Evidence Synthesis · Community Portal

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style="width:33%;"><div><fieldset aria-label="General"><table role="presentation" class="section"><colgroup></colgroup><tr> <td colspan="1" rowspan="1" class="clearfix cell picklist-cell"><div class="info required"><label for="cr047_typeofrequest" id="cr047_typeofrequest_label" class="field-label">Type of request</label><div class="validators"><span id="RequiredFieldValidatorcr047_typeofrequest" style="display:none;">*</span></div></div><div class="control"><select name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_typeofrequest" id="cr047_typeofrequest" class="form-control picklist " onchange="setIsDirty(this.id);" required="" aria-required="true" aria-invalid="false" title="Please select an item in this list"> <option value="" label="Select" aria-label="Select"></option> <option value="928710000">Ask a question</option> <option value="928710001">Editing</option> <option selected="selected" value="928710011">Evidence 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horizontal " role="presentation" onchange="setIsDirty(this.id);" data-required="true" aria-invalid="false" title="Please select an item in this list"><input id="cr047_customerdivision_0" type="radio" name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_customerdivision" value="928710001" /><label for="cr047_customerdivision_0"><span class='sr-only'>Customer Division </span>NIH</label><input id="cr047_customerdivision_1" type="radio" name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_customerdivision" value="928710000" /><label for="cr047_customerdivision_1"><span class='sr-only'>Customer Division </span>HHS</label><input id="cr047_customerdivision_2" type="radio" name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_customerdivision" value="928710002" /><label for="cr047_customerdivision_2"><span class='sr-only'>Customer Division </span>Public</label></span></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell picklist-cell"><div class="info"><label for="cr047_nihic" id="cr047_nihic_label" class="field-label">IC\agency</label><div class="validators"></div></div><div class="control"><select name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_nihic" id="cr047_nihic" class="form-control picklist " onchange="setIsDirty(this.id);"> <option selected="selected" value="" label="Select" aria-label="Select"></option> <option value="100000000">ARPA-H</option> <option value="928710000">CC</option> <option value="928710001">CIT</option> <option value="928710002">CSR</option> <option value="928710003">FIC</option> <option value="928710004">NCATS</option> <option value="928710005">NCCIH</option> <option value="928710106">NCI</option> <option value="928710007">NEI</option> <option value="928710008">NHGRI</option> <option value="928710009">NHLBI</option> <option value="928710010">NIA</option> <option value="928710011">NIAAA</option> <option value="928710012">NIAID</option> <option value="928710013">NIAMS</option> <option value="928710014">NIBIB</option> <option value="928710015">NICHD</option> <option value="928710116">NIDA</option> <option value="928710017">NIDCD</option> <option value="928710018">NIDCR</option> <option value="928710019">NIDDK</option> <option value="928710020">NIEHS</option> <option value="928710021">NIGMS</option> <option value="928710022">NIMH</option> <option value="928710023">NIMHD</option> <option value="928710024">NINDS</option> <option value="928710025">NINR</option> <option value="928710026">NLM</option> <option value="928710027">OD</option> </select></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell picklist-cell"><div class="info"><label for="cr047_hhsopdiv" id="cr047_hhsopdiv_label" class="field-label">IC\agency</label><div class="validators"></div></div><div class="control"><select name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_hhsopdiv" id="cr047_hhsopdiv" class="form-control picklist " onchange="setIsDirty(this.id);"> <option selected="selected" value="" label="Select" aria-label="Select"></option> <option value="1928710000">ACF</option> <option value="1928710001">ACL</option> <option value="1928710002">AHRQ</option> <option value="1928710003">CMS</option> <option value="1928710004">HRSA</option> <option value="1928710005">IHS/Headquarters</option> <option value="1928710006">IHS/Alaska</option> <option value="1928710007">IHS/Albuquerque</option> <option value="1928710008">IHS/Bemidji</option> <option value="1928710009">IHS/Billings</option> <option value="1928710010">IHS/California</option> <option value="1928710011">IHS/Great Plains</option> <option value="1928710012">IHS/Nashville</option> <option value="1928710013">IHS/Navajo</option> <option