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Form Metadata

  • Select|""
  • Dr|Dr
  • Mr|Mr
  • Miss|Miss
  • Ms|Ms
  • Mrs|Mrs
  • Other|Other
  • Select|""
  • Doctor|Doctor
  • Registrar|Registrar
  • Retail Pharmacist|Retail Pharmacist
  • Nurse|Nurse
  • HCP Demonstration|HCP Demonstration
  • Select|""
  • Allergist|Allergist
  • Anaesthetist|Anaesthetist
  • Cardiologist|Cardiologist
  • Community Nurse|Community Nurse
  • Consultant Physician|Consultant Physician
  • Dermatologist|Dermatologist
  • Diabetologist|Diabetologist
  • Ear Nose Throat Specialist|Ear Nose Throat Specialist
  • Endocrinologist|Endocrinologist
  • General Practitioner|General Practitioner
  • General Surgeon|General Surgeon
  • Geriatrician|Geriatrician
  • Haematologist|Haematologist
  • Hospital Pharmacist|Hospital Pharmacist
  • Immunologist|Immunologist
  • Infectious Diseases|Infectious Diseases
  • Intensive Care Specialist|Intensive Care Specialist
  • Medical Oncologist|Medical Oncologist
  • Nurses|Nurses
  • Other|Other
  • medicalprovidernumber|A_PROF_GMCNO

{"data.TITLE":{"required":[{"value":"true","msg":"this field is required"}]},"data.academicTitle":{"required":[{"value":"true","msg":"this field is required"}]},"profile.firstName":{"required":[{"value":"true","msg":"this field is required"}]},"profile.lastName":{"required":[{"value":"true","msg":"this field is required"}]},"data.PROFESSION":{"required":[{"value":"true","msg":"this field is required"}]},"data.SPECIALITY":{"required":[{"value":"true","msg":"this field is required"}]},"data.PROFESSIONALID":{"required":[{"value":"false","msg":""}]},"data.CHANNEL.SMS.PHONE":{"required":[{"value":"false","msg":""}],"regex":[{"value":"^[\\(\\)/\\d\\w\\- \\+\\.]{8,18}$","msg":"field need to be in correct format"}]},"data.HOSPITALNAME":{"required":[{"value":"true","msg":"this field is required"}]},"data.ADDRESS.LINE1":{"required":[{"value":"true","msg":"this field is required"}]},"data.ADDRESS.CITY":{"required":[{"value":"true","msg":"this field is required"}]},"data.ADDRESS.DISTRICT":{"required":[{"value":"false","msg":""}]},"data.ADDRESS.ZIP":{"required":[{"value":"true","msg":"this field is required"}],"regex":[{"value":"^(([^\u0000-]|[a-zA-Z\\d]){5})$","msg":"field need to be in correct format"}]},"data.PHONE.WORK":{"required":[{"value":"true","msg":"this field is required"}],"regex":[{"value":"^[\\(\\)/\\d\\w\\- \\+\\.]{8,18}$","msg":"field need to be in correct format"}]},"email":{"required":[{"value":"true","msg":"this field is required"}],"regex":[{"value":"^[\\w_-]+(\\.[\\w_-]+)*@[\\w_-]+(\\.[\\w_-]+)*\\.\\w{2,4}$","msg":"field need to be in correct format"}]},"data.crmid":{"required":[{"value":"true","msg":"this field is required"}]},"password":{"required":[{"value":"true","msg":"this field is required"}],"min-length":[{"value":"3","msg":"min length is 3"}]},"passwordRetype":{"required":[{"value":"true","msg":"this field is required"}],"min-length":[{"value":"3","msg":"min length is 3"}],"must-match":[{"value":"password","msg":"password must match"}]},"data.email_validation":{"required":[{"value":"true","msg":"this field is required"}],"regex":[{"value":"^(?=(.{1,64}@.{1,255}))([!#$%\u0026'*+\\-\\/=?\\^_`{|}~a-zA-Z0-9}]{1,64}(\\.[!#$%\u0026'*+\\-\\/=?\\^_`{|}~a-zA-Z0-9]{0,}){0,})@((\\[(25[0-5]|2[0-4][0-9]|[01]?[0-9][0-9]?)(\\.(25[0-5]|2[0-4][0-9]|[01]?[0-9][0-9]?)){3}\\])|([a-zA-Z0-9-]{1,63}(\\.[a-zA-Z0-9-]{2,63}){1,}))$","msg":"field need to be in correct format"}]}}