Ok, the full page is too large to post, but here is the main content of the page!
Code:
</table></td><td align="right" valign="top" nowrap="true" style="padding-left:5px;"><a id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl00_ctl00_ctl00_ctl04_ctl00_ctl00_UserField_checkNames" title="Check Names" onclick="var arg=getUplevel('ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl00_ctl00_ctl00_ctl04_ctl00_ctl00_UserField');var ctx='ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl00_ctl00_ctl00_ctl04_ctl00_ctl00_UserField';EntityEditorSetWaitCursor(ctx);WebForm_DoCallback('ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl00$ctl00$ctl00$ctl04$ctl00$ctl00$UserField',arg,EntityEditorHandleCheckNameResult,ctx,EntityEditorHandleCheckNameError,true);return false;" href="javascript:"><img title="Check Names" src="/_layouts/images/checknames.gif" alt="Check Names" style="border-width:0px;" /></a> <a id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl00_ctl00_ctl00_ctl04_ctl00_ctl00_UserField_browse" accesskey="B" title="Browse" onclick="__Dialog__ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl00_ctl00_ctl00_ctl04_ctl00_ctl00_UserField(); return false;" href="javascript:"><img title="Browse" src="/_layouts/images/addressbook.gif" alt="Browse" style="border-width:0px;" /></a></td>
</tr><tr>
<td colspan="3"><span id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl00_ctl00_ctl00_ctl04_ctl00_ctl00_UserField_errorLabel" class="ms-error">You are only allowed to enter one item.</span></td>
</tr>
</table></span>
</span>
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>Requester Org<span class="ms-formvalidation"> *</span></nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="Requester Org"
FieldInternalName="Requester_x0020_Org"
FieldType="SPFieldLookup"
-->
<span dir="none"><select name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl01$ctl00$ctl00$ctl04$ctl00$Lookup" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl01_ctl00_ctl00_ctl04_ctl00_Lookup" title="Requester Org">
<option value="15">{Select One}</option>
<option value="4">Erewash CCG</option>
<option selected="selected" value="16">GEM</option>
<option value="5">Hardwick CCG</option>
<option value="6">High Peak CCG</option>
<option value="7">North Derbyshire CCG</option>
<option value="14">Other</option>
<option value="8">Partner Organisations</option>
<option value="9">Primary Care</option>
<option value="10">Provider Services</option>
<option value="11">Public Health</option>
<option value="12">Southern Derbyshire CCG</option>
</select><br/></span>
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>Work Title<span class="ms-formvalidation"> *</span></nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="Work Title"
FieldInternalName="Title"
FieldType="SPFieldText"
-->
<span dir="none">
<input name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl02$ctl00$ctl00$ctl04$ctl00$ctl00$TextField" type="text" value="Test" maxlength="255" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl02_ctl00_ctl00_ctl04_ctl00_ctl00_TextField" title="Work Title" class="ms-long" /><br>
</span>
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>Purpose<span class="ms-formvalidation"> *</span></nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="Purpose"
FieldInternalName="Body"
FieldType="SPFieldNote"
-->
<span dir="none">
<textarea name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl03$ctl00$ctl00$ctl04$ctl00$ctl00$TextField" rows="6" cols="20" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl03_ctl00_ctl00_ctl04_ctl00_ctl00_TextField" title="Purpose" class="ms-long" dir="none">test</textarea><br>
</span>
Purpose: Aim/Description/Specific criteria of work
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>Planned Work?</nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="Planned Work?"
