{% extends "layouts/base.html" %} {% load i18n %} {% block title %}{% trans "Send Survey Manually" %} - PX360{% endblock %} {% block content %}

{% trans "Send Survey Manually" %}

{% trans "Select a survey template and send it to a patient or staff member" %}

{% trans "Back to Surveys" %}
{% trans "Search Existing" %} {% trans "Enter Phone" %} {% trans "Upload CSV" %}

{% trans "Survey Details" %}

{% csrf_token %}
{% if form.survey_template.errors %}
{% for error in form.survey_template.errors %}{{ error }}{% endfor %}
{% endif %}

{% trans "Start typing to search. Select a recipient from the dropdown." %}

{% for value, label in form.delivery_channel.field.choices %} {% endfor %}
{% if form.delivery_channel.errors %}
{% for error in form.delivery_channel.errors %}{{ error }}{% endfor %}
{% endif %}
{% if form.custom_message.errors %}
{% for error in form.custom_message.errors %}{{ error }}{% endfor %}
{% endif %}

{% trans "Add a personalized message to the survey invitation" %}

{% trans "Cancel" %}
{% endblock %}