Class: PdfFill::Forms::Va1010cg

Inherits:
FormBase
  • Object
show all
Defined in:
lib/pdf_fill/forms/va1010cg.rb

Constant Summary collapse

PDF_INPUT_LOCATIONS = 
OpenStruct.new(
  veteran: {
    name: {
      last: 'form1[0].#subform[15].LastName[0]',
      first: 'form1[0].#subform[15].FirstName[0]',
      middle: 'form1[0].#subform[15].MiddleName[0]',
      suffix: 'form1[0].#subform[15].Suffix[0]'
    },
    ssn: 'form1[0].#subform[15].SSN_TaxID[0]',
    dob: 'form1[0].#subform[15].DateOfBirth[0]',
    gender: 'form1[0].#subform[15].RadioButtonList[0]', # "2" | "3" | "Off"
    address: {
      street: 'form1[0].#subform[15].StreetAddress[0]',
      city: 'form1[0].#subform[15].City[0]',
      county: 'form1[0].#subform[15].County[0]',
      state: 'form1[0].#subform[15].State[0]',
      zip: 'form1[0].#subform[15].Zip[0]'
    },
    primary_phone: 'form1[0].#subform[15].PrimaryPhone[0]',
    alternative_phone: 'form1[0].#subform[15].AltPhone[0]',
    email: 'form1[0].#subform[15].Email[0]',
    planned_clinic: 'form1[0].#subform[15].NameVAMedicalCenter[0]',
    signature: {
      name: 'form1[0].#subform[15].Signature[0]',
      date: 'form1[0].#subform[15].DateSigned[0]'
    }
  },
  primaryCaregiver: {
    name: {
      last: 'form1[0].#subform[16].LastName[1]',
      first: 'form1[0].#subform[16].FirstName[1]',
      middle: 'form1[0].#subform[16].MiddleName[1]',
      suffix: 'form1[0].#subform[16].Suffix[1]'
    },
    ssn: 'form1[0].#subform[16].SSN_TaxID[1]',
    dob: 'form1[0].#subform[16].DateOfBirth[1]',
    gender: 'form1[0].#subform[16].RadioButtonList[1]', # "2" | "3" | "Off"
    address: {
      street: 'form1[0].#subform[16].StreetAddress[1]',
      city: 'form1[0].#subform[16].City[1]',
      county: 'form1[0].#subform[16].County[1]',
      state: 'form1[0].#subform[16].State[1]',
      zip: 'form1[0].#subform[16].Zip[1]'
    },
    mailingAddress: {
      street: 'form1[0].#subform[16].MailingStreetAddress[0]',
      city: 'form1[0].#subform[16].City[2]',
      county: 'form1[0].#subform[16].County[2]',
      state: 'form1[0].#subform[16].State[2]',
      zip: 'form1[0].#subform[16].Zip[2]'
    },
    primary_phone: 'form1[0].#subform[16].PrimaryPhone[1]',
    alternative_phone: 'form1[0].#subform[16].AltPhone[1]',
    email: 'form1[0].#subform[16].Email[1]',
    vet_relationship: 'form1[0].#subform[16].Relationship[0]',
    signature: {
      name: 'form1[0].#subform[16].Signature[1]',
      date: 'form1[0].#subform[16].DateSigned[1]'
    }
  },
  secondaryCaregiverOne: {
    name: {
      last: 'form1[0].#subform[17].LastName[2]',
      first: 'form1[0].#subform[17].FirstName[2]',
      middle: 'form1[0].#subform[17].MiddleName[2]',
      suffix: 'form1[0].#subform[17].Suffix[2]'
    },
    ssn: 'form1[0].#subform[17].SSN_TaxID[2]',
    dob: 'form1[0].#subform[17].DateOfBirth[2]',
    gender: 'form1[0].#subform[17].RadioButtonList[2]', # "2" | "3" | "Off"
    address: {
      street: 'form1[0].#subform[17].StreetAddress[2]',
      city: 'form1[0].#subform[17].City[3]',
      county: 'form1[0].#subform[17].County[3]',
      state: 'form1[0].#subform[17].State[3]',
      zip: 'form1[0].#subform[17].Zip[3]'
    },
    mailingAddress: {
      street: 'form1[0].#subform[17].MailingStreetAddress[1]',
      city: 'form1[0].#subform[17].City[4]',
      county: 'form1[0].#subform[17].County[4]',
      state: 'form1[0].#subform[17].State[4]',
      zip: 'form1[0].#subform[17].Zip[4]'
    },
    primary_phone: 'form1[0].#subform[17].PrimaryPhone[2]',
    alternative_phone: 'form1[0].#subform[17].AltPhone[2]',
    email: 'form1[0].#subform[17].Email[2]',
    vet_relationship: 'form1[0].#subform[17].Relationship[1]',
    signature: {
      name: 'form1[0].#subform[17].Signature[2]',
      date: 'form1[0].#subform[17].DateSigned[2]'
    }
  },
  secondaryCaregiverTwo: {
    name: {
      last: 'form1[0].#subform[18].LastName[3]',
      first: 'form1[0].#subform[18].FirstName[3]',
      middle: 'form1[0].#subform[18].MiddleName[3]',
      suffix: 'form1[0].#subform[18].Suffix[3]'
    },
    ssn: 'form1[0].#subform[18].SSN_TaxID[3]',
    dob: 'form1[0].#subform[18].DateOfBirth[3]',
