
// type: "text",
|
|
// },
|
|
// {
|
|
// question_key: 'birthdate',
|
|
// question: "When were you born?",
|
|
// type: "date",
|
|
// sub_title: 'To proceed with medication, kindly input your accurate date of birth using the format mm/dd/yyyy.'
|
|
// },
|
|
{
|
|
question_key: 'past_harmone_treatments',
|
|
question: "Have you been prescribed any hormone treatments currently or in the past?",
|
|
type: "radio",
|
|
options: ["Thyroid Medication", "Testosterone Treatment", "Estrogen Blocker", "HGH", "Ipamoreline", "Colomipheine", "HCG", "Other", "None"],
|
|
},
|
|
{
|
|
question_key: 'take_medications',
|
|
question: "Are you currently using or have you used any over-the-counter or prescription medications, excluding hormone treatments? (Please note that your responses will be cross-checked against prescription and insurance records. Failure to disclose current prescriptions and/or medical conditions may result in disapproval for your safety.)",
|
|
type: "radio",
|
|
options: ["Yes", "No"],
|
|
},
|
|
{
|
|
question_key: 'have_medications_allegies',
|
|
question: "Do you have any allergies to medications?",
|
|
type: "radio",
|
|
options: ["Yes", "No"],
|
|
},
|
|
{
|
|
question_key: 'plan_children',
|
|
question: "Do you intend to have children at some point in the future?",
|
|
type: "radio",
|
|
options: ["Yes", "No"],
|
|
},
|
|
{
|
|
question_key: 'partner_pregnant',
|
|
question: "Is your partner currently pregnant or breastfeeding?",
|
|
type: "radio",
|
|
options: ["Yes", "No", "Not Applicable"],
|
|
},
|
|
{
|
|
question_key: 'experience_ed',
|
|
question: "Are you currently experiencing any erectile dysfunction (ED) issues?",
|
|
type: "radio",
|
|
options: ["Never", "Almost Never", "Occasionally", "Almost Always", "Always"],
|
|
},
|
|
{
|
|
question_key: 'thyroid_disorders',
|
|
question: "Have you ever been diagnosed with thyroid disorders such as hypothyroidism (underactive thyroid), hyperthyroidism (overactive thyroid), Hashimoto's Disease, or Graves' Disease?",
|
|
type: "radio",
|
|
options: ["Yes", "No"],
|
|
},
|
|
{
|
|
question_key: 'family_history',
|
|
question: "Does your family have a history of any of the following disorders?",
|
|
type: "radio",
|
|
options: ["Drug Alcohol", "Cancer", "Heart Disease", "Thyroid Disease", "Low Testosterone",
|
|
"None"],
|
|
},
|
|
{
|
|
question_key: 'patient_concent',
|
|
question: "Please read and accept",
|
|
linktext: "Patient Content",
|
|
type: "signalCheckbox",
|
|
},
|
|
{
|
|
question_key: 'appointment_cancel',
|
|
question: "Please read and accept",
|
|
linktext: "Appointment Cancel",
|
|
type: "signalCheckbox",
|
|
},
|
|
{
|
|
question_key: 'medicare_disclaimer',
|
|
question: "Please read and accept",
|
|
linktext: "Medicare Disclaimer",
|
|
type: "signalCheckbox",
|
|
},
|
|
{
|
|
question_key: 'telehealth_concent',
|
|
question: "Please read and accept",
|
|
linktext: "Telehealth Concent",
|
|
type: "signalCheckbox",
|
|
},
|
|
{
|
|
question_key: 'secondary_contact',
|
|
question: "Please read and accept",
|
|
linktext: "Secondary Contact Disclosure(optional)",
|
|
type: "signalCheckbox",
|
