DREAM Forms

dic type	ctrl type	order	column name	value index	description	view condition
String	Linea di divisione	1		0	Anticonvulsant medication in use
String	Linea di divisione	2		0	Anticonvulsant medication number 1
String	Text box	3	vt1	0	Name of anticonvulsant medication 1
String	Text box	4	vt2	0	daily dose of anticonvulsant medication 1
Datetime	Date Picker	5	vd1	0	day started medication 1
String	Linea di divisione	6		0	Anticonvulsant medication number 2
String	Text box	7	vt3	0	Name of anticonvulsant medication 2
String	Text box	8	vt4	0	daily dose of anticonvulsant medication 2
Datetime	Date Picker	9	vd2	0	day started medication 2
String	Linea di divisione	10		0	Anticonvulsant medication number 3
String	Text box	11	vt5	0	Name of anticonvulsant medication 3
String	Text box	12	vt6	0	daily dose of anticonvulsant medication 3
Datetime	Date Picker	13	vd3	0	day started medication 3
String	Linea di divisione	14		0	Previous anticonvulsant medication
String	Linea di divisione	15		0	Previous anticonvulsant medication number 1
String	Text box	16	vt7	0	Name of anticonvulsant medication 1
String	Text box	17	vt8	0	Daily dose of anticonvulsant medication 1
Datetime	Date Picker	18	vd4	0	START date, medication 1
Datetime	Date Picker	19	vd1	1	END date, medication 1
String	Select	20	vt9	0	Effectiveness of medication 1
Boolan (Yes/No)	Select	21	vb1	0	Adverse effects for medication 1?
String	Text area	22	vt10	0	If yes, describe	vb1
String	Linea di divisione	23		0	Previous anticonvulsant medication number 2
String	Text box	24	vt11	0	Name of anticonvulsant medication 2
String	Text box	25	vt12	0	Daily dose of anticonvulsant medication 2
Datetime	Date Picker	26	vd2	1	START date, medication 2
Datetime	Date Picker	27	vd3	1	END date, medication 2
String	Select	28	vt13	0	Effectiveness of medication 2
Boolan (Yes/No)	Select	29	vb2	0	Adverse effects for medication 2?
String	Text area	30	vt14	0	If yes, describe	vb2
String	Linea di divisione	31		0	Previous anticonvulsant medication number 3
String	Text box	32	vt15	0	Name of anticonvulsant medication 3
String	Text box	33	vt16	0	Daily dose of anticonvulsant medication 3
Datetime	Date Picker	34	vd4	1	START date, medication 3
Datetime	Date Picker	35	vd1	2	END date, medication 3
String	Select	36	vt17	0	Effectiveness of medication 3
Boolan (Yes/No)	Select	37	vb3	0	Adverse effects for medication 3?
String	Text area	38	vt18	0	If yes, describe	vb3

id dictionary	FRM_EPI_THER
description	Epilepsy Treatment Form
is single ?
category
linked event	TREAT_EPILEPSY
order	110
v. index	19
used
hide in forms
filter hivpos	ALL
filter gender	ALL
filter agemin	0
filter agemax	150

Form fields