value="1928710014">IHS/Oklahoma</option> <option value="1928710015">IHS/Phoenix</option> <option value="1928710016">IHS/Portland</option> <option value="1928710017">IHS/Tucson</option> <option value="1928710018">IOS</option> <option value="969400000">OS/ASFR</option> <option value="1928710019">OS/ASPE</option> <option value="1928710020">OS/ASPR</option> <option value="1928710021">OS/DAB</option> <option value="1928710022">OS/OASH</option> <option value="1928710023">OS/OCR</option> <option value="1928710024">OS/OGA</option> <option value="1928710025">OS/OGC</option> <option value="1928710026">OS/OIG</option> <option value="1928710027">OS/OMH</option> <option value="1928710028">OS/OMHA</option> <option value="1928710029">OS/ONC</option> <option value="1928710030">PSC</option> <option value="928710031">SAMHSA</option> </select></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell text form-control-cell"><div class="info required"><label for="cr047_firstname" id="cr047_firstname_label" class="field-label">First Name </label><div class="validators"><span id="RequiredFieldValidatorcr047_firstname" style="display:none;">*</span><span id="MaximumLengthValidatorcr047_firstname" style="visibility:hidden;">*</span></div></div><div class="control"><input name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_firstname" type="text" maxlength="100" id="cr047_firstname" class="text form-control " onchange="setIsDirty(this.id);" aria-required="true" title="First Name  is a required field." aria-label="First Name " onkeypress="javascript:return LengthError(this, event);" /></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell text form-control-cell"><div class="info required"><label for="cr047_lastname" id="cr047_lastname_label" class="field-label">Last Name</label><div class="validators"><span id="RequiredFieldValidatorcr047_lastname" style="display:none;">*</span><span id="MaximumLengthValidatorcr047_lastname" style="visibility:hidden;">*</span></div></div><div class="control"><input name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_lastname" type="text" maxlength="100" id="cr047_lastname" class="text form-control " onchange="setIsDirty(this.id);" aria-required="true" title="Last Name is a required field." aria-label="Last Name" onkeypress="javascript:return LengthError(this, event);" /></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell text form-control-cell"><div class="info required"><label for="cr047_email" id="cr047_email_label" class="field-label">Email</label><div class="validators"><span id="EmailFormatValidatorcr047_email" style="visibility:hidden;">*</span><span id="RequiredFieldValidatorcr047_email" style="display:none;">*</span><span id="MaximumLengthValidatorcr047_email" style="visibility:hidden;">*</span></div></div><div class="control"><input name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_email" maxlength="100" id="cr047_email" class="text form-control " type="email" ondblclick="launchEmail(this.value);" onchange="setIsDirty(this.id);" required="" onkeypress="javascript:return LengthError(this, event);" style="text-decoration:underline;" /></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell text form-control-cell"><div class="info"><label for="emailaddress" id="emailaddress_label" class="field-label">Confirm Email</label><div class="validators"><span id="EmailFormatValidatoremailaddress" style="visibility:hidden;">*</span><span id="MaximumLengthValidatoremailaddress" style="visibility:hidden;">*</span></div></div><div class="control"><input name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$emailaddress" maxlength="100" id="emailaddress" class="text form-control " type="email" ondblclick="launchEmail(this.value);" onchange="setIsDirty(this.id);" onkeypress="javascript:return LengthError(this, event);" style="text-decoration:underline;" /></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell text form-control-cell"><div class="info"><label for="cr047_phone" id="cr047_phone_label" class="field-label">Phone</label><div class="validators"><span id="MaximumLengthValidatorcr047_phone" style="visibility:hidden;">*</span></div></div><div class="control"><input name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_phone" type="text" maxlength="100" id="cr047_phone" class="text form-control " onchange="setIsDirty(this.id);" placeholder="Provide a telephone number" onkeypress="javascript:return LengthError(this, event);" /></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell textarea form-control-cell"><div class="info required"><label for="cr047_description" id="cr047_description_label" class="field-label">Request Description</label><div class="validators"><span id="RequiredFieldValidatorcr047_description" style="display:none;">*</span><span