|
},
|
|
|
|
]);
|
|
onBeforeMount(async () => {
|
|
store.dispatch('updateIsLoading', true)
|
|
store.dispatch('updateCurrentPage', 'additional-information')
|
|
localStorage.setItem('currentPage', 'additional-information')
|
|
await store.dispatch('getPatientInfo')
|
|
await store.dispatch('getPlanInfo')
|
|
// await store.dispatch('getPatientAppointment')
|
|
await store.dispatch('getAdditionalInformation')
|
|
|
|
planName.value = store.getters.getPatientPlan.plan_name
|
|
planAmount.value = store.getters.getPatientPlan.plan_amount
|
|
list_one_title.value = store.getters.getPatientPlan.list_one_title
|
|
list_sub_title.value = store.getters.getPatientPlan.list_sub_title
|
|
list_two_title.value = store.getters.getPatientPlan.list_two_title
|
|
prescription_required.value = store.getters.getPatientPlan.prescription_required
|
|
shipping_price.value = store.getters.getPatientPlan.shipping_price
|
|
|
|
storeAnswers.value = store.getters.getAdditionalInformation.answers
|
|
if (storeAnswers.value) {
|
|
let tempAns = storeAnswers.value
|
|
for (let answer of tempAns) {
|
|
answers.value[answer.question_key] = answer.answer
|
|
}
|
|
}
|
|
|
|
let productsData = products.filter(item => item.title !== "Doctor Visit")
|
|
productsData.forEach(product => {
|
|
if(product.category_name)
|
|
productCategoryName.value = product.category_name.toLowerCase().replace(/\s+|-/g, '_')
|
|
})
|
|
console.log('---->', productCategoryName.value)
|
|
if (productCategoryName.value) {
|
|
categoryName.value = productCategoryName.value
|
|
} else {
|
|
categoryName.value = 'weight_loss';
|
|
}
|
|
currentForm.value = cardiologyCategory[categoryName.value.replace(/[\s_]/g, '')]
|
|
store.dispatch('updateIsLoading', false)
|
|
})
|
|
const validateQuestion = async () => {
|
|
const { valid: isValid } = await questionForm.value?.validate();
|
|
console.log('isValid ', isValid);
|
|
if (isValid)
|
|
saveAnswers()
|
|
};
|
|
|
|
onMounted(async () => {
|
|
window.addEventListener('resize', checkIfMobile);
|
|
let setting = await axios.post('/api/settings', {})
|
|
// console.log(setting.data)
|
|
seetingPlanLogo.value = '/assets/logo/' + setting.data.logo
|
|
})
|
|
// Detach event listener on component unmount
|
|
onUnmounted(() => {
|
|
window.removeEventListener('resize', checkIfMobile);
|
|
|
|
});
|
|
const checkIfMobile = () => {
|
|
isMobile.value = window.innerWidth <= 768;
|
|
};
|
|
|
|
|
|
const saveAnswers = async () => {
|
|
isLoadingVisible.value = true;
|
|
const patient_id = localStorage.getItem('patient_id');
|
|
const jsonData = {
|
|
questions: questions.value.reduce((accumulator, question, index) => {
|
|
const answerValue = answers.value[question.question_key];
|
|
|
|
if (answerValue !== undefined) {
|
|
accumulator.push({
|
|
question_key: question.question_key,
|
|
type: question.type,
|
|
answer: answerValue,
|
|
});
|
|
}
|
|
|
|
return accumulator;
|
|
}, []),
|
|
};
|
|
let qaData = Array({ 'answers': jsonData.questions });
|
|
console.log('answers ', JSON.stringify(qaData));
|
|
|
|
await store.dispatch('saveAdditionalInformation', {
|
|
answers: jsonData.questions,
