From f3510ef5efe139429f0154273b4b0168a25d0487 Mon Sep 17 00:00:00 2001
From: Jason Kulatunga <jason@thesparktree.com>
Date: Fri, 19 Jul 2024 21:10:23 -0700
Subject: [PATCH] update form.

---
 dev/index.html  | 83 +------------------------------------------------
 prod/index.html | 75 +-------------------------------------------
 2 files changed, 2 insertions(+), 156 deletions(-)

diff --git a/dev/index.html b/dev/index.html
index f347f3a..64fd22f 100644
--- a/dev/index.html
+++ b/dev/index.html
@@ -110,70 +110,7 @@ <h1 id="header_53" class="form-header" data-component="header">New Patient Regis
               <span class="form-sub-label-container" style="vertical-align:top">
 								<select name="q56_birthDate[year]" id="input_56_year" class="form-dropdown" data-component="birthdate-year" aria-labelledby="label_56 sublabel_56_year">
 									<option value="">Please select a year</option>
-									<option value="2024">2024</option>
-									<option value="2023">2023</option>
-									<option value="2022">2022</option>
-									<option value="2021">2021</option>
-									<option value="2020">2020</option>
-									<option value="2019">2019</option>
-									<option value="2018">2018</option>
-									<option value="2017">2017</option>
-									<option value="2016">2016</option>
-									<option value="2015">2015</option>
-									<option value="2014">2014</option>
-									<option value="2013">2013</option>
-									<option value="2012">2012</option>
-									<option value="2011">2011</option>
-									<option value="2010">2010</option>
-									<option value="2009">2009</option>
-									<option value="2008">2008</option>
-									<option value="2007">2007</option>
-									<option value="2006">2006</option>
-									<option value="2005">2005</option>
-									<option value="2004">2004</option>
-									<option value="2003">2003</option>
-									<option value="2002">2002</option>
-									<option value="2001">2001</option>
-									<option value="2000">2000</option>
-									<option value="1999">1999</option>
-									<option value="1998">1998</option>
-									<option value="1997">1997</option>
-									<option value="1996">1996</option>
-									<option value="1995">1995</option>
-									<option value="1994">1994</option>
-									<option value="1993">1993</option>
-									<option value="1992">1992</option>
-									<option value="1991">1991</option>
-									<option value="1990">1990</option>
-									<option value="1989">1989</option>
-									<option value="1988">1988</option>
-									<option value="1987">1987</option>
-									<option value="1986">1986</option>
-									<option value="1985">1985</option>
 									<option value="1984">1984</option>
-									<option value="1983">1983</option>
-									<option value="1982">1982</option>
-									<option value="1981">1981</option>
-									<option value="1980">1980</option>
-									<option value="1979">1979</option>
-									<option value="1978">1978</option>
-									<option value="1977">1977</option>
-									<option value="1976">1976</option>
-									<option value="1975">1975</option>
-									<option value="1974">1974</option>
-									<option value="1973">1973</option>
-									<option value="1972">1972</option>
-									<option value="1971">1971</option>
-									<option value="1970">1970</option>
-									<option value="1969">1969</option>
-									<option value="1968">1968</option>
-									<option value="1967">1967</option>
-									<option value="1966">1966</option>
-									<option value="1965">1965</option>
-									<option value="1964">1964</option>
-									<option value="1963">1963</option>
-									<option value="1962">1962</option>
-									<option value="1961">1961</option>
 									<option value="1960">1960</option>
 									<option value="1959">1959</option>
 									<option value="1958">1958</option>
@@ -233,18 +170,6 @@ <h1 id="header_53" class="form-header" data-component="header">New Patient Regis
             <input type="text" id="input_14" name="q14_homePhone" data-type="input-textbox" class="form-textbox" data-defaultvalue="" style="width:310px" size="310" data-component="textbox" aria-labelledby="label_14" value="" />
           </div>
         </li>
-        <li class="form-line" data-type="control_dropdown" id="id_16">
