org_type
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: How would you best describe your organization?, type: esriFieldTypeString
, Coded Values:
[health_facility: I am a healthcare or first response entity (this includes entities such as Police, Fire, Blood Banks, etc).]
, [non_health: I am a Community Based Organization, Educational Institution, Licensing Agency, or other type of entity.]
)
primary_facility
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Please enter the primary Site/Organization you are submitting this membership agreement for:, type: esriFieldTypeString
)
primary_other_org_select
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: If your organization is not listed, choose "Other Site/Organization", type: esriFieldTypeString
, Coded Values:
[other_org: Other Organization]
)
primary_other_org_input
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Please type in the organization you are responding for., type: esriFieldTypeString
)
primary_relationshipinput
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Please note if this is a parent or sister/branch organization., type: esriFieldTypeString
)
primary_discipline_input
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: If you selected other, please type in your Site/Organization Discipline, type: esriFieldTypeString
)
primary_siteadmin_same
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Is your Site Administrator the same as your Primary Coalition Contact?, type: esriFieldTypeString
, Coded Values:
[primary: Primary Coalition Contact]
, [no: No - I need to input Site Adminstrator information]
)
primary_siteadmin_contact_name
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Name of Site Administrator, type: esriFieldTypeString
)
primary_emergency_same
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Is your Emergency Contact the same as the Primary Coalition Contact or the Site Adminstrator?, type: esriFieldTypeString
, Coded Values:
[primary: Primary Coalition Contact]
, [site_admin: Site Administrator]
, [no: No - I need to input an emergency contact]
)
primary_emergency_same_cbo
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Is your Emergency Contact the same as the Primary Coalition Contact?, type: esriFieldTypeString
, Coded Values:
[primary: Primary Coalition Contact]
, [no: No - I need to input an emergency contact]
)
primary_site_type_confirmation
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Please confirm your physical site status before proceeding., type: esriFieldTypeString
, Coded Values:
[yes_facility: This is a physical site that cares for patients.]
, [yes_office: This is a location that does not directly care for patients.]
, [no_facility: We do not currently have a physical location.]
)
primary_capacity
(
nullable: true, editable: true, defaultValue: null, alias: What is your total licensed bed/patient capacity?, type: esriFieldTypeInteger
)
primary_generator_confirm
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Is there a generator on site at all times?, type: esriFieldTypeString
, Coded Values:
[yes: Yes]
, [no: No]
)
primary_vehicles
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Do you have any facility or organization-owned vehicles?, type: esriFieldTypeString
, Coded Values:
[yes: Yes]
, [no: No]
)
multiplesites_confirm
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Are you including additional sites in this form?, type: esriFieldTypeString
, Coded Values:
[yes: Yes]
, [no: No]
)
numberofsites
(
nullable: true, editable: true, defaultValue: null, alias: Number of Additional Sites/Organizations included in this agreement, type: esriFieldTypeInteger
)
member_status
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: What is your membership status?, type: esriFieldTypeString
, Coded Values:
[new_member: I am a new member of the HCC]
, [existing_member: I am an existing member of the HCC]
)
new_member_q
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: What are some of the reasons you are joining the Coalition? What are you hoping to gain from membership?, type: esriFieldTypeString
)
existing_member_q
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: What are some of the reasons you are continuing membership with the Coalition? What have you found most helpful from membership?, type: esriFieldTypeString
)
all_member_1
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: What training topics/content would you like to see from the coalition?, type: esriFieldTypeString
)
all_member_2
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: In the event of a county-wide emergency requiring mutual aid, what are some examples of assistance/supplies you could provide to the coalition?, type: esriFieldTypeString
)
member_signature_confirm
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: To complete your Membership Registration, please input your electronic signature below., type: esriFieldTypeString
)
primary_cbo_site_conf
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Please confirm your physical site status before proceeding., type: esriFieldTypeString
, Coded Values:
[yes_location: This is a physical site.]
, [no_location: We do not currently have a physical location.]
)
Templates:
Name: New Feature
Description:
Prototype:
Drawing Tool: N/A
Relationships:
VCHCC_Member_Agreement_multi_profile_repeat (0) -- Related To:
multi_profile_repeat (1)
multi_other_org_select
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: If your organization is not listed, choose "Other Site/Organization", type: esriFieldTypeString
, Coded Values:
[other_org: Other Organization]
)
multi_other_org_input
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Please type in the organization you are responding for., type: esriFieldTypeString
)
multi_relationshipinput
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Please note if this is a parent or sister/branch organization., type: esriFieldTypeString
)
multi_discipline_input
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: If you selected other, please type in your Site/Organization Discipline, type: esriFieldTypeString
)
multi_siteadmin_same
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Is your Site Administrator the same as your Primary Coalition Contact?, type: esriFieldTypeString
, Coded Values:
[primary: Primary Coalition Contact]
, [no: No - I need to input Site Adminstrator information]
)
multi_siteadmin_contact_name
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Name of Site Administrator, type: esriFieldTypeString
)
multi_emergency_same
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Is your Emergency Contact the same as the Primary Coalition Contact or the Site Adminstrator?, type: esriFieldTypeString
, Coded Values:
[primary: Primary Coalition Contact]
, [site_admin: Site Administrator]
, [no: No - I need to input an emergency contact]
)
multi_site_type_confirmation
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Please confirm your physical site status before proceeding., type: esriFieldTypeString
, Coded Values:
[yes_facility: This is a physical site that cares for patients.]
, [yes_office: This is a location that does not directly care for patients.]
, [no_facility: We do not currently have a physical location.]
)
multi_capacity
(
nullable: true, editable: true, defaultValue: null, alias: What is your total licensed bed/patient capacity?, type: esriFieldTypeInteger
)
multi_generator_confirm
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Is there a generator on site at all times?, type: esriFieldTypeString
, Coded Values:
[yes: Yes]
, [no: No]
)