{% extends "base.html" %}
{% block title %}{{ 'Edit Draft' if incident.id else 'New OVR' }}{% endblock %}
{% block page_title %}Confidential Occurrence Reporting{% endblock %}
{% block content %}
<div class="page-header">
  <div><h1>{{ 'Edit Draft ' ~ incident.reference_no if incident.id else 'New Occurrence / Variance Report' }}</h1><p>Complete known facts only. Submit during the same shift or within 24 hours of occurrence or discovery, regardless of perceived severity.</p></div>
  <div class="page-actions"><a class="button secondary" href="{{ url_for('main.incident_detail', incident_id=incident.id) if incident.id else url_for('main.incidents') }}">Cancel</a></div>
</div>
<div class="confidential-note" style="margin-bottom:16px"><strong>Confidential, non-punitive reporting.</strong> Completing this report is not an admission of liability. Attend to urgent care first, notify the appropriate clinician, and preserve any involved equipment for examination.</div>
<form class="card" method="post" novalidate>
  <input type="hidden" name="csrf_token" value="{{ csrf_token() }}">
  <section class="form-section">
    <div class="section-heading"><span class="section-number">1</span><div><h2>Incident Setting</h2><p>Where and when the occurrence or variance happened</p></div></div>
    <div class="form-grid">
      <label class="span-6 required">Branch
        <select name="branch_id" data-branch-select="#report-department" required {% if current_user.role.scope != 'all' %}aria-readonly="true"{% endif %}>
          <option value="">Select branch</option>{% for branch in branches %}<option value="{{ branch.id }}" {% if (request.form.get('branch_id',type=int) or incident.branch_id or current_user.branch_id)==branch.id %}selected{% endif %}>{{ branch.name }}</option>{% endfor %}
        </select>
      </label>
      <label class="span-6 required">Reporting Department / Clinic
        <select id="report-department" name="department_id" required><option value="">Select department</option>{% for department in departments %}<option value="{{ department.id }}" data-branch="{{ department.branch_id }}" {% if (request.form.get('department_id',type=int) or incident.department_id or current_user.department_id)==department.id %}selected{% endif %}>{{ department.name }}</option>{% endfor %}</select>
      </label>
      <label class="span-4 required">Incident Date<input type="date" name="incident_date" value="{{ request.form.get('incident_date') or (incident.incident_date.isoformat() if incident.incident_date else '') }}" max="{{ today if today is defined else '' }}" required></label>
      <label class="span-4 required">Incident Time<input type="time" name="incident_time" value="{{ request.form.get('incident_time') or (incident.incident_time.strftime('%H:%M') if incident.incident_time else '') }}" required></label>
      <label class="span-4 required">Incident Location<input type="text" name="location" value="{{ request.form.get('location') or incident.location or '' }}" placeholder="Room, clinic, ward, or area" required></label>
      <label class="span-12">Other Involved Departments
        <select name="involved_department_ids" multiple size="4">{% set selected_depts = request.form.getlist('involved_department_ids') if request.method == 'POST' else incident.involved_departments|map(attribute='id')|map('string')|list %}{% for department in departments %}<option value="{{ department.id }}" data-branch="{{ department.branch_id }}" {% if department.id|string in selected_depts %}selected{% endif %}>{{ department.branch.code }} · {{ department.name }}</option>{% endfor %}</select>
      </label>
    </div>
  </section>
  <section class="form-section">
    <div class="section-heading"><span class="section-number">2</span><div><h2>Person Involved</h2><p>Use a separate report for each person when multiple individuals are involved</p></div></div>
    <div class="form-grid">
      <div class="span-12"><label class="required">Person Type</label><div class="choice-grid">{% for item in person_types %}<label class="choice"><input type="radio" name="person_type" value="{{ item }}" {% if (request.form.get('person_type') or incident.person_type)==item %}checked{% endif %} required> {{ item }}</label>{% endfor %}</div></div>
      <label class="span-6">Name of Person Involved<input type="text" name="person_name" value="{{ request.form.get('person_name') or incident.person_name or '' }}"></label>
      <label class="span-3">Position<input type="text" name="person_position" value="{{ request.form.get('person_position') or incident.person_position or '' }}"></label>
      <label class="span-3">Mobile / Badge No.<input type="text" name="person_mobile_badge" value="{{ request.form.get('person_mobile_badge') or incident.person_mobile_badge or '' }}"></label>
      <label class="span-6">Person's Department / Clinic<input type="text" name="person_department" value="{{ request.form.get('person_department') or incident.person_department or '' }}"></label>
      <label class="span-6">Patient Medical Record No.<input type="text" name="patient_mrn" value="{{ request.form.get('patient_mrn') or incident.patient_mrn or '' }}"></label>
    </div>
  </section>
  <section class="form-section">
