View source for Form:Private

<noinclude></noinclude><includeonly>
<div id="wikiPreview" style="display: none; padding-bottom: 25px; margin-bottom: 25px; border-bottom: 1px solid #AAAAAA;"></div>
{{{for template|Private}}}
{{{field|Full name|hidden}}}
<p>'''Health info: '''</p>
{{{field|Health info|input type=textarea}}}
== Private Contacts ==
{{{field|Contacts|holds template}}}
{{{end template}}}
{{{for template|Contact|multiple|embed in field=Private[Contacts]|add button text=Public Contact}}}
{| class="formtable"
|- 
! Type
| {{{field|Contact type|input type=dropdown|property=Contact type|show on select=Email=>email;Phone=>phone;Other=>other;|default=Email|mandatory}}} 
|- id="email"
! Email: 
| {{{field|Email|input type=text}}}
|- id="phone"
! Phone: 
| {{{field|Phone|input type=text}}}
|- id="other"
! Other: 
| {{{field|Other|input type=text}}}
|-
!
|{{{field|Is preferred|input type=checkbox|label=Is preferred}}} {{{field|Is emergency|input type=checkbox|label=Emergency contact}}}
|}
{{{end template}}}
</includeonly>