-          <label class="form-label form-label-left form-label-auto" id="label_16" for="input_16" aria-hidden="false"> Preferred Method of Contact </label>
-          <div id="cid_16" class="form-input" data-layout="half">
-            <select class="form-dropdown" id="input_16" name="q16_preferredMethod" style="width:310px" data-component="dropdown" aria-label="Preferred Method of Contact">
-              <option value="">Please Select</option>
-              <option value="Mail">Mail</option>
-              <option value="Cell Phone">Cell Phone</option>
-              <option value="Work Phone">Work Phone</option>
-              <option value="Home Phone">Home Phone</option>
-            </select>
-          </div>
-        </li>
         <li class="form-line" data-type="control_textbox" id="id_17">
           <label class="form-label form-label-left form-label-auto" id="label_17" for="input_17" aria-hidden="false"> Driver's License </label>
           <div id="cid_17" class="form-input" data-layout="half">
@@ -290,15 +215,9 @@ <h1 id="header_53" class="form-header" data-component="header">New Patient Regis
             <input type="text" id="input_28" name="q28_currentEmployer" data-type="input-textbox" class="form-textbox" data-defaultvalue="" style="width:310px" size="310" data-component="textbox" aria-labelledby="label_28" value="" />
           </div>
         </li>
-        <li class="form-line" data-type="control_textbox" id="id_30">
-          <label class="form-label form-label-left form-label-auto" id="label_30" for="input_30" aria-hidden="false"> Primary Care Provider </label>
-          <div id="cid_30" class="form-input" data-layout="half">
-            <input type="text" id="input_30" name="q30_primaryCare" data-type="input-textbox" class="form-textbox" data-defaultvalue="" style="width:310px" size="310" data-component="textbox" aria-labelledby="label_30" value="" />
-          </div>
-        </li>
 
 		  <li class="form-line" data-type="control_textbox" id="id_31">
-			  <label class="form-label form-label-left form-label-auto" id="label_31" for="input_30" aria-hidden="false"> Attach Medical Records</label>
+			  <label class="form-label form-label-left form-label-auto" id="label_31" aria-hidden="false"> Attach Medical Records</label>
 			  <fasten-stitch public-id="public_test_rei2un7aagh5pquwikxh2dsyq23bsdyu4l8vm9eq29ftu" external-id="user-opaque-id-1231241"></fasten-stitch>
 		  </li>
         <li class="form-line" data-type="control_button" id="id_52">
diff --git a/prod/index.html b/prod/index.html
index 8566cd2..6f40ad4 100644
--- a/prod/index.html
+++ b/prod/index.html
@@ -110,61 +110,6 @@ <h1 id="header_53" class="form-header" data-component="header">New Patient Regis
               <span class="form-sub-label-container" style="vertical-align:top">
 								<select name="q56_birthDate[year]" id="input_56_year" class="form-dropdown" data-component="birthdate-year" aria-labelledby="label_56 sublabel_56_year">
 									<option value="">Please select a year</option>
-									<option value="2024">2024</option>
-									<option value="2023">2023</option>
-									<option value="2022">2022</option>
-									<option value="2021">2021</option>
-									<option value="2020">2020</option>
-									<option value="2019">2019</option>
-									<option value="2018">2018</option>
-									<option value="2017">2017</option>
-									<option value="2016">2016</option>
-									<option value="2015">2015</option>
-									<option value="2014">2014</option>
-									<option value="2013">2013</option>
-									<option value="2012">2012</option>
-									<option value="2011">2011</option>
-									<option value="2010">2010</option>
-									<option value="2009">2009</option>
-									<option value="2008">2008</option>
-									<option value="2007">2007</option>
-									<option value="2006">2006</option>
-									<option value="2005">2005</option>
-									<option value="2004">2004</option>
-									<option value="2003">2003</option>
-									<option value="2002">2002</option>
-									<option value="2001">2001</option>
-									<option value="2000">2000</option>
-									<option value="1999">1999</option>
-									<option value="1998">1998</option>
-									<option value="1997">1997</option>