    <div class="section-heading"><span class="section-number">3</span><div><h2>Classification of Occurrence / Variance</h2><p>Select the main classification and every applicable item</p></div></div>
    <div class="form-grid">
      <label class="span-6 required">Main Classification<select name="classification_category" data-classification required><option value="">Select classification</option>{% for category in classifications %}<option value="{{ category }}" {% if (request.form.get('classification_category') or incident.classification_category)==category %}selected{% endif %}>{{ category }}</option>{% endfor %}</select></label>
      <label class="span-6">Other / Additional Detail<input type="text" name="classification_other" value="{{ request.form.get('classification_other') or incident.classification_other or '' }}"></label>
      <div class="span-12">
        {% set selected_items = request.form.getlist('classification_items') if request.method == 'POST' else incident.classification_items %}
        {% for category, items in classifications.items() %}<div data-classification-group="{{ category }}" hidden><label>{{ category }} items</label><div class="choice-grid">{% for item in items %}<label class="choice"><input type="checkbox" name="classification_items" value="{{ item }}" {% if item in selected_items %}checked{% endif %}> {{ item }}</label>{% endfor %}</div></div>{% endfor %}
      </div>
    </div>
  </section>
  <section class="form-section">
    <div class="section-heading"><span class="section-number">4</span><div><h2>What Is Being Reported?</h2><p>Describe outcome, injury, preliminary harm, and medication-error category where applicable</p></div></div>
    <div class="form-grid">
      <div class="span-12"><label class="required">Report Type</label><div class="choice-grid">{% for item in report_types %}<label class="choice"><input type="radio" name="report_type" value="{{ item }}" {% if (request.form.get('report_type') or incident.report_type)==item %}checked{% endif %} required> {{ item }}</label>{% endfor %}</div></div>
      <div class="span-4"><label class="choice"><input type="checkbox" name="injury_occurred" value="1" data-toggle-target="#injury-fields" {% if request.form.get('injury_occurred') or incident.injury_occurred %}checked{% endif %}> Injury occurred</label></div>
      <div id="injury-fields" class="span-8 form-grid">
        <label class="span-6">Type of Injury<select name="injury_type"><option value="">Select</option>{% for item in injury_types %}<option value="{{ item }}" {% if (request.form.get('injury_type') or incident.injury_type)==item %}selected{% endif %}>{{ item }}</option>{% endfor %}</select></label>
        <label class="span-6">Preliminary Level of Harm<select name="harm_level"><option value="">Select</option>{% for item in harm_levels %}<option value="{{ item }}" {% if (request.form.get('harm_level') or incident.harm_level)==item %}selected{% endif %}>{{ item }}</option>{% endfor %}</select></label>
      </div>
      <label class="span-6">Preliminary Likelihood<select name="likelihood"><option value="">Select</option>{% for item in likelihoods %}<option value="{{ item }}" {% if (request.form.get('likelihood') or incident.likelihood)==item %}selected{% endif %}>{{ item }}</option>{% endfor %}</select></label>
      <label class="span-6">Medication Harm Category (A-I)<select name="medication_harm_category"><option value="">Not a medication error / not yet known</option>{% for code,description in medication_harm.items() %}<option value="{{ code }}" {% if (request.form.get('medication_harm_category') or incident.medication_harm_category)==code %}selected{% endif %}>{{ code }} — {{ description }}</option>{% endfor %}</select></label>
    </div>
  </section>
  <section class="form-section">
    <div class="section-heading"><span class="section-number">5</span><div><h2>Known Facts and Immediate Response</h2><p>Do not speculate, assign blame, or include unrelated information</p></div></div>
    <div class="form-grid">
      <label class="span-12 required">Factual Description of Occurrence / Variance<textarea name="description" minlength="20" required placeholder="Describe exactly what happened, in chronological order, using known facts.">{{ request.form.get('description') or incident.description or '' }}</textarea></label>
      <label class="span-12">Immediate Action Taken / Treatment Given<textarea name="immediate_action" placeholder="Urgent treatment, containment, notification, preservation of equipment, or other immediate action.">{{ request.form.get('immediate_action') or incident.immediate_action or '' }}</textarea></label>
      <div class="span-12"><label class="choice"><input type="checkbox" name="is_anonymous" value="1" {% if request.form.get('is_anonymous') or incident.is_anonymous %}checked{% endif %}> Display me as an anonymous reporter to non-QPS viewers</label><div class="form-note" style="margin-top:8px">Your identity remains securely recorded so authorized QPS personnel can request necessary information, but it is masked from users without protected-identity permission.</div></div>
    </div>
  </section>
  <div class="form-actions"><button class="button secondary" type="submit" name="action" value="draft">Save Draft</button><button class="button primary" type="submit" name="action" value="submit">Submit Confidential OVR</button></div>
</form>
{% endblock %}