FieldInternalName="PlannedWork"
FieldType="SPFieldChoice"
-->
<span dir="none"><select name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl04$ctl00$ctl00$ctl04$ctl00$DropDownChoice" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl04_ctl00_ctl00_ctl04_ctl00_DropDownChoice" title="Planned Work?" class="ms-RadioText">
<option selected="selected" value="Planned Work">Planned Work</option>
<option value="Unplanned Work">Unplanned Work</option>
<option value="Performance">Performance</option>
</select><br></span>
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>Reason for Work<span class="ms-formvalidation"> *</span></nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="Reason for Work"
FieldInternalName="Reason_x0020_for_x0020_Work"
FieldType="SPFieldLookup"
-->
<span dir="none"><select name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl05$ctl00$ctl00$ctl04$ctl00$Lookup" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl05_ctl00_ctl00_ctl04_ctl00_Lookup" title="Reason for Work">
<option value="10">{Select One}</option>
<option value="1">For contract monitoring</option>
<option selected="selected" value="2">For directors</option>
<option value="3">For investigation</option>
<option value="4">For meeting</option>
<option value="5">For performance monitoring</option>
<option value="6">For presentation</option>
<option value="7">For report</option>
<option value="9">Other</option>
<option value="8">Statutory report</option>
</select><br/></span>
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>Level of data required<span class="ms-formvalidation"> *</span></nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="Level of data required"
FieldInternalName="Level_x0020_of_x0020_data_x0020_"
FieldType="SPFieldLookupMulti"
-->
<span dir="none">
<input id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl06_ctl00_ctl00_ctl04_ctl00_ctl00_MultiLookupPicker" name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl06$ctl00$ctl00$ctl04$ctl00$ctl00$MultiLookupPicker" type="hidden" value="1|tCCG"></input><input id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl06_ctl00_ctl00_ctl04_ctl00_ctl00_MultiLookupPicker_data" name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl06$ctl00$ctl00$ctl04$ctl00$ctl00$MultiLookupPicker$data" type="hidden" value="1|tCCG|t |t |t2|tCluster|t |t |t3|tLocality|t |t |t10|tNot applicable|t |t |t9|tOther|t |t |t5|tPatient (Clear)|t |t |t11|tPatient (Pseudonymised)|t |t |t6|tPCT|t |t |t7|tPractice|t |t |t4|tProvider|t |t |t8|tSHA|t |t "></input><input id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl06_ctl00_ctl00_ctl04_ctl00_ctl00_MultiLookupPicker_initial" name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl06$ctl00$ctl00$ctl04$ctl00$ctl00$MultiLookupPicker$initial" type="hidden" value="1|tCCG"></input>
<table class="ms-long" cellpadding="0" cellspacing="0" border="0">
<tr>
<td class="ms-input">
<div style='width:143px;height:125px;overflow:scroll'><select name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl06$ctl00$ctl00$ctl04$ctl00$ctl00$SelectCandidate" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl06_ctl00_ctl00_ctl04_ctl00_ctl00_SelectCandidate" multiple="multiple" title="Level of data required possible values" onchange="GipSelectCandidateItems(ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl06_ctl00_ctl00_ctl04_ctl00_ctl00_MultiLookupPicker_m);" ondblclick="GipAddSelectedItems(ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl06_ctl00_ctl00_ctl04_ctl00_ctl00_MultiLookupPicker_m); return false" onKeyDown="GipHandleHScroll(event)">
</select></div>
</td>
<td style="padding-left:10px">
<td align="center" valign="middle" class="ms-input"><button id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl06_ctl00_ctl00_ctl04_ctl00_ctl00_AddButton" class="ms-buttonheightwidth" onclick="GipAddSelectedItems(ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl06_ctl00_ctl00_ctl04_ctl00_ctl00_MultiLookupPicker_m); return false"> Add > </button><br>
<br><button id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl06_ctl00_ctl00_ctl04_ctl00_ctl00_RemoveButton" class="ms-buttonheightwidth" onclick="GipRemoveSelectedItems(ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl06_ctl00_ctl00_ctl04_ctl00_ctl00_MultiLookupPicker_m); return false"> < Remove </button>
</td>
<td style="padding-left:10px">
<td class="ms-input">