|
|
})
|
|
router.replace(route.query.to && route.query.to != '/additional-information' ? String(route.query.to) : '/thankyou')
|
|
};
|
|
const getCurrentDate = () => {
|
|
const today = new Date();
|
|
const year = today.getFullYear();
|
|
let month = today.getMonth() + 1;
|
|
let day = today.getDate();
|
|
|
|
// Format the date to match the input type="date" format
|
|
month = month < 10 ? `0${month}` : month;
|
|
day = day < 10 ? `0${day}` : day;
|
|
|
|
return `${month}-${day}-${year}`;
|
|
};
|
|
const openDialog = (question_key) => {
|
|
currentDialoagkey.value = question_key;
|
|
isDialogVisible.value = true;
|
|
window.addEventListener('click', closeDialogOnOutsideClick);
|
|
};
|
|
const closeDialogOnOutsideClick = (event) => {
|
|
const dialogElement = refs.myDialog.$el;
|
|
if (!dialogElement.contains(event.target)) {
|
|
isDialogVisible.value = false;
|
|
window.removeEventListener('click', closeDialogOnOutsideClick);
|
|
}
|
|
};
|
|
const handleContinueClick = (currentDialoagkey) => {
|
|
isDialogVisible.value = false; // Hide the dialog
|
|
answers.value[currentDialoagkey] = true; // Update the answers object
|
|
};
|
|
const backFun = () => {
|
|
store.dispatch('updateIsLoading', true)
|
|
router.replace(route.query.to && route.query.to != '/additional-information' ? String(route.query.to) : '/review-appointment')
|
|
}
|
|
</script>
|
|
|
|
<template>
|
|
<StartOverPupup :showPopup="store.getters.getShowStartOverPupup"></StartOverPupup>
|
|
<!-- <VDialog v-model="store.getters.getIsLoading" width="110" height="150" color="primary">
|
|
<VCardText class="" style="color: white !important;">
|
|
<div class="demo-space-x">
|
|
<VProgressCircular :size="40" color="primary" indeterminate />
|
|
</div>
|
|
</VCardText>
|
|
</VDialog> -->
|
|
<VRow><CustomNav :logo='seetingPlanLogo'></CustomNav></VRow>
|
|
<VRow
|
|
style="min-height: 100dvh; margin: 0px;"
|
|
:style="isMobile ? { marginTop: '90px' } : { marginTop: '60px' }"
|
|
>
|
|
<!-- <VCol cols="12" md="5" class="bg-custom col-order-1"
|
|
:class="isMobile ? '' : 'auth-wrapper d-flex align-center justify-center pa-4'">
|
|
<Cart></Cart>
|
|
</VCol> -->
|
|
<VCol cols="12" md="12" class="bg-custom-color col-order-2"
|
|
:class="isMobile ? '' : 'auth-wrapper d-flex align-center justify-center pa-4'">
|
|
<!-- <div class="auth-wrapper d-flex align-center justify-center pa-4"> -->
|
|
<VCard class="auth-card pa-2 rounded-5" style="" :class="isMobile ? '' : 'card-wid'">
|
|
|
|
<VRow class=" mx-0 gy-3 px-lg-5">
|
|
<VCol cols="12" lg="12" md="12">
|
|
<router-link to="/" class="text-center mb-2 mt-2"
|
|
style="width: 100%;position: relative;display: block;padding-top: 20px;">
|
|
<span class="text-center">
|
|
<VImg :src="seetingPlanLogo" width="250" height="50" class="logo-img" />
|
|
<!-- <svg width="32" height="22" viewBox="0 0 32 22" fill="none"
|
|
xmlns="http://www.w3.org/2000/svg">
|
|
<path fill-rule="evenodd" clip-rule="evenodd"
|
|
d="M0.00172773 0V6.85398C0.00172773 6.85398 -0.133178 9.01207 1.98092 10.8388L13.6912 21.9964L19.7809 21.9181L18.8042 9.88248L16.4951 7.17289L9.23799 0H0.00172773Z"
|
|
