373 lines
19 KiB
HTML
373 lines
19 KiB
HTML
{% extends "layouts/source_user_base.html" %}
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{% load i18n %}
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{% block title %}{% trans "Create Complaint" %} - {{ source.name_en }}{% endblock %}
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{% block extra_css %}
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<style>
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@keyframes fadeIn {
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from { opacity: 0; transform: translateY(20px); }
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to { opacity: 1; transform: translateY(0); }
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}
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.animate-in {
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animation: fadeIn 0.5s ease-out forwards;
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}
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</style>
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{% endblock %}
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{% block content %}
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<div class="p-6 md:p-8 bg-gradient-to-br from-light to-blue-50 min-h-screen">
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<!-- Page Header -->
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<div class="flex flex-wrap justify-between items-center gap-4 mb-8 animate-in">
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<div class="flex items-center gap-3">
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<div class="flex items-center justify-center w-14 h-14 bg-gradient-to-br from-orange-400 to-orange-500 rounded-2xl shadow-lg shadow-orange-200">
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<i data-lucide="plus-circle" class="w-8 h-8 text-white"></i>
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</div>
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<div>
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<h1 class="text-2xl font-bold text-navy">
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{% trans "Create Complaint" %}
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</h1>
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<p class="text-slate text-sm">
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{% trans "Submit a new complaint from" %} <strong>{{ source.name_en }}</strong>
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</p>
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</div>
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</div>
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<a href="{% url 'px_sources:source_user_complaint_list' %}"
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class="inline-flex items-center gap-2 px-5 py-2.5 bg-white border-2 border-blue-200 text-navy rounded-xl font-semibold hover:bg-blue-50 transition">
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<i data-lucide="arrow-left" class="w-4 h-4"></i>
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{% trans "Back to Complaints" %}
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</a>
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</div>
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<!-- Info Banner -->
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<div class="bg-blue-50 border border-blue-200 rounded-2xl p-4 mb-8 animate-in">
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<div class="flex items-start gap-3">
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<i data-lucide="info" class="w-5 h-5 text-blue-600 mt-0.5 flex-shrink-0"></i>
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<div>
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<p class="text-sm font-bold text-blue-800 mb-1">{% trans "Source Information" %}</p>
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<p class="text-sm text-blue-700">
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{% trans "This complaint will be automatically linked to" %} <strong>{{ source.name_en }}</strong>.
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{% trans "All required fields are marked with" %} <span class="text-red-500">*</span>
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</p>
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</div>
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</div>
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</div>
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<!-- Form -->
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<div class="bg-white rounded-2xl shadow-sm border border-blue-100 overflow-hidden animate-in">
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<form method="post" novalidate>
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{% csrf_token %}
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<div class="p-6 md:p-8">
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<div class="grid grid-cols-1 md:grid-cols-2 gap-6">
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<!-- Complainant Name -->
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<div>
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<label for="{{ form.complainant_name.id_for_label }}" class="block text-sm font-bold text-navy mb-2">
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{{ form.complainant_name.label }} <span class="text-red-500">*</span>
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</label>
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{{ form.complainant_name }}
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{% if form.complainant_name.errors %}
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<div class="flex items-center gap-2 mt-2 text-red-600 text-sm">
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<i data-lucide="alert-circle" class="w-4 h-4"></i>
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{% for error in form.complainant_name.errors %}{{ error }}{% endfor %}
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</div>
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{% endif %}
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</div>
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<!-- Mobile Number -->
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<div>
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<label for="{{ form.mobile_number.id_for_label }}" class="block text-sm font-bold text-navy mb-2">
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{{ form.mobile_number.label }} <span class="text-red-500">*</span>
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</label>
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{{ form.mobile_number }}
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{% if form.mobile_number.errors %}
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<div class="flex items-center gap-2 mt-2 text-red-600 text-sm">
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<i data-lucide="alert-circle" class="w-4 h-4"></i>
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{% for error in form.mobile_number.errors %}{{ error }}{% endfor %}
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</div>
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{% endif %}
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</div>
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<!-- Email -->
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<div>
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<label for="{{ form.email.id_for_label }}" class="block text-sm font-bold text-navy mb-2">
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{{ form.email.label }}
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</label>
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{{ form.email }}
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{% if form.email.errors %}
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<div class="flex items-center gap-2 mt-2 text-red-600 text-sm">
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<i data-lucide="alert-circle" class="w-4 h-4"></i>
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{% for error in form.email.errors %}{{ error }}{% endfor %}
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</div>
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{% endif %}
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</div>
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<!-- Relation to Patient -->
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<div>
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<label for="{{ form.relation_to_patient.id_for_label }}" class="block text-sm font-bold text-navy mb-2">
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{{ form.relation_to_patient.label }} <span class="text-red-500">*</span>
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</label>
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{{ form.relation_to_patient }}
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{% if form.relation_to_patient.errors %}
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<div class="flex items-center gap-2 mt-2 text-red-600 text-sm">
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<i data-lucide="alert-circle" class="w-4 h-4"></i>
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{% for error in form.relation_to_patient.errors %}{{ error }}{% endfor %}
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</div>
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{% endif %}
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</div>
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<!-- Patient Name -->
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<div>
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<label for="{{ form.patient_name.id_for_label }}" class="block text-sm font-bold text-navy mb-2">
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{{ form.patient_name.label }} <span class="text-red-500">*</span>
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</label>
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{{ form.patient_name }}
