{# clinician_contact_request_submit.html #} {% extends "base.html" %} {% comment %} template parameters: form: Form {% endcomment %} {% block content %}

Submit patient contact request

Using database: {{ db_description }}

You can request that one or more of your patients is included in a study. You will receive an email about this (for each patient you submit) but you do not need to act on it as we already have your affirmative response.

{% csrf_token %} {{ form }}
{% endblock %}