fill="#7367F0" />
|
|
<path opacity="0.06" fill-rule="evenodd" clip-rule="evenodd"
|
|
d="M7.69824 16.4364L12.5199 3.23696L16.5541 7.25596L7.69824 16.4364Z"
|
|
fill="#161616" />
|
|
<path opacity="0.06" fill-rule="evenodd" clip-rule="evenodd"
|
|
d="M8.07751 15.9175L13.9419 4.63989L16.5849 7.28475L8.07751 15.9175Z"
|
|
fill="#161616" />
|
|
<path fill-rule="evenodd" clip-rule="evenodd"
|
|
d="M7.77295 16.3566L23.6563 0H32V6.88383C32 6.88383 31.8262 9.17836 30.6591 10.4057L19.7824 22H13.6938L7.77295 16.3566Z"
|
|
fill="#7367F0" />
|
|
</svg> -->
|
|
</span>
|
|
</router-link>
|
|
</VCol>
|
|
<VCol cols="12" md="12">
|
|
<!-- 👉 Title and subtitle -->
|
|
<div class="text-left">
|
|
<h5 class="text-h5 pricing-title mb-0">
|
|
Doctor Intake Request
|
|
</h5>
|
|
<p>Please complete the medical intake form before your appointment to ensure a smooth consultation with the doctor.</p>
|
|
</div>
|
|
</VCol>
|
|
<VCol cols="12" md="12">
|
|
<formview v-if="currentForm" :questionCategory="categoryName" :steps="currentForm.steps"
|
|
:schema="currentForm.schema" :redirectTo="redirectTo" :redirectBack="redirectBack"
|
|
:finishLabel="'All done'" :newForm="true" :returningUser="patientExist">
|
|
</formview>
|
|
</VCol>
|
|
</VRow>
|
|
<VRow>
|
|
<VDialog v-model="isDialogVisible" refs="myDialog" persistent width="500">
|
|
<!-- Dialog Content -->
|
|
<VCard>
|
|
<VCardText v-if="currentDialoagkey == 'patient_concent'"
|
|
title="Male Harmone therapy Patient consent">
|
|
|
|
<!-- <DialogCloseBtn variant="text" size="small" @click="isDialogVisible = false" /> -->
|
|
<VCardText class="pt-0"><b>Med Excel Clinic, P.A. ("Hgh HRT")</b>
|
|
</VCardText>
|
|
<VCardText><b>Nature of Hormone replacement and supplements therapy</b>
|
|
</VCardText>
|
|
<VDivider class="m-0"></VDivider>
|
|
<VCardText class="scrollable-text px-0 py-3">
|
|
I hereby give my consent to be treated using hormone replacement
|
|
therapy.
|
|
(antioxidants), and other medications prescribed to aid in improving my
|
|
overall health. I further consent to receive hormone replacement
|
|
therapy.
|
|
|
|
|
|
</VCardText>
|
|
<VCardText class="p-0">
|
|
<VRow>
|
|
<VCol cols="12" lg="6" md="6">
|
|
<VTextField v-model="patient_concent_Signature" label="Full Name Signature"
|
|
:rules="[requiredValidator]" />
|
|
|
|
</VCol>
|
|
<VCol cols="12" lg="6" md="6">
|
|
<VTextField v-model="date" type="date" disabled label="date"
|
|
:rules="[requiredValidator]" />
|
|
</VCol>
|
|
</VRow>
|
|
</VCardText>
|
|
<VCardText class="text-end pt-0 mt-5">
|
|
<VBtn @click.prevent="handleContinueClick(currentDialoagkey)">
|
|
Continue
|
|
</VBtn>
|
|
</VCardText>
|
|
|
|
|
|
</VCardText>
|
|
<VCardText v-if="currentDialoagkey == 'appointment_cancel'" title="">
|
|
<v-card-title class="p-0">
|
|
<span class="headline"><b>Medical Provider consultation
|
|
cancellation</b></span>
|
|
</v-card-title>
|
|
<VDivider></VDivider>
|
|
<!-- <DialogCloseBtn variant="text" size="small" @click="isDialogVisible = false" /> -->
|
|
<VCardText class="scrollable-text px-0 py-3">
|
|
I acknowledge that Hgh Medical charges a $59 for missed
|
|
appiontments.