<div style='width:143px;height:125px;overflow:scroll'><select name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl06$ctl00$ctl00$ctl04$ctl00$ctl00$SelectResult" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl06_ctl00_ctl00_ctl04_ctl00_ctl00_SelectResult" multiple="multiple" title="Level of data required selected values" onchange="GipSelectResultItems(ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl06_ctl00_ctl00_ctl04_ctl00_ctl00_MultiLookupPicker_m);" ondblclick="GipRemoveSelectedItems(ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl06_ctl00_ctl00_ctl04_ctl00_ctl00_MultiLookupPicker_m); return false" onKeyDown="GipHandleHScroll(event)">
</select></div>
</td>
</tr>
</table>
</span>
If accessing clear patient level data, complete the pseudonymisation log below (RIGHT-CLICK AND OPEN IN NEW TAB): <br><a href="http://share.derbycity.nhs.uk/sites/perf/Knowledge_Management/theunit/Lists/Pseudonymisation%20Log/NewForm.aspx?Source=http%3A%2F%2Fshare%2Ederbycity%2Enhs%2Euk%2Fsites%2Fperf%2FKnowledge%5FManagement%2Ftheunit%2FLists%2FPseudonymisation%2520Log%2FLog%2Easpx">http://share.derbycity.nhs.uk/sites/perf/Knowledge_Management/theunit/Lists/Pseudonymisation%20Log/NewForm.aspx?Source=http%3A%2F%2Fshare%2Ederbycity%2Enhs%2Euk%2Fsites%2Fperf%2FKnowledge%5FManagement%2Ftheunit%2FLists%2FPseudonymisation%2520Log%2FLog%2Easpx</a>
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>Area of Work<span class="ms-formvalidation"> *</span></nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="Area of Work"
FieldInternalName="Area_x0020_of_x0020_Work"
FieldType="SPFieldLookup"
-->
<span dir="none"><select name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl07$ctl00$ctl00$ctl04$ctl00$Lookup" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl07_ctl00_ctl00_ctl04_ctl00_Lookup" title="Area of Work">
<option value="15">{Select One}</option>
<option value="1">Child Health</option>
<option selected="selected" value="2">Community</option>
<option value="3">Contract</option>
<option value="4">End of Life</option>
<option value="5">Finance</option>
<option value="6">Maternity</option>
<option value="7">Mental Health</option>
<option value="14">Other</option>
<option value="16">Performance</option>
<option value="8">Planned Care</option>
<option value="9">Prescribing</option>
<option value="10">Public Health</option>
<option value="11">QIPP</option>
<option value="12">RightCare</option>
<option value="13">Urgent Care</option>
</select><br/></span>
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>Date Requested<span class="ms-formvalidation"> *</span></nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="Date Requested"
FieldInternalName="StartDate"
FieldType="SPFieldDateTime"
-->
<span dir="none">
<SCRIPT language='javascript'>g_strDateTimeControlIDs["SPStartDate"] = "ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl08_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_DateTimeFieldDate";</SCRIPT>
<table border=0 cellpadding=0 cellspacing=0><tr>
<td class="ms-dtinput" >
<label for="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl08_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_DateTimeFieldDate" style="display:none">Date Requested Date</label>
<input name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl08$ctl00$ctl00$ctl04$ctl00$ctl00$DateTimeField$DateTimeFieldDate" type="text" value="07/05/2013" maxlength="45" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl08_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_DateTimeFieldDate" title="Date Requested" class="ms-input" AutoPostBack="0" /></td>
<td class="ms-dtinput" >
<A href="#" onclick='clickDatePicker("ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl08_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_DateTimeFieldDate", "\u002fsites\u002fperf\u002fKnowledge_Management\u002ftheunit\u002f_layouts\u002fiframe.aspx?&cal=1&lcid=2057&langid=1033&tz=00:59:59.9994422&ww=0111110&fdow=1&fwoy=0&hj=0&swn=False&minjday=109207&maxjday=2666269&date=", "07\u002f05\u002f2013"); return false;' ><IMG id=ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl08_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_DateTimeFieldDateDatePickerImage src="/_layouts/images/calendar.gif" border="0" alt="Select a date from the calendar."></IMG></A></td>
<IFRAME id=ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl08_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_DateTimeFieldDateDatePickerFrame SRC="/_layouts/images/blank.gif" FRAMEBORDER=0 SCROLLING=no style="DISPLAY:none;POSITION:absolute; width:200px; Z-INDEX:101;" title="Select a date from the calendar."></IFRAME></tr></table>
