Submission Widget Library
Browse and manage exam submission widgets. Configure final submission settings, validation rules, redirect URLs, and session timeouts for different service types including Good Faith Exams, RX Packages, Urgent Care, and Custom Pharmacy.
Good Faith Exam - Standard Submission
v1Standard exam submission for Good Faith Exam with required questionnaire answers and optional lab work attachments
Submission ID: 4001
Service: Good Faith Exam
Validation: Strict
Timeout: 60m
Requirements: Answers
Duplicate: Blocked
Created: 2025-01-20
By: Kris Zizzo
Modified: 2025-01-20
By: Kris Zizzo
Good Faith Exam - With Lab Work Required
v1Good Faith Exam submission requiring both questionnaire completion and mandatory lab work file uploads before provider review
Submission ID: 4002
Service: Good Faith Exam
Validation: Strict
Timeout: 60m
Requirements: Answers, Attachments
Duplicate: Blocked
Created: 2025-01-20
By: Kris Zizzo
Modified: 2025-01-20
By: Kris Zizzo
Good Faith Exam - Lenient Validation
v1Good Faith Exam submission with lenient validation allowing partial completion for follow-up later
Submission ID: 4003
Service: Good Faith Exam
Validation: Lenient
Timeout: 120m
Requirements: Answers
Duplicate: Allowed
Created: 2025-01-20
By: Kris Zizzo
Modified: 2025-01-20
By: Kris Zizzo
QualiphyRx Package - Weight Loss Submission
v1Submission for QualiphyRx weight loss package including GLP-1 questionnaire and health screening before prescription review
Submission ID: 4004
Service: Rx Package
Validation: Strict
Timeout: 60m
Requirements: Answers
Duplicate: Blocked
Created: 2025-01-20
By: Kris Zizzo
Modified: 2025-01-20
By: Kris Zizzo
QualiphyRx Package - Hormone Therapy Submission
v1Submission for QualiphyRx hormone therapy package requiring questionnaire and mandatory lab results upload
Submission ID: 4005
Service: Rx Package
Validation: Strict
Timeout: 60m
Requirements: Answers, Attachments
Duplicate: Blocked
Created: 2025-01-20
By: Kris Zizzo
Modified: 2025-01-20
By: Kris Zizzo
QualiphyRx Package - Peptide Stack Submission
v1Submission for QualiphyRx peptide stack package with health questionnaire before prescription processing
Submission ID: 4006
Service: Rx Package
Validation: Strict
Timeout: 60m
Requirements: Answers
Duplicate: Blocked
Created: 2025-01-20
By: Kris Zizzo
Modified: 2025-01-20
By: Kris Zizzo
QualiphyRx Package - NAD+ Injectable Submission
v1Submission for QualiphyRx NAD+ injectable package with cognitive health assessment and medical history
Submission ID: 4007
Service: Rx Package
Validation: Strict
Timeout: 60m
Requirements: Answers
Duplicate: Blocked
Created: 2025-01-20
By: Kris Zizzo
Modified: 2025-01-20
By: Kris Zizzo
Urgent Care Visit - Standard Submission
v1Urgent care submission with symptom questionnaire and medical history before provider consultation
Submission ID: 4008
Service: Urgent Care
Validation: Strict
Timeout: 30m
Requirements: Answers
Duplicate: Blocked
Created: 2025-01-20
By: Kris Zizzo
Modified: 2025-01-20
By: Kris Zizzo
Urgent Care Visit - With Photo Upload
v1Urgent care submission requiring symptom photos or documentation upload for visual assessment before consultation
Submission ID: 4009
Service: Urgent Care
Validation: Strict
Timeout: 30m
Requirements: Answers, Attachments
Duplicate: Blocked
Created: 2025-01-20
By: Kris Zizzo
Modified: 2025-01-20
By: Kris Zizzo
Urgent Care Visit - Pediatric Submission
v1Pediatric urgent care submission with guardian consent and child health questionnaire before provider review
Submission ID: 4010
Service: Urgent Care
Validation: Strict
Timeout: 30m
Requirements: Answers
Duplicate: Blocked
Created: 2025-01-20
By: Kris Zizzo
Modified: 2025-01-20
By: Kris Zizzo
Custom Pharmacy - Standard Submission
v1Submission for custom pharmacy selection with questionnaire and pharmacy information before prescription processing
Submission ID: 4011
Service: Custom Pharmacy
Validation: Strict
Timeout: 60m
Requirements: Answers
Duplicate: Blocked
Created: 2025-01-20
By: Kris Zizzo
Modified: 2025-01-20
By: Kris Zizzo
Custom Pharmacy - With Insurance Upload
v1Custom pharmacy submission requiring insurance card upload and pharmacy selection for billing coordination
Submission ID: 4012
Service: Custom Pharmacy
Validation: Strict
Timeout: 60m
Requirements: Answers, Attachments
Duplicate: Blocked
Created: 2025-01-20
By: Kris Zizzo
Modified: 2025-01-20
By: Kris Zizzo
Extended Session - Complex Questionnaire
v1Submission with extended 2-hour session timeout for complex multi-section questionnaires requiring detailed responses
Submission ID: 4013
Service: Good Faith Exam
Validation: Strict
Timeout: 120m
Requirements: Answers
Duplicate: Blocked
Created: 2025-01-20
By: Kris Zizzo
Modified: 2025-01-20
By: Kris Zizzo
Custom Validation - Partial Completion Allowed
v1Submission with custom validation rules allowing partial completion and save-for-later functionality
Submission ID: 4014
Service: Good Faith Exam
Validation: Custom
Timeout: 60m
Requirements: Answers
Duplicate: Allowed
Created: 2025-01-20
By: Kris Zizzo
Modified: 2025-01-20
By: Kris Zizzo
Follow-up Submission - Treatment Progress
v1Follow-up submission for monitoring treatment progress with simplified questionnaire and optional photo uploads
Submission ID: 4015
Service: Good Faith Exam
Validation: Lenient
Timeout: 60m
Requirements: Answers
Duplicate: Allowed
Created: 2025-01-20
By: Kris Zizzo
Modified: 2025-01-20
By: Kris Zizzo