|
|
</VCardText>
|
|
<VCardText class="p-0">
|
|
<VRow>
|
|
<VCol cols="12" lg="6" md="6">
|
|
<VTextField v-model="appointment_cancel_Signature"
|
|
label="Full Name Signature" :rules="[requiredValidator]" />
|
|
|
|
</VCol>
|
|
<VCol cols="12" lg="6" md="6">
|
|
<VTextField v-model="date" type="date" disabled label="date"
|
|
:rules="[requiredValidator]" />
|
|
</VCol>
|
|
</VRow>
|
|
</VCardText>
|
|
<VCardText class="text-end pt-0 mt-5">
|
|
<VBtn @click.prevent="handleContinueClick(currentDialoagkey)">
|
|
Continue
|
|
</VBtn>
|
|
</VCardText>
|
|
</VCardText>
|
|
<VCardText v-if="currentDialoagkey == 'medicare_disclaimer'">
|
|
<v-card-title class="p-0">
|
|
<span class="headline"><b>DISCLAIMER OF MEDICARE / <br> INSURANCE
|
|
BENEFIT</b></span>
|
|
</v-card-title>
|
|
<VDivider></VDivider>
|
|
<!-- <DialogCloseBtn variant="text" size="small" @click="isDialogVisible = false" /> -->
|
|
<VCardText class="scrollable-text px-0 py-3">
|
|
The patient acknowledge Hgh HRT or any of its
|
|
representatives
|
|
have made no representation or warranty that the treatment or any
|
|
portion
|
|
thereof qualifies or will qualify for reimbursement or assignment under
|
|
any
|
|
other government or private insurance program.
|
|
</VCardText>
|
|
<VCardText class="p-0">
|
|
<VRow>
|
|
<VCol cols="12" lg="6" md="6">
|
|
<VTextField v-model="medicare_disclaimer_Signature"
|
|
label="Full Name Signature" :rules="[requiredValidator]" />
|
|
|
|
</VCol>
|
|
<VCol cols="12" lg="6" md="6">
|
|
<VTextField v-model="date" type="date" disabled label="date"
|
|
:rules="[requiredValidator]" />
|
|
</VCol>
|
|
</VRow>
|
|
|
|
</VCardText>
|
|
<VCardText class="text-end pt-0 mt-5">
|
|
<VBtn @click.prevent="handleContinueClick(currentDialoagkey)">
|
|
Continue
|
|
</VBtn>
|
|
</VCardText>
|
|
</VCardText>
|
|
<VCardText v-if="currentDialoagkey == 'telehealth_concent'" title="">
|
|
<v-card-title class="p-0">
|
|
<span class="headline"><b>Hgh Medical, P.A. Telehealth <br> Informed
|
|
Consent</b></span>
|
|
</v-card-title>
|
|
<VDivider></VDivider>
|
|
<!-- <DialogCloseBtn variant="text" size="small" @click="isDialogVisible = false" /> -->
|
|
<VCardText class="scrollable-text px-0 py-3">
|
|
Telehealth involves the use of secure electronic communications,
|
|
information technology, or other means to enable a healthcare provider
|
|
and
|
|
a patient at different locations to communicate and share individual
|
|
patient
|
|
health information for the purpose of rendering clinical care. This
|
|
"Telehealth Informed Consent" informs the patient ("patient," "you")
|
|
</VCardText>
|
|
<VCardText class="p-0">
|
|
<VRow>
|
|
<VCol cols="12" lg="6" md="6">
|
|
<VTextField v-model="telehealth_concent_Signature"
|
|
label="Full Name Signature" :rules="[requiredValidator]" />
|
|
|
