1004: UI