    gender: 'form1[0].#subform[18].RadioButtonList[3]', # "2" | "3" | "Off"
    address: {
      street: 'form1[0].#subform[18].StreetAddress[3]',
      city: 'form1[0].#subform[18].City[5]',
      county: 'form1[0].#subform[18].County[5]',
      state: 'form1[0].#subform[18].State[5]',
      zip: 'form1[0].#subform[18].Zip[5]'
    },
    mailingAddress: {
      street: 'form1[0].#subform[18].MailingStreetAddress[2]',
      city: 'form1[0].#subform[18].City[6]',
      county: 'form1[0].#subform[18].County[6]',
      state: 'form1[0].#subform[18].State[6]',
      zip: 'form1[0].#subform[18].Zip[6]'
    },
    primary_phone: 'form1[0].#subform[18].PrimaryPhone[3]',
    alternative_phone: 'form1[0].#subform[18].AltPhone[3]',
    email: 'form1[0].#subform[18].Email[3]',
    vet_relationship: 'form1[0].#subform[18].Relationship[2]',
    signature: {
      name: 'form1[0].#subform[18].Signature[3]',
      date: 'form1[0].#subform[18].DateSigned[3]'
    }
  }
)
KEY = 
{
  # Formatted fields
  'helpers' => {
    'veteran' => {
      'address' => {
        'street' => {
          key: PDF_INPUT_LOCATIONS.veteran[:address][:street],
          limit: 80,
          question_num: 108,
          question_text: 'VETERAN/SERVICEMEMBER > Address > Street'
        }
      },
      'gender' => {
        key: PDF_INPUT_LOCATIONS.veteran[:gender]
      },
      'signature' => {
        'name' => {
          key: PDF_INPUT_LOCATIONS.veteran[:signature][:name]
        },
        'date' => {
          key: PDF_INPUT_LOCATIONS.veteran[:signature][:date],
          format: 'date'
        }
      },
      'plannedClinic' => {
        key: PDF_INPUT_LOCATIONS.veteran[:planned_clinic]
      }
    },
    'primaryCaregiver' => {
      'address' => {
        'street' => {
          key: PDF_INPUT_LOCATIONS.primaryCaregiver[:address][:street],
          limit: 80,
          question_num: 208,
          question_text: 'PRIMARY FAMILY CAREGIVER > Address > Street'
        }
      },
      'mailingAddress' => {
        'street' => {
          key: PDF_INPUT_LOCATIONS.primaryCaregiver[:mailingAddress][:street],
          limit: 80,
          question_num: 213,
          question_text: 'PRIMARY FAMILY CAREGIVER > Mailing Address > Street'
        }
      },
      'gender' => {
        key: PDF_INPUT_LOCATIONS.primaryCaregiver[:gender]
      },
      'signature' => {
        'name' => {
          key: PDF_INPUT_LOCATIONS.primaryCaregiver[:signature][:name]
        },
        'date' => {
          key: PDF_INPUT_LOCATIONS.primaryCaregiver[:signature][:date],
          format: 'date'
        }
      }
    },
    'secondaryCaregiverOne' => {
      'address' => {
        'street' => {
          key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:address][:street],
          limit: 80,
          question_num: 308,
          question_text: 'SECONDARY FAMILY CAREGIVER (1) > Address > Street'
        }
      },
      'mailingAddress' => {
        'street' => {
          key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:mailingAddress][:street],
          limit: 80,
          question_num: 213,
          question_text: 'SECONDARY FAMILY CAREGIVER (1) > Mailing Address > Street'
        }
      },
      'gender' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:gender]
      },
      'signature' => {
        'name' => {
          key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:signature][:name]
        },
        'date' => {
          key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:signature][:date],
          format: 'date'
        }
      }
    },
    'secondaryCaregiverTwo' => {
      'address' => {
        'street' => {
          key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:address][:street],
          limit: 80,
          question_num: 408,
          question_text: 'SECONDARY FAMILY CAREGIVER (2) > Address > Street'
        }
      },
      'mailingAddress' => {
        'street' => {
          key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:mailingAddress][:street],
          limit: 80,
          question_num: 413,
          question_text: 'SECONDARY FAMILY CAREGIVER (2) > Mailing Address > Street'
        }
      },