|
</VCol>
|
|
<VCol cols="12" lg="6" md="6">
|
|
<VTextField v-model="date" type="date" disabled label="date"
|
|
:rules="[requiredValidator]" />
|
|
</VCol>
|
|
</VRow>
|
|
|
|
</VCardText>
|
|
<VCardText class="text-end pt-0 mt-5">
|
|
<VBtn @click.prevent="handleContinueClick(currentDialoagkey)">
|
|
Continue
|
|
</VBtn>
|
|
</VCardText>
|
|
</VCardText>
|
|
<VCardText v-if="currentDialoagkey == 'secondary_contact'" title="">
|
|
<!-- <DialogCloseBtn variant="text" size="small" @click="isDialogVisible = false" /> -->
|
|
<v-card-title class="p-0">
|
|
<span class="headline"><b>Secondary Disclosure</b></span>
|
|
</v-card-title>
|
|
<VDivider></VDivider>
|
|
<VCardText class="scrollable-text pt-0 px-0 py-0">
|
|
Hgh HRT , PC is not permitted by law to provide information
|
|
</VCardText>
|
|
<VCardText class="p-0">
|
|
<VRow>
|
|
<VCol cols="12" lg="12" md="6">
|
|
<VTextField v-model="auth_information"
|
|
label="Authorize Release of Medical Information to (enter name) "
|
|
:rules="[requiredValidator]" />
|
|
</VCol>
|
|
</VRow>
|
|
<VRow>
|
|
<VCol cols="12" md="6">
|
|
<VTextField v-model="dob_auth_person" type="date" :max="getCurrentDate()"
|
|
label="DOB of authorized person above " :rules="[requiredValidator]" />
|
|
</VCol>
|
|
<VCol cols="12" md="6">
|
|
<VTextField v-model="relationship_auth_person"
|
|
label="Relationship of authorize person" :rules="[requiredValidator]" />
|
|
</VCol>
|
|
</VRow>
|
|
</VCardText>
|
|
|
|
<VCardText class="p-0">
|
|
<VRow>
|
|
<VCol cols="12" lg="6" md="6">
|
|
<VTextField v-model="secondary_contact_Signature"
|
|
label="Full Name Signature" :rules="[requiredValidator]" />
|
|
|
|
</VCol>
|
|
<VCol cols="12" lg="6" md="6">
|
|
<VTextField v-model="date" type="date" disabled label="date"
|
|
:rules="[requiredValidator]" />
|
|
</VCol>
|
|
</VRow>
|
|
|
|
</VCardText>
|
|
<VCardText class="text-end pt-0 mt-5">
|
|
<VBtn @click.prevent="handleContinueClick(currentDialoagkey)">
|
|
Continue
|
|
</VBtn>
|
|
</VCardText>
|
|
|
|
|
|
</VCardText>
|
|
</VCard>
|
|
|
|
</VDialog>
|
|
</VRow>
|
|
</VCard>
|
|
</VCol>
|
|
</VRow>
|
|
|
|
</template>
|
|
<style scoped>
|
|
@media only screen and (max-width: 768px) {
|
|
.card-wid {
|
|
max-width: 600px !important;
|
|
min-width: auto !important;
|
|
}
|
|
|
|
.col-order-1 {
|
|
order: 2;
|
|
}
|
|
|
|
.col-order-2 {
|
|
order: 1;
|
|
}
|
|
}
|
|
|
|
@media only screen and (min-width: 769px) {
|
|
.col-order-1 {
|
|
order: 1;
|
|
}
|
|
|
|
.col-order-2 {
|
|
order: 2;
|
|
}
|
|
}
|
|
|
|
.total-font {
|
|
font-size: 20px;
|
|
margin-bottom: 5px;
|
|
}
|
|
|
|
.bg-custom {
|
|
background: #fffeee;
|
|
}
|
|
|
|
.bg-custom-color {
|
|
background: #fedfde;
|
|
}
|
|
|
|
.bg-white bg-change-bk .current-plan {
|
|
border: 2px solid rgb(var(--v-theme-primary));
|
|
}
|
|
|