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{% if form.patient_name.errors %}
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<div class="flex items-center gap-2 mt-2 text-red-600 text-sm">
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<i data-lucide="alert-circle" class="w-4 h-4"></i>
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{% for error in form.patient_name.errors %}{{ error }}{% endfor %}
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</div>
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{% endif %}
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</div>
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<!-- National ID -->
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<div>
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<label for="{{ form.national_id.id_for_label }}" class="block text-sm font-bold text-navy mb-2">
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{{ form.national_id.label }} <span class="text-red-500">*</span>
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</label>
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{{ form.national_id }}
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{% if form.national_id.errors %}
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<div class="flex items-center gap-2 mt-2 text-red-600 text-sm">
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<i data-lucide="alert-circle" class="w-4 h-4"></i>
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{% for error in form.national_id.errors %}{{ error }}{% endfor %}
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</div>
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{% endif %}
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</div>
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<!-- Incident Date -->
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<div>
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<label for="{{ form.incident_date.id_for_label }}" class="block text-sm font-bold text-navy mb-2">
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{{ form.incident_date.label }} <span class="text-red-500">*</span>
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</label>
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{{ form.incident_date }}
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{% if form.incident_date.errors %}
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<div class="flex items-center gap-2 mt-2 text-red-600 text-sm">
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<i data-lucide="alert-circle" class="w-4 h-4"></i>
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{% for error in form.incident_date.errors %}{{ error }}{% endfor %}
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</div>
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{% endif %}
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</div>
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<!-- Staff Name -->
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<div>
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<label for="{{ form.staff_name.id_for_label }}" class="block text-sm font-bold text-navy mb-2">
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{{ form.staff_name.label }}
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</label>
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{{ form.staff_name }}
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<p class="text-xs text-slate mt-1">{% trans "Optional - Name of staff involved" %}</p>
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{% if form.staff_name.errors %}
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<div class="flex items-center gap-2 mt-2 text-red-600 text-sm">
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<i data-lucide="alert-circle" class="w-4 h-4"></i>
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{% for error in form.staff_name.errors %}{{ error }}{% endfor %}
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</div>
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{% endif %}
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</div>
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<!-- Hospital -->
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<div>
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<label for="{{ form.hospital.id_for_label }}" class="block text-sm font-bold text-navy mb-2">
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{{ form.hospital.label }} <span class="text-red-500">*</span>
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</label>
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{{ form.hospital }}
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{% if form.hospital.errors %}
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<div class="flex items-center gap-2 mt-2 text-red-600 text-sm">
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<i data-lucide="alert-circle" class="w-4 h-4"></i>
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{% for error in form.hospital.errors %}{{ error }}{% endfor %}
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</div>
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{% endif %}
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</div>
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<!-- Location -->
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<div>
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<label for="{{ form.location.id_for_label }}" class="block text-sm font-bold text-navy mb-2">
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{{ form.location.label }} <span class="text-red-500">*</span>
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</label>
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{{ form.location }}
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{% if form.location.errors %}
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<div class="flex items-center gap-2 mt-2 text-red-600 text-sm">
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<i data-lucide="alert-circle" class="w-4 h-4"></i>
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{% for error in form.location.errors %}{{ error }}{% endfor %}
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</div>
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{% endif %}
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</div>
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<!-- Main Section -->
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<div>
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<label for="{{ form.main_section.id_for_label }}" class="block text-sm font-bold text-navy mb-2">
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{{ form.main_section.label }} <span class="text-red-500">*</span>
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</label>
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{{ form.main_section }}
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{% if form.main_section.errors %}
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<div class="flex items-center gap-2 mt-2 text-red-600 text-sm">
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<i data-lucide="alert-circle" class="w-4 h-4"></i>
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{% for error in form.main_section.errors %}{{ error }}{% endfor %}
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</div>
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{% endif %}
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</div>
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<!-- Subsection -->
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<div>
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<label for="{{ form.subsection.id_for_label }}" class="block text-sm font-bold text-navy mb-2">
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{{ form.subsection.label }} <span class="text-red-500">*</span>
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</label>
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{{ form.subsection }}
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{% if form.subsection.errors %}
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<div class="flex items-center gap-2 mt-2 text-red-600 text-sm">
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<i data-lucide="alert-circle" class="w-4 h-4"></i>
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{% for error in form.subsection.errors %}{{ error }}{% endfor %}
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</div>
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{% endif %}
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</div>
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<!-- Complaint Details (Description) -->
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<div class="md:col-span-2">
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<label for="{{ form.complaint_details.id_for_label }}" class="block text-sm font-bold text-navy mb-2">
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{{ form.complaint_details.label }} <span class="text-red-500">*</span>
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</label>
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{{ form.complaint_details }}
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{% if form.complaint_details.errors %}
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<div class="flex items-center gap-2 mt-2 text-red-600 text-sm">
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<i data-lucide="alert-circle" class="w-4 h-4"></i>
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{% for error in form.complaint_details.errors %}{{ error }}{% endfor %}
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</div>
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{% endif %}
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</div>
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<!-- Expected Result -->
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<div class="md:col-span-2">
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<label for="{{ form.expected_result.id_for_label }}" class="block text-sm font-bold text-navy mb-2">