<span id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl08_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_ctl00" style="color:Red;display:none;">You must specify a value for this required field.</span>
</span>
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>Due Date<span class="ms-formvalidation"> *</span></nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="Due Date"
FieldInternalName="DueDate"
FieldType="SPFieldDateTime"
-->
<span dir="none">
<SCRIPT language='javascript'>g_strDateTimeControlIDs["SPDueDate"] = "ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl09_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_DateTimeFieldDate";</SCRIPT>
<table border=0 cellpadding=0 cellspacing=0><tr>
<td class="ms-dtinput" >
<label for="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl09_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_DateTimeFieldDate" style="display:none">Due Date Date</label>
<input name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl09$ctl00$ctl00$ctl04$ctl00$ctl00$DateTimeField$DateTimeFieldDate" type="text" value="07/05/2013" maxlength="45" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl09_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_DateTimeFieldDate" title="Due Date" class="ms-input" AutoPostBack="0" /></td>
<td class="ms-dtinput" >
<A href="#" onclick='clickDatePicker("ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl09_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_DateTimeFieldDate", "\u002fsites\u002fperf\u002fKnowledge_Management\u002ftheunit\u002f_layouts\u002fiframe.aspx?&cal=1&lcid=2057&langid=1033&tz=00:59:59.9994422&ww=0111110&fdow=1&fwoy=0&hj=0&swn=False&minjday=109207&maxjday=2666269&date=", "07\u002f05\u002f2013"); return false;' ><IMG id=ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl09_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_DateTimeFieldDateDatePickerImage src="/_layouts/images/calendar.gif" border="0" alt="Select a date from the calendar."></IMG></A></td>
<IFRAME id=ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl09_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_DateTimeFieldDateDatePickerFrame SRC="/_layouts/images/blank.gif" FRAMEBORDER=0 SCROLLING=no style="DISPLAY:none;POSITION:absolute; width:200px; Z-INDEX:101;" title="Select a date from the calendar."></IFRAME></tr></table>
<span id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl09_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_ctl00" style="color:Red;display:none;">You must specify a value for this required field.</span>
</span>
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>Information request responded to in 24 hours</nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="Information request responded to in 24 hours"
FieldInternalName="InfoRequestReponse24"
FieldType="SPFieldChoice"
-->
<span dir="none"><select name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl10$ctl00$ctl00$ctl04$ctl00$DropDownChoice" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl10_ctl00_ctl00_ctl04_ctl00_DropDownChoice" title="Information request responded to in 24 hours" class="ms-RadioText">
<option selected="selected" value=""></option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select><br></span>
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>Assigned To</nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="Assigned To"
FieldInternalName="AssignedTo"
FieldType="SPFieldUserMulti"
-->
<span dir="none">
<input name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl11$ctl00$ctl00$ctl04$ctl00$ctl00$HiddenUserFieldValue" type="hidden" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl11_ctl00_ctl00_ctl04_ctl00_ctl00_HiddenUserFieldValue" value="253; />
<td><table cellspacing="0" cellpadding="0" border="0" style="width:100%;border-collapse:collapse;">
<tr>
<td valign="top" style="width:90%;"><span style="font-size:8pt;">Enter users separated with semicolons.</span></td><td valign="top" nowrap="true" style="padding-left:5px;"><a id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl11_ctl00_ctl00_ctl04_ctl00_ctl00_UserField_checkNames" title="Check Names" onclick="var arg=getUplevel('ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl11_ctl00_ctl00_ctl04_ctl00_ctl00_UserField');var ctx='ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl11_ctl00_ctl00_ctl04_ctl00_ctl00_UserField';EntityEditorSetWaitCursor(ctx);WebForm_DoCallback('ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl11$ctl00$ctl00$ctl04$ctl00$ctl00$UserField',arg,EntityEditorHandleCheckNameResult,ctx,EntityEditorHandleCheckNameError,true);return false;" href="javascript:"><img title="Check Names" src="/_layouts/images/checknames.gif" alt="Check Names" style="border-width:0px;" /></a> <a id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl11_ctl00_ctl00_ctl04_ctl00_ctl00_UserField_browse" accesskey="B" title="Browse" onclick="__Dialog__ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl11_ctl00_ctl00_ctl04_ctl00_ctl00_UserField(); return false;" href="javascript:"><img title="Browse" src="/_layouts/images/addressbook.gif" alt="Browse" style="border-width:0px;" /></a></td>