      'gender' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:gender]
      },
      'signature' => {
        'name' => {
          key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:signature][:name]
        },
        'date' => {
          key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:signature][:date],
          format: 'date'
        }
      }
    }
  },
  # Direct input
  'veteran' => {
    'fullName' => {
      'last' => {
        key: PDF_INPUT_LOCATIONS.veteran[:name][:last],
        limit: 29,
        question_num: 101,
        question_text: 'VETERAN/SERVICEMEMBER > Last Name'
      },
      'first' => {
        key: PDF_INPUT_LOCATIONS.veteran[:name][:first],
        limit: 29,
        question_num: 102,
        question_text: 'VETERAN/SERVICEMEMBER > First Name'
      },
      'middle' => {
        key: PDF_INPUT_LOCATIONS.veteran[:name][:middle],
        limit: 29,
        question_num: 103,
        question_text: 'VETERAN/SERVICEMEMBER > Middle Name'
      },
      'suffix' => {
        key: PDF_INPUT_LOCATIONS.veteran[:name][:suffix]
      }
    },
    'ssnOrTin' => {
      key: PDF_INPUT_LOCATIONS.veteran[:ssn]
    },
    'dateOfBirth' => {
      key: PDF_INPUT_LOCATIONS.veteran[:dob],
      format: 'date'
    },
    'address' => {
      'city' => {
        key: PDF_INPUT_LOCATIONS.veteran[:address][:city],
        limit: 29,
        question_num: 109,
        question_text: 'VETERAN/SERVICEMEMBER > Address > City'
      },
      'county' => {
        key: PDF_INPUT_LOCATIONS.veteran[:address][:county],
        limit: 29,
        question_num: 110,
        question_text: 'VETERAN/SERVICEMEMBER > Address > County'
      },
      'state' => {
        key: PDF_INPUT_LOCATIONS.veteran[:address][:state],
        limit: 29,
        question_num: 111,
        question_text: 'VETERAN/SERVICEMEMBER > Address > State'
      },
      'postalCode' => {
        key: PDF_INPUT_LOCATIONS.veteran[:address][:zip],
        limit: 29,
        question_num: 112,
        question_text: 'VETERAN/SERVICEMEMBER > Address > Zip Code'
      }
    },
    'primaryPhoneNumber' => {
      key: PDF_INPUT_LOCATIONS.veteran[:primary_phone]
    },
    'alternativePhoneNumber' => {
      key: PDF_INPUT_LOCATIONS.veteran[:alternative_phone]
    },
    'email' => {
      key: PDF_INPUT_LOCATIONS.veteran[:email],
      limit: 79,
      question_num: 115,
      question_text: 'VETERAN/SERVICEMEMBER > Email'
    }
  },
  'primaryCaregiver' => {
    'fullName' => {
      'last' => {
        key: PDF_INPUT_LOCATIONS.primaryCaregiver[:name][:last],
        limit: 29,
        question_num: 201,
        question_text: 'PRIMARY FAMILY CAREGIVER > Last Name'
      },
      'first' => {
        key: PDF_INPUT_LOCATIONS.primaryCaregiver[:name][:first],
        limit: 29,
        question_num: 202,
        question_text: 'PRIMARY FAMILY CAREGIVER > First Name'
      },
      'middle' => {
        key: PDF_INPUT_LOCATIONS.primaryCaregiver[:name][:middle],
        limit: 29,
        question_num: 203,
        question_text: 'PRIMARY FAMILY CAREGIVER > Middle Name'
      },
      'suffix' => {
        key: PDF_INPUT_LOCATIONS.primaryCaregiver[:name][:suffix]
      }
    },
    'ssnOrTin' => {
      key: PDF_INPUT_LOCATIONS.primaryCaregiver[:ssn]
    },
    'dateOfBirth' => {
      key: PDF_INPUT_LOCATIONS.primaryCaregiver[:dob],
      format: 'date'
    },
    'address' => {
      'city' => {
        key: PDF_INPUT_LOCATIONS.primaryCaregiver[:address][:city],
        limit: 29,
        question_num: 209,
        question_text: 'PRIMARY FAMILY CAREGIVER > Address > City'
      },
      'county' => {
        key: PDF_INPUT_LOCATIONS.primaryCaregiver[:address][:county],
        limit: 210,
        question_text: 'PRIMARY FAMILY CAREGIVER > Address > County'
      },
      'state' => {
        key: PDF_INPUT_LOCATIONS.primaryCaregiver[:address][:state],
        limit: 29,
        question_num: 211,
        question_text: 'PRIMARY FAMILY CAREGIVER > Address > State'
      },
      'postalCode' => {
        key: PDF_INPUT_LOCATIONS.primaryCaregiver[:address][:zip],
        limit: 29,
        question_num: 212,
