- <div class="section attendance">
- <h3>$(l10n course_attendance)</h3>
- $(listcourses |while read each; do
- cname="$(sed -rn 's:^SUMMARY\:(.*)$:\1:p' "$_DATA/ical/$each")"
- echo '<label><input type="checkbox" name="attendance" value="'$each'" '$(check_a "$each")'/>'$cname'</label>'
- done)
- </div>
+printf '</div>'
+
+if [ "$PROFILE" = circus ]; then
+ list_section phone TEL
+ list_section message EMAIL IMPP URL
+ list_section address ADR
+ list_section note NOTE X-CLIENT-REFERRAL
+ cat <<-END_HTML
+ <div class="section attendance">
+ <h3>$(l10n course_attendance)</h3>
+ $(listcourses |while read each; do
+ cname="$(sed -rn 's:^SUMMARY\:(.*)$:\1:p' "$_DATA/ical/$each")"
+ printf '<label><input type="checkbox" name="attendance" value="%s" %s/>%s</label>' \
+ "$(attribsafe "$each")" "$(check_a "$each")" "$(htmlsafe "$cname")"
+ done)
+ </div>
+ END_HTML
+elif [ "$PROFILE" = medical ]; then
+ list_section address ADR
+ list_section phone TEL EMAIL IMPP URL
+ cat <<-END_HTML
+ <div class="section insurance">
+ <h3>$(l10n X-HEALTH-INSURANCE)</h3>
+ <input type="radio" name="hi_select" value="list" id="hi_select_list" checked /><label for="hi_select_list">$(l10n hi_from_list)</label
+ ><input type="radio" name="hi_select" value="other" id="hi_other"><label for="hi_other">$(l10n hi_other)</label>
+ <select class="item" name="hi_company">
+ <option value="" disabled="disabled" ${hi_company:-selected}>$(l10n hi_company)</option>
+ $(list_hi_companies |while read -r f; do
+ printf '<option value="%s" %s>%s</option>
+ ' "$(attribsafe "$f")" "$([ "$f" = "$hi_company" ] && setselected )" "$(htmlsafe "$f")"
+ done)
+ </select>
+ <input type="text" name="hi_other" value="$hi_company" placeholder="$(l10n hi_company)" />
+ <input name="hi_number" value="$hi_number" placeholder="$(l10n hi_number)" />
+ <input name="hi_status" value="$hi_status" placeholder="$(l10n hi_status)" />
+ </div>
+ END_HTML
+ list_section note NOTE X-CLIENT-REFERRAL
+fi