-									<option value="1996">1996</option>
-									<option value="1995">1995</option>
-									<option value="1994">1994</option>
-									<option value="1993">1993</option>
-									<option value="1992">1992</option>
-									<option value="1991">1991</option>
-									<option value="1990">1990</option>
-									<option value="1989">1989</option>
-									<option value="1988">1988</option>
-									<option value="1987">1987</option>
-									<option value="1986">1986</option>
-									<option value="1985">1985</option>
-									<option value="1984">1984</option>
-									<option value="1983">1983</option>
-									<option value="1982">1982</option>
-									<option value="1981">1981</option>
-									<option value="1980">1980</option>
-									<option value="1979">1979</option>
-									<option value="1978">1978</option>
-									<option value="1977">1977</option>
-									<option value="1976">1976</option>
-									<option value="1975">1975</option>
-									<option value="1974">1974</option>
-									<option value="1973">1973</option>
-									<option value="1972">1972</option>
-									<option value="1971">1971</option>
-									<option value="1970">1970</option>
 									<option value="1969">1969</option>
 									<option value="1968">1968</option>
 									<option value="1967">1967</option>
@@ -233,18 +178,6 @@ <h1 id="header_53" class="form-header" data-component="header">New Patient Regis
             <input type="text" id="input_14" name="q14_homePhone" data-type="input-textbox" class="form-textbox" data-defaultvalue="" style="width:310px" size="310" data-component="textbox" aria-labelledby="label_14" value="" />
           </div>
         </li>
-        <li class="form-line" data-type="control_dropdown" id="id_16">
-          <label class="form-label form-label-left form-label-auto" id="label_16" for="input_16" aria-hidden="false"> Preferred Method of Contact </label>
-          <div id="cid_16" class="form-input" data-layout="half">
-            <select class="form-dropdown" id="input_16" name="q16_preferredMethod" style="width:310px" data-component="dropdown" aria-label="Preferred Method of Contact">
-              <option value="">Please Select</option>
-              <option value="Mail">Mail</option>
-              <option value="Cell Phone">Cell Phone</option>
-              <option value="Work Phone">Work Phone</option>
-              <option value="Home Phone">Home Phone</option>
-            </select>
-          </div>
-        </li>
         <li class="form-line" data-type="control_textbox" id="id_17">
           <label class="form-label form-label-left form-label-auto" id="label_17" for="input_17" aria-hidden="false"> Driver's License </label>
           <div id="cid_17" class="form-input" data-layout="half">
@@ -290,15 +223,9 @@ <h1 id="header_53" class="form-header" data-component="header">New Patient Regis
             <input type="text" id="input_28" name="q28_currentEmployer" data-type="input-textbox" class="form-textbox" data-defaultvalue="" style="width:310px" size="310" data-component="textbox" aria-labelledby="label_28" value="" />
           </div>
         </li>
-        <li class="form-line" data-type="control_textbox" id="id_30">
-          <label class="form-label form-label-left form-label-auto" id="label_30" for="input_30" aria-hidden="false"> Primary Care Provider </label>
-          <div id="cid_30" class="form-input" data-layout="half">
-            <input type="text" id="input_30" name="q30_primaryCare" data-type="input-textbox" class="form-textbox" data-defaultvalue="" style="width:310px" size="310" data-component="textbox" aria-labelledby="label_30" value="" />
-          </div>
-        </li>
 
 		  <li class="form-line" data-type="control_textbox" id="id_31">
-			  <label class="form-label form-label-left form-label-auto" id="label_31" for="input_30" aria-hidden="false"> Attach Medical Records</label>
+			  <label class="form-label form-label-left form-label-auto" id="label_31" aria-hidden="false"> Attach Medical Records</label>
 			  <fasten-stitch public-id="public_test_6f5j7qj54rlyajv6u8r36z0iu5v9qjf87f77tzl3k6ezu" external-id="user-opaque-id-8923472"></fasten-stitch>
 		  </li>
         <li class="form-line" data-type="control_button" id="id_52">