        question_text: 'PRIMARY FAMILY CAREGIVER > Address > Zip Code'
      }
    },
    'mailingAddress' => {
      'city' => {
        key: PDF_INPUT_LOCATIONS.primaryCaregiver[:mailingAddress][:city],
        limit: 29,
        question_num: 214,
        question_text: 'PRIMARY FAMILY CAREGIVER > Mailing Address > City'
      },
      'county' => {
        key: PDF_INPUT_LOCATIONS.primaryCaregiver[:mailingAddress][:county],
        limit: 29,
        question_num: 215,
        question_text: 'PRIMARY FAMILY CAREGIVER > Mailing Address > County'
      },
      'state' => {
        key: PDF_INPUT_LOCATIONS.primaryCaregiver[:mailingAddress][:state],
        limit: 29,
        question_num: 216,
        question_text: 'PRIMARY FAMILY CAREGIVER > Mailing Address > State'
      },
      'postalCode' => {
        key: PDF_INPUT_LOCATIONS.primaryCaregiver[:mailingAddress][:zip],
        limit: 29,
        question_num: 217,
        question_text: 'PRIMARY FAMILY CAREGIVER > Mailing Address > Zip Code'
      }
    },
    'primaryPhoneNumber' => {
      key: PDF_INPUT_LOCATIONS.primaryCaregiver[:primary_phone]
    },
    'alternativePhoneNumber' => {
      key: PDF_INPUT_LOCATIONS.primaryCaregiver[:alternative_phone]
    },
    'email' => {
      key: PDF_INPUT_LOCATIONS.primaryCaregiver[:email],
      limit: 45,
      question_num: 220,
      question_text: 'PRIMARY FAMILY CAREGIVER > Email'
    },
    'vetRelationship' => {
      key: PDF_INPUT_LOCATIONS.primaryCaregiver[:vet_relationship]
    }
  },
  'secondaryCaregiverOne' => {
    'fullName' => {
      'last' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:name][:last],
        limit: 29,
        question_num: 301,
        question_text: 'SECONDARY FAMILY CAREGIVER (1) > Last Name'
      },
      'first' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:name][:first],
        limit: 29,
        question_num: 302,
        question_text: 'SECONDARY FAMILY CAREGIVER (1) > First Name'
      },
      'middle' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:name][:middle],
        limit: 29,
        question_num: 303,
        question_text: 'SECONDARY FAMILY CAREGIVER (1) > Middle Name'
      },
      'suffix' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:name][:suffix],
        question_text: 'SECONDARY FAMILY CAREGIVER (1) > Suffix'
      }
    },
    'ssnOrTin' => {
      key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:ssn]
    },
    'dateOfBirth' => {
      key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:dob],
      format: 'date'
    },
    'address' => {
      'city' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:address][:city],
        limit: 29,
        question_num: 309,
        question_text: 'SECONDARY FAMILY CAREGIVER (1) > Address > City'
      },
      'county' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:address][:county],
        limit: 29,
        question_num: 310,
        question_text: 'SECONDARY FAMILY CAREGIVER (1) > Address > County'
      },
      'state' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:address][:state],
        limit: 29,
        question_num: 311,
        question_text: 'SECONDARY FAMILY CAREGIVER (1) > Address > State'
      },
      'postalCode' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:address][:zip],
        limit: 29,
        question_num: 312,
        question_text: 'SECONDARY FAMILY CAREGIVER (1) > Address > Zip Code'
      }
    },
    'mailingAddress' => {
      'city' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:mailingAddress][:city],
        limit: 29,
        question_num: 314,
        question_text: 'SECONDARY FAMILY CAREGIVER (1) > Mailing Address > City'
      },
      'county' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:mailingAddress][:county],
        limit: 29,
        question_num: 315,
        question_text: 'SECONDARY FAMILY CAREGIVER (1) > Mailing Address > County'
      },
      'state' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:mailingAddress][:state],
        limit: 29,
        question_num: 316,
        question_text: 'SECONDARY FAMILY CAREGIVER (1) > Mailing Address > State'
      },
      'postalCode' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:mailingAddress][:zip],