id="MaximumLengthValidatorcr047_description" style="visibility:hidden;">*</span></div></div><div class="control"><textarea name="ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$EntityFormControl_EntityFormView$cr047_description" rows="4" cols="20" maxlength="4000" id="cr047_description" class="textarea form-control " onchange="setIsDirty(this.id);" aria-required="true" aria-label="Request Description" title="Request Description is a required field." onkeydown="javascript:return LimitInput(this, event);" oninput="javascript:return LimitInput(this, event);" onpaste="javascript:return LimitPaste(this, event);"> </textarea></div></td> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td colspan="1" rowspan="1" class="clearfix cell"></td> <td class="cell zero-cell"></td> </tr> </table></fieldset></div></div><div class="tab-column" style="width:66%;"><div><fieldset aria-label="Notes"><table role="presentation" class="section"><colgroup></colgroup><tr> <td colspan="1" rowspan="15" class="clearfix cell"></td> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> </tr> <tr> <td class="cell zero-cell"></td> 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'Processing...';}};WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("ctl00$ctl00$ContentContainer$MainContent$EntityControls$EntityFormControl$InsertButton", "", true, "", "", false, true))" id="InsertButton" class="submit-btn btn btn-primary form-action-container-left" /></div> </div> </div> </div> <div class="page-metadata clearfix"> <div class="xrm-attribute xrm-editable-text"> <div class="xrm-attribute-value"><script> </script></div> </div> </div> <link href="https://gov.content.powerapps.us/resource/powerappsportal/dist/editor.bundle-a512fd8d1f.css" onerror="javascript: var target = event.target; var link = document.createElement('link'); link.crossOrigin = target.crossOrigin; link.href = '/dist/editor.bundle-a512fd8d1f.css'; link.rel = 'stylesheet'; target.insertAdjacentElement('afterend',link);" rel="stylesheet" /> <script onerror="javascript: var target = event.target; var script = document.createElement('script'); script.crossOrigin = target.crossOrigin; script.src = '/dist/editor.bundle-90ea956569.js'; script.type = 'text/javascript'; target.insertAdjacentElement('afterend',script);" src="https://gov.content.powerapps.us/resource/powerappsportal/dist/editor.bundle-90ea956569.js" type="text/javascript"></script> </div> <script type="text/javascript"> //<![CDATA[ var Page_ValidationSummaries = new Array(document.getElementById("ValidationSummaryEntityFormControl_EntityFormView")); var Page_Validators = new Array(document.getElementById("RequiredFieldValidatorcr047_typeofrequest"), document.getElementById("RequiredFieldValidatorcr047_customerdivision"), document.getElementById("RequiredFieldValidatorcr047_firstname"), document.getElementById("MaximumLengthValidatorcr047_firstname"), document.getElementById("RequiredFieldValidatorcr047_lastname"), document.getElementById("MaximumLengthValidatorcr047_lastname"), document.getElementById("EmailFormatValidatorcr047_email"), document.getElementById("RequiredFieldValidatorcr047_email"), document.getElementById("MaximumLengthValidatorcr047_email"), document.getElementById("EmailFormatValidatoremailaddress"), document.getElementById("MaximumLengthValidatoremailaddress"), document.getElementById("MaximumLengthValidatorcr047_phone"), document.getElementById("RequiredFieldValidatorcr047_description"), document.getElementById("MaximumLengthValidatorcr047_description"), document.getElementById("ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ctl00")); //]]> </script> <script type="text/javascript"> //<![CDATA[ var cr047_description = document.all ? document.all["cr047_description"] : document.getElementById("cr047_description"); cr047_description.exMaxLen = "4000"; var ValidationSummaryEntityFormControl_EntityFormView = document.all ? document.all["ValidationSummaryEntityFormControl_EntityFormView"] : document.getElementById("ValidationSummaryEntityFormControl_EntityFormView"); ValidationSummaryEntityFormControl_EntityFormView.headertext = "<h2 class=\'validation-header\'><span role=\'presentation\' class=\'fa fa-info-circle\'></span> The form could not be submitted for the following reasons:</h2>"; var RequiredFieldValidatorcr047_typeofrequest = document.all ? document.all["RequiredFieldValidatorcr047_typeofrequest"] : document.getElementById("RequiredFieldValidatorcr047_typeofrequest"); RequiredFieldValidatorcr047_typeofrequest.controltovalidate = "cr047_typeofrequest"; RequiredFieldValidatorcr047_typeofrequest.errormessage = "<a href=\'#cr047_typeofrequest_label\' onclick=\'javascript:scrollToAndFocus(\"cr047_typeofrequest_label\",\"cr047_typeofrequest\");return false;\' referenceControlId=cr047_typeofrequest>Type of request is a required field. </a>"; RequiredFieldValidatorcr047_typeofrequest.display = "Dynamic"; RequiredFieldValidatorcr047_typeofrequest.