</tr>
</table></td>
</tr>
</table></span>
</span>
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>Priority</nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="Priority"
FieldInternalName="Priority"
FieldType="SPFieldChoice"
-->
<span dir="none"><select name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl12$ctl00$ctl00$ctl04$ctl00$DropDownChoice" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl12_ctl00_ctl00_ctl04_ctl00_DropDownChoice" title="Priority" class="ms-RadioText">
<option value="(1) High">(1) High</option>
<option selected="selected" value="(2) Normal">(2) Normal</option>
<option value="(3) Low">(3) Low</option>
</select><br></span>
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>Status</nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="Status"
FieldInternalName="Status"
FieldType="SPFieldChoice"
-->
<span dir="none"><select name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl13$ctl00$ctl00$ctl04$ctl00$DropDownChoice" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl13_ctl00_ctl00_ctl04_ctl00_DropDownChoice" title="Status" class="ms-RadioText">
<option value="Not Started">Not Started</option>
<option selected="selected" value="In Progress">In Progress</option>
<option value="Completed">Completed</option>
<option value="Deferred">Deferred</option>
<option value="Waiting on someone else">Waiting on someone else</option>
</select><br></span>
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>Information request formally responded to within 7 days</nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="Information request formally responded to within 7 days"
FieldInternalName="InfoRequestResponse7Days"
FieldType="SPFieldChoice"
-->
<span dir="none"><select name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl14$ctl00$ctl00$ctl04$ctl00$DropDownChoice" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl14_ctl00_ctl00_ctl04_ctl00_DropDownChoice" title="Information request formally responded to within 7 days" class="ms-RadioText">
<option selected="selected" value=""></option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select><br></span>
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>If No Response within 7 Days:</nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="If No Response within 7 Days:"
FieldInternalName="No7DayResonse"
FieldType="SPFieldChoice"
-->
<span dir="none"><table cellpadding="0" cellspacing="1">
<tr>
<td><span class="ms-RadioText" title="Locally agreed deadline which is outside of 7 days"><input id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl15_ctl00_ctl00_ctl04_ctl00_ctl00" type="radio" name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl15$ctl00$ctl00$ctl04$ctl00$RadioButtons" value="ctl00" /><label for="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl15_ctl00_ctl00_ctl04_ctl00_ctl00">Locally agreed deadline which is outside of 7 days</label></span></td>
</tr><tr>
<td><span class="ms-RadioText" title="Data not available to deliver information request – Client notified"><input id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl15_ctl00_ctl00_ctl04_ctl00_ctl01" type="radio" name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl15$ctl00$ctl00$ctl04$ctl00$RadioButtons" value="ctl01" /><label for="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl15_ctl00_ctl00_ctl04_ctl00_ctl01">Data not available to deliver information request – Client notified</label></span></td>
</tr><tr>
<td><span class="ms-RadioText" title="Data incorrect and so cannot complete query – Client notified"><input id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl15_ctl00_ctl00_ctl04_ctl00_ctl02" type="radio" name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl15$ctl00$ctl00$ctl04$ctl00$RadioButtons" value="ctl02" /><label for="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl15_ctl00_ctl00_ctl04_ctl00_ctl02">Data incorrect and so cannot complete query – Client notified</label></span></td>
