{% load static %} {% block title %}Reschedule Appointment{% endblock %} {% block css %} {% endblock %} {% block content %}

Current Appointment

Patient:
{{ appointment.patient.first_name }} {{ appointment.patient.last_name }}
Provider:
{{ appointment.provider.first_name }} {{ appointment.provider.last_name }}
Department:
{{ appointment.department.name }}
Date:
{{ appointment.appointment_date|date:"M d, Y" }}
Time:
{{ appointment.appointment_time|time:"g:i A" }}
Type:
{{ appointment.appointment_type.name }}

New Appointment Details

{% if messages %} {% for message in messages %} {% endfor %} {% endif %}
{% csrf_token %}
{% if form.new_date.errors %}
{{ form.new_date.errors.0 }}
{% endif %}
{% if form.new_time.errors %}
{{ form.new_time.errors.0 }}
{% endif %}
{% if form.new_provider.errors %}
{{ form.new_provider.errors.0 }}
{% endif %}
{% if form.reschedule_reason.errors %}
{{ form.reschedule_reason.errors.0 }}
{% endif %}
{% if form.reschedule_notes.errors %}
{{ form.reschedule_notes.errors.0 }}
{% endif %}
Cancel
{% endblock %} {% block js %} {% endblock %}