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; 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href=\'#cr047_firstname_label\' onclick=\'javascript:scrollToAndFocus(\"cr047_firstname_label\",\"cr047_firstname\");return false;\' referenceControlId=cr047_firstname>First Name exceeds the maximum length of 100 characters. </a>"; MaximumLengthValidatorcr047_firstname.evaluationfunction = "CustomValidatorEvaluateIsValid"; var RequiredFieldValidatorcr047_lastname = document.all ? document.all["RequiredFieldValidatorcr047_lastname"] : document.getElementById("RequiredFieldValidatorcr047_lastname"); RequiredFieldValidatorcr047_lastname.controltovalidate = "cr047_lastname"; RequiredFieldValidatorcr047_lastname.errormessage = "<a href=\'#cr047_lastname_label\' onclick=\'javascript:scrollToAndFocus(\"cr047_lastname_label\",\"cr047_lastname\");return false;\' referenceControlId=cr047_lastname>Last Name is a required field. </a>"; RequiredFieldValidatorcr047_lastname.display = "Dynamic"; RequiredFieldValidatorcr047_lastname.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; 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document.all["ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ctl00"] : document.getElementById("ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ctl00"); ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ctl00.errormessage = "<a href=\'#captcha\' onclick=\'javascript:scrollToAndFocusCapatch();return false;\'>Captcha is incorrect, please re-enter captcha.</a>"; ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ctl00.display = "None"; ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ctl00.evaluationfunction = "CustomValidatorEvaluateIsValid"; //]]> </script> <script type="text/javascript"> //<![CDATA[ function loadCaptchaToolTip() {setTimeout(function() 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document.getElementById('MaximumLengthValidatorcr047_lastname').dispose = function() { Array.remove(Page_Validators, document.getElementById('MaximumLengthValidatorcr047_lastname')); } document.getElementById('EmailFormatValidatorcr047_email').dispose = function() { Array.remove(Page_Validators, document.getElementById('EmailFormatValidatorcr047_email')); } document.getElementById('RequiredFieldValidatorcr047_email').dispose = function() { Array.remove(Page_Validators, document.getElementById('RequiredFieldValidatorcr047_email')); } document.getElementById('MaximumLengthValidatorcr047_email').dispose = function() { Array.remove(Page_Validators, document.getElementById('MaximumLengthValidatorcr047_email')); } document.getElementById('EmailFormatValidatoremailaddress').dispose = function() { Array.remove(Page_Validators, document.getElementById('EmailFormatValidatoremailaddress')); } document.getElementById('MaximumLengthValidatoremailaddress').dispose = function() { Array.remove(Page_Validators, document.getElementById('MaximumLengthValidatoremailaddress')); } document.getElementById('MaximumLengthValidatorcr047_phone').dispose = function() { Array.remove(Page_Validators, document.getElementById('MaximumLengthValidatorcr047_phone')); } document.getElementById('RequiredFieldValidatorcr047_description').dispose = function() { Array.remove(Page_Validators, document.getElementById('RequiredFieldValidatorcr047_description')); } document.getElementById('MaximumLengthValidatorcr047_description').dispose = function() { Array.remove(Page_Validators, document.getElementById('MaximumLengthValidatorcr047_description')); } document.getElementById('ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ctl00').dispose = function() { Array.remove(Page_Validators, document.getElementById('ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ctl00')); } Sys.Application.add_init(function() { $create(Telerik.Web.UI.RadCaptcha, {"_audioUrl":"/Telerik.Web.UI.WebResource.axd?type=cah\u0026isc=false\u0026guid=613b5b32-dda8-4c0f-8788-1a8e7c7a482c","_enableAudio":true,"_persistCode":false,"clientStateFieldID":"ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha_ClientState"}, {"load":radcaptcha.onClientLoad}, null, $get("ctl00_ctl00_ContentContainer_MainContent_EntityControls_EntityFormControl_EntityFormControl_EntityFormView_captcha")); }); //]]> </script> </form> <script onerror="javascript: var target = event.target; var script = document.createElement('script'); script.crossOrigin = target.crossOrigin; script.src = '/dist/pcf-loader.bundle-f4a0e619b8.js'; script.type = 'text/javascript'; 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