</tr><tr>
<td><span class="ms-RadioText" title="New Data Development"><input id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl15_ctl00_ctl00_ctl04_ctl00_ctl03" type="radio" name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl15$ctl00$ctl00$ctl04$ctl00$RadioButtons" value="ctl03" /><label for="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl15_ctl00_ctl00_ctl04_ctl00_ctl03">New Data Development</label></span></td>
</tr>
</table></span>
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>% Complete<span class="ms-formvalidation"> *</span></nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="% Complete"
FieldInternalName="PercentComplete"
FieldType="SPFieldNumber"
-->
<span dir="none">
<input name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl16$ctl00$ctl00$ctl04$ctl00$ctl00$TextField" type="text" value="0" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl16_ctl00_ctl00_ctl04_ctl00_ctl00_TextField" title="% Complete" class="ms-input" Size="11" style="ime-mode:inactive;" />%<br>
</span>
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>Work Time (Estimated)<span class="ms-formvalidation"> *</span></nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="Work Time (Estimated)"
FieldInternalName="Work_x0020_Time_x0020__x0028_Est"
FieldType="SPFieldNumber"
-->
<span dir="none">
<input name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl17$ctl00$ctl00$ctl04$ctl00$ctl00$TextField" type="text" value="0" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl17_ctl00_ctl00_ctl04_ctl00_ctl00_TextField" title="Work Time (Estimated)" class="ms-input" Size="11" style="ime-mode:inactive;" /><br>
</span>
Minutes
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>Comments</nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="Comments"
FieldInternalName="Comments"
FieldType="SPFieldNote"
-->
<span dir="none">
<textarea name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl18$ctl00$ctl00$ctl04$ctl00$ctl00$TextField" rows="6" cols="20" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl18_ctl00_ctl00_ctl04_ctl00_ctl00_TextField" title="Comments" class="ms-long" dir="none"></textarea><br>
</span>
<div>No existing entries.</div>
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>Work Time (Actual)</nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="Work Time (Actual)"
FieldInternalName="Work_x0020_Time_x0020__x0028_Act"
FieldType="SPFieldNumber"
-->
<span dir="none">
<input name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl19$ctl00$ctl00$ctl04$ctl00$ctl00$TextField" type="text" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl19_ctl00_ctl00_ctl04_ctl00_ctl00_TextField" title="Work Time (Actual)" class="ms-input" Size="11" style="ime-mode:inactive;" /><br>
</span>
Minutes
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>Date Delivered</nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="Date Delivered"
FieldInternalName="Date_x0020_Delivered"
FieldType="SPFieldDateTime"
-->
<span dir="none">
<SCRIPT language='javascript'>g_strDateTimeControlIDs["SPDate_x0020_Delivered"] = "ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl20_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_DateTimeFieldDate";</SCRIPT>
<table border=0 cellpadding=0 cellspacing=0><tr>
<td class="ms-dtinput" >
<label for="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl20_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_DateTimeFieldDate" style="display:none">Date Delivered Date</label>
<input name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl20$ctl00$ctl00$ctl04$ctl00$ctl00$DateTimeField$DateTimeFieldDate" type="text" maxlength="45" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl20_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_DateTimeFieldDate" title="Date Delivered" class="ms-input" AutoPostBack="0" /></td>
<td class="ms-dtinput" >
<A href="#" onclick='clickDatePicker("ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl20_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_DateTimeFieldDate", "\u002fsites\u002fperf\u002fKnowledge_Management\u002ftheunit\u002f_layouts\u002fiframe.aspx?&cal=1&lcid=2057&langid=1033&tz=00:59:59.9990260&ww=0111110&fdow=1&fwoy=0&hj=0&swn=False&minjday=109207&maxjday=2666269&date=", ""); return false;' ><IMG id=ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl20_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_DateTimeFieldDateDatePickerImage src="/_layouts/images/calendar.gif" border="0" alt="Select a date from the calendar."></IMG></A></td>