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{{ form.expected_result.label }}
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</label>
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{{ form.expected_result }}
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<p class="text-xs text-slate mt-1">{% trans "What do you expect as a resolution? (Optional)" %}</p>
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{% if form.expected_result.errors %}
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<div class="flex items-center gap-2 mt-2 text-red-600 text-sm">
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<i data-lucide="alert-circle" class="w-4 h-4"></i>
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{% for error in form.expected_result.errors %}{{ error }}{% endfor %}
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</div>
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{% endif %}
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</div>
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</div>
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</div>
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<!-- Form Actions -->
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<div class="px-6 py-4 bg-gradient-to-r from-blue-50 to-transparent border-t border-blue-100 flex gap-3">
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<button type="submit"
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class="inline-flex items-center gap-2 px-6 py-3 bg-gradient-to-r from-navy to-blue text-white rounded-xl font-semibold hover:from-navy hover:to-blue transition shadow-lg shadow-blue-200">
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<i data-lucide="check" class="w-5 h-5"></i>
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{% trans "Submit Complaint" %}
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</button>
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<a href="{% url 'px_sources:source_user_complaint_list' %}"
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class="inline-flex items-center gap-2 px-6 py-3 bg-white border-2 border-slate-200 text-slate-700 rounded-xl font-semibold hover:bg-slate-50 transition">
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<i data-lucide="x" class="w-5 h-5"></i>
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{% trans "Cancel" %}
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</a>
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</div>
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</form>
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</div>
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</div>
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<script>
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document.addEventListener('DOMContentLoaded', function() {
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lucide.createIcons();
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// Set max date for incident date to today
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const incidentDateInput = document.getElementById('{{ form.incident_date.id_for_label }}');
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if (incidentDateInput) {
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const today = new Date().toISOString().split('T')[0];
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incidentDateInput.setAttribute('max', today);
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}
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// Cascading dropdowns for Location → Section → Subsection
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const locationSelect = document.getElementById('{{ form.location.id_for_label }}');
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const mainSectionSelect = document.getElementById('{{ form.main_section.id_for_label }}');
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const subsectionSelect = document.getElementById('{{ form.subsection.id_for_label }}');
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// Load sections when location changes
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if (locationSelect && mainSectionSelect) {
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locationSelect.addEventListener('change', function() {
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const locationId = this.value;
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// Clear and disable dependent dropdowns
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mainSectionSelect.innerHTML = '<option value="">Select Section</option>';
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subsectionSelect.innerHTML = '<option value="">Select Subsection</option>';
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mainSectionSelect.disabled = true;
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subsectionSelect.disabled = true;
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if (locationId) {
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// Fetch sections for this location using the AJAX endpoint
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fetch(`/organizations/ajax/main-sections/?location_id=${locationId}`)
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.then(response => response.json())
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.then(data => {
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if (data.sections && data.sections.length > 0) {
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data.sections.forEach(section => {
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const option = document.createElement('option');
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option.value = section.id;
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option.textContent = section.name_en || section.name;
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mainSectionSelect.appendChild(option);
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});
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mainSectionSelect.disabled = false;
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}
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})
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.catch(error => {
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console.error('Error loading sections:', error);
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});
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}
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});
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// Trigger change on page load if location is pre-selected
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if (locationSelect.value) {
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locationSelect.dispatchEvent(new Event('change'));
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}
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}
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// Load subsections when main section changes
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if (mainSectionSelect && subsectionSelect) {
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mainSectionSelect.addEventListener('change', function() {
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const locationId = locationSelect ? locationSelect.value : null;
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const sectionId = this.value;
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// Clear and disable subsection dropdown
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subsectionSelect.innerHTML = '<option value="">Select Subsection</option>';
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subsectionSelect.disabled = true;
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if (locationId && sectionId) {
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// Fetch subsections for this location and section
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fetch(`/organizations/ajax/subsections/?location_id=${locationId}&main_section_id=${sectionId}`)
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.then(response => response.json())
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.then(data => {
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if (data.subsections && data.subsections.length > 0) {
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data.subsections.forEach(subsection => {
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const option = document.createElement('option');
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option.value = subsection.id;
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option.textContent = subsection.name_en || subsection.name;
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subsectionSelect.appendChild(option);
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});
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subsectionSelect.disabled = false;
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}
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})
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.catch(error => {
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console.error('Error loading subsections:', error);
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});
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}
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});
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// Trigger change on page load if section is pre-selected
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if (mainSectionSelect.value) {
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mainSectionSelect.dispatchEvent(new Event('change'));
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}
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}
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});
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</script>
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{% endblock %}
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