<% if( typeof editMode === 'undefined' || editMode === true) { %>

Please document the vaccination record for the patient.


* indicates required

<% } else { %>

The following vaccination record will be submitted for the patient. Please review and validate. Click "Back" to make any corrections.


<% } %> <% if( showVaccineProfile ){ %>
<% } %>

Visit Related To<% if( typeof editMode === 'undefined' || editMode === true) { %> *<% } %>

<% if (editMode === false) { %>
Reasons for visiting <% } %>
<% if (editMode === false) { %>
<% } %>

Vaccination Record

Immunization Record
<% if (typeof editMode === 'undefined' || editMode === true) { %>
Vaccine Administration <% } %>
<% if( typeof editMode === 'undefined' || editMode === true) { %> <% } %> <% } else { %>: <% } %>
<% if( typeof editMode === 'undefined' || editMode === true) { %> <% } %> <% } else { %>: <% } %>
<% if (typeof editMode === 'undefined' || editMode === true) { %>
Immunization Notes <% } %>
<% } else { %>: <% } %>
<% if( typeof editMode === 'undefined' || editMode === true) { %>

The following information will be added to the Comments / Notes:

<% questionsCollection.each( function(item){ %>

<%= item.get('legend') %> <%= item.get('user_response') %>

<% }); %>
<% } else { %>
<%= vaccineProfile.comments %>

<% questionsCollection.each( function(question ){ %>

<%= question.get('legend') %> <%= question.get('user_response') %>

<% }); %>
<% } %>
<% if (typeof vaccinator !== 'undefined' && !_.isEmpty( vaccinator )) { %>
value="<%= vaccinator.title %>" <% if ($.trim(vaccinator.title) !== "") { %> readonly="readonly" disabled="disabled" <% } %> <% } else { %> value="" <% } %> />
<% } %>