<IFRAME id=ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl20_ctl00_ctl00_ctl04_ctl00_ctl00_DateTimeField_DateTimeFieldDateDatePickerFrame SRC="/_layouts/images/blank.gif" FRAMEBORDER=0 SCROLLING=no style="DISPLAY:none;POSITION:absolute; width:200px; Z-INDEX:101;" title="Select a date from the calendar."></IFRAME></tr></table>
</span>
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>Deadline Met</nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="Deadline Met"
FieldInternalName="DeadlineMet"
FieldType="SPFieldChoice"
-->
<span dir="none"><select name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl21$ctl00$ctl00$ctl04$ctl00$DropDownChoice" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl21_ctl00_ctl00_ctl04_ctl00_DropDownChoice" title="Deadline Met" class="ms-RadioText">
<option selected="selected" value=""></option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select><br></span>
</TD>
</TR>
<TR>
<TD nowrap="true" valign="top" width="190px" class="ms-formlabel"><H3 class="ms-standardheader">
<nobr>File Path</nobr>
</H3></TD>
<TD valign="top" class="ms-formbody" width="400px">
<!-- FieldName="File Path"
FieldInternalName="File_x0020_Path"
FieldType="SPFieldText"
-->
<span dir="none">
<input name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl04$ctl22$ctl00$ctl00$ctl04$ctl00$ctl00$TextField" type="text" maxlength="255" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl04_ctl22_ctl00_ctl00_ctl04_ctl00_ctl00_TextField" title="File Path" class="ms-long" /><br>
</span>
</TD>
</TR>
<TR id=idAttachmentsRow>
<TD nowrap="true" valign="top" class="ms-formlabel" width="20%">
<nobr>Attachments</nobr>
</TD>
<TD valign="top" class="ms-formbody" width="80%">
<span dir="none">
<TABLE border=0 cellpadding=0 cellspacing=0 id=idAttachmentsTable>
</TABLE>
</span>
<SCRIPT>
var elm = document.getElementById("idAttachmentsTable");
if (elm == null || elm.rows.length == 0)
document.getElementById("idAttachmentsRow").style.display='none';
</SCRIPT>
</TD></TR>
</TABLE>
<table cellpadding=0 cellspacing=0 width=100%><tr><td class="ms-formline"><IMG SRC="/_layouts/images/blank.gif" width=1 height=1 alt=""></td></tr></table>
<TABLE cellpadding=0 cellspacing=0 width=100% style="padding-top: 7px"><tr><td width=100%>
<input name="ctl00$m$g_dfc47c47_9160_4019_9aa9_224df8bf194e$ctl00$ctl07$ctl00$owshiddenversion" type="HIDDEN" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_ctl07_ctl00_owshiddenversion" value="1" />
<table class="ms-formtoolbar" cellpadding="2" cellspacing="0" border="0" id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_toolBarTbl" width="100%" >
<tr>
<td class="ms-toolbar" nowrap="true">
<table cellpadding=0 cellspacing=0>
<tr><td class="ms-descriptiontext" ID=onetidinfoblockV>Version:
1.0
</td></tr>
<tr><td nowrap class="ms-descriptiontext" ID=onetidinfoblock1>
<span id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_toolBarTbl_RptControls_ctl00_ctl00_ctl02">Created at 07/05/2013 15:04 by <nobr><span><A ONCLICK="GoToLink(this);return false;" HREF="/sites/perf/Knowledge_Management/theunit/_layouts/userdisp.aspx?ID=253">Lister Rick (RY8) Derbyshire Community Health Services</A><img border="0" height="1" width="3" src="/_layouts/images/blank.gif" alt="" /><a href="javascript:" onclick="IMNImageOnClick();return false;" class="ms-imnlink"><img title="" alt="No presence information" name="imnmark" border="0" valign="middle" height="12" width="12" src="/_layouts/images/blank.gif" sip="Rick.Lister@dchs.nhs.uk" id="imn0,type=smtp" ></a></span></nobr> </span>
</td></tr>
<tr><td nowrap class="ms-descriptiontext" ID=onetidinfoblock2>
<span id="ctl00_m_g_dfc47c47_9160_4019_9aa9_224df8bf194e_ctl00_toolBarTbl_RptControls_ctl00_ctl00_ctl03">Last modified at 07/05/2013 15:04 by <nobr><span><A ONCLICK="GoToLink(this);return false;" HREF="/sites/perf/Knowledge_Management/theunit/_layouts/userdisp.aspx?ID=253">Lister Rick (RY8) Derbyshire Community Health Services</A><img border="0" height="1" width="3" src="/_layouts/images/blank.gif" alt="" /><a href="javascript:" onclick="IMNImageOnClick();return false;" class="ms-imnlink"><img title="" alt="No presence information" name="imnmark" border="0" valign="middle" height="12" width="12" src="/_layouts/images/blank.gif" sip="Rick.Lister@dchs.nhs.uk" id="imn1,type=smtp" ></a></span></nobr> </span>
</td></tr>
</table>
</td>
<td width="99%" class="ms-toolbar" nowrap><IMG SRC="/_layouts/images/blank.gif" width=1 height=18 alt=""></td>
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