        limit: 29,
        question_num: 317,
        question_text: 'SECONDARY FAMILY CAREGIVER (1) > Mailing Address > Zip Code'
      }
    },
    'primaryPhoneNumber' => {
      key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:primary_phone]
    },
    'alternativePhoneNumber' => {
      key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:alternative_phone]
    },
    'email' => {
      key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:email],
      limit: 45,
      question_num: 320,
      question_text: 'SECONDARY FAMILY CAREGIVER (1) > Email'
    },
    'vetRelationship' => {
      key: PDF_INPUT_LOCATIONS.secondaryCaregiverOne[:vet_relationship]
    }
  },
  'secondaryCaregiverTwo' => {
    'fullName' => {
      'last' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:name][:last],
        limit: 29,
        question_num: 401,
        question_text: 'SECONDARY FAMILY CAREGIVER (2) > Last Name'
      },
      'first' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:name][:first],
        limit: 29,
        question_num: 402,
        question_text: 'SECONDARY FAMILY CAREGIVER (2) > First Name'
      },
      'middle' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:name][:middle],
        limit: 29,
        question_num: 403,
        question_text: 'SECONDARY FAMILY CAREGIVER (2) > Middle Name'
      },
      'suffix' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:name][:suffix],
        question_text: 'SECONDARY FAMILY CAREGIVER (2) > Suffix'
      }
    },
    'ssnOrTin' => {
      key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:ssn]
    },
    'dateOfBirth' => {
      key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:dob],
      format: 'date'
    },
    'address' => {
      'city' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:address][:city],
        limit: 29,
        question_num: 409,
        question_text: 'SECONDARY FAMILY CAREGIVER (2) > Address > City'
      },
      'county' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:address][:county],
        limit: 29,
        question_num: 410,
        question_text: 'SECONDARY FAMILY CAREGIVER (2) > Address > County'
      },
      'state' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:address][:state],
        limit: 29,
        question_num: 411,
        question_text: 'SECONDARY FAMILY CAREGIVER (2) > Address > State'
      },
      'postalCode' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:address][:zip],
        limit: 29,
        question_num: 412,
        question_text: 'SECONDARY FAMILY CAREGIVER (2) > Address > Zip'
      }
    },
    'mailingAddress' => {
      'city' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:mailingAddress][:city],
        limit: 29,
        question_num: 414,
        question_text: 'SECONDARY FAMILY CAREGIVER (2) > Mailing Address > City'
      },
      'county' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:mailingAddress][:county],
        limit: 29,
        question_num: 415,
        question_text: 'SECONDARY FAMILY CAREGIVER (2) > Mailing Address > County'
      },
      'state' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:mailingAddress][:state],
        limit: 29,
        question_num: 416,
        question_text: 'SECONDARY FAMILY CAREGIVER (2) > Mailing Address > State'
      },
      'postalCode' => {
        key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:mailingAddress][:zip],
        limit: 29,
        question_num: 417,
        question_text: 'SECONDARY FAMILY CAREGIVER (2) > Mailing Address > Zip Code'
      }
    },
    'primaryPhoneNumber' => {
      key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:primary_phone]
    },
    'alternativePhoneNumber' => {
      key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:alternative_phone]
    },
    'email' => {
      key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:email],
      limit: 45,
      question_num: 420,
      question_text: 'SECONDARY FAMILY CAREGIVER (2) > Email'
    },
    'vetRelationship' => {
      key: PDF_INPUT_LOCATIONS.secondaryCaregiverTwo[:vet_relationship]
    }
  }
}.freeze

Instance Attribute Summary

Attributes inherited from FormBase

#form_data

Instance Method Summary collapse

Methods inherited from FormBase

#combine_both_addr, #combine_full_address, #combine_full_address_extras, #combine_full_name, #combine_hash, #combine_name_addr, #combine_name_addr_extras, #combine_postal_code, #combine_previous_names, date_strftime, #expand_checkbox, #expand_date_range, #expand_signature, #initialize

Constructor Details

This class inherits a constructor from PdfFill::Forms::FormBase

Instance Method Details

#generate_signiture_timestamp ⇒ Object (private) 



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# File 'lib/pdf_fill/forms/va1010cg.rb', line 704

def generate_signiture_timestamp
  Time.now.in_time_zone('Eastern Time (US & Canada)').strftime('%m/%d/%Y %l:%M%P %Z')
end

#merge_address_helpers ⇒ Object (private) 



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# File 'lib/pdf_fill/forms/va1010cg.rb', line 647

def merge_address_helpers
  subjects.each do |subject|
    @form_data['helpers'][subject]['address'] = {
      'street' => combine_hash(@form_data.dig(subject, 'address'), %w[street street2])
    }
  end
end

#merge_fields(options = {}) ⇒ Object 



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# File 'lib/pdf_fill/forms/va1010cg.rb', line 628

def merge_fields(options = {})
  @form_data['helpers'] = {
    'veteran' => {},
    'primaryCaregiver' => {},
    'secondaryCaregiverOne' => {},
    'secondaryCaregiverTwo' => {}
  }

  merge_address_helpers
  merge_mailing_address_helpers
  merge_sex_helpers
  merge_signature_helpers if options[:sign]
  merge_planned_facility_label_helper

  @form_data
end

#merge_mailing_address_helpers ⇒ Object (private) 



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# File 'lib/pdf_fill/forms/va1010cg.rb', line 655

def merge_mailing_address_helpers
  %w[primaryCaregiver secondaryCaregiverOne secondaryCaregiverTwo].each do |subject|
    @form_data['helpers'][subject]['mailingAddress'] = {
      'street' => combine_hash(@form_data.dig(subject, 'mailingAddress'), %w[street street2])
    }
  end
end

#merge_planned_facility_label_helper ⇒ Object (private) 



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# File 'lib/pdf_fill/forms/va1010cg.rb', line 696

def merge_planned_facility_label_helper
  target_facility_code = @form_data.dig 'veteran', 'plannedClinic'
  caregiver_facilities = VetsJsonSchema::CONSTANTS['caregiverProgramFacilities'].values.flatten
  selected_facility = caregiver_facilities.find { |facility| facility['code'] == target_facility_code }
  display_value = selected_facility.nil? ? nil : "#{selected_facility['code']} - #{selected_facility['label']}"
  @form_data['helpers']['veteran']['plannedClinic'] = display_value
end

#merge_sex_helpers ⇒ Object (private) 



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# File 'lib/pdf_fill/forms/va1010cg.rb', line 663

def merge_sex_helpers
  subjects.each do |subject|
    @form_data['helpers'][subject]['gender'] = case @form_data.dig(subject, 'gender')
                                               when 'M'
                                                 '2'
                                               when 'F'
                                                 '3'
                                               else
                                                 'Off'
                                               end
  end
end

#merge_signature_helpers ⇒ Object (private) 



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# File 'lib/pdf_fill/forms/va1010cg.rb', line 676

def merge_signature_helpers
  timestamp = generate_signiture_timestamp

  subjects.each do |subject|
    user_provided_signature = @form_data.dig(subject, 'signature')
    signature = user_provided_signature || combine_full_name(@form_data.dig(subject, 'fullName'))

    if @form_data[subject].present? && signature.present?
      @form_data['helpers'][subject]['signature'] = {
        'name' => "/es/ #{signature}",
        'date' => timestamp
      }
    end
  end
end

#subjects ⇒ Object (private) 



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# File 'lib/pdf_fill/forms/va1010cg.rb', line 692

def subjects
  %w[veteran primaryCaregiver secondaryCaregiverOne secondaryCaregiverTwo]
end