|
.cut-text {
|
|
white-space: nowrap;
|
|
overflow: hidden;
|
|
text-overflow: ellipsis;
|
|
text-decoration: line-through;
|
|
text-decoration-color: red;
|
|
text-decoration-thickness: 1px;
|
|
}
|
|
|
|
.plan-card {
|
|
margin: 0rem;
|
|
margin-bottom: 0;
|
|
}
|
|
|
|
.card-wid {
|
|
max-width: 600px;
|
|
border-radius: 10px !important;
|
|
}
|
|
|
|
.layout-wrapper {
|
|
justify-content: center;
|
|
}
|
|
|
|
.error-message {
|
|
color: #ff2f2f;
|
|
font-size: 15px;
|
|
}
|
|
</style>
|
|
<style lang="scss">
|
|
.bg-custom {
|
|
background: #fffeee;
|
|
}
|
|
|
|
.bg-custom-color {
|
|
background: #fedfde;
|
|
}
|
|
|
|
.total-font {
|
|
font-size: 20px;
|
|
margin-bottom: 5px;
|
|
}
|
|
|
|
.card-title {
|
|
font-family: "Public Sans", -apple-system, BlinkMacSystemFont, "Segoe UI", "Oxygen", "Ubuntu", "Cantarell", "Fira Sans", "Droid Sans", "Helvetica Neue", sans-serif;
|
|
}
|
|
|
|
.v-list-item-title {
|
|
white-space: inherit !important;
|
|
;
|
|
}
|
|
|
|
.logo-img {
|
|
display: block;
|
|
position: relative;
|
|
margin: 0 auto;
|
|
}
|
|
|
|
.v-list {
|
|
min-height: 168px;
|
|
}
|
|
|
|
@media (min-width: 320px) and (max-width: 768px) {
|
|
.v-container {
|
|
padding: 0px !important;
|
|
}
|
|
|
|
.auth-wrapper {
|
|
padding: 0px !important;
|
|
}
|
|
|
|
.input-width {
|
|
max-width: 100% !important;
|
|
}
|
|
}
|
|
|
|
// .input-width {
|
|
// max-width: 50%;
|
|
// }
|
|
|
|
.form-check-input[type=checkbox] {
|
|
border-radius: 0.25em;
|
|
}
|
|
|
|
.form-check .form-check-input {
|
|
float: left;
|
|
margin-right: 0.5em;
|
|
}
|
|
|
|
.form-check-input {
|
|
cursor: pointer;
|
|
}
|
|
|
|
.form-check-input {
|
|
width: 1.2em;
|
|
height: 1.2em;
|
|
margin-top: 0.135em;
|
|
vertical-align: top;
|
|
background-color: #fff;
|
|
background-repeat: no-repeat;
|
|
background-position: center;
|
|
background-size: contain;
|
|
border: 2px solid #dbdade;
|
|
appearance: none;
|
|
}
|
|
|
|
.form-check .form-check-input:checked,
|
|
.form-check .form-check-input[type=checkbox]:indeterminate {
|
|
box-shadow: 0 0.125rem 0.25rem rgba(165, 163, 174, 0.3);
|
|
}
|
|
|
|
.form-check-input:checked[type=checkbox] {
|
|
background-image: url("data:image/svg+xml,%3Csvg xmlns='http://www.w3.org/2000/svg' width='11' height='13' viewBox='0 0 15 14' fill='none'%3E%3Cpath d='M3.41667 7L6.33333 9.91667L12.1667 4.08333' stroke='%23fff' stroke-width='1.5' stroke-linecap='round' stroke-linejoin='round'/%3E%3C/svg%3E");
|
|
}
|
|
|
|
.form-check-input:checked,
|
|
.form-check-input[type=checkbox]:indeterminate {
|
|
background-color: #7367f0;
|
|
border-color: #7367f0;
|
|
}
|
|
|
|
.form-check-input:checked {
|
|
background-color: #7367f0;
|
|
border-color: #7367f0;
|
|
}
|
|
|
|
.form-check-input[type=checkbox] {
|
|
border-radius: 0.25em;
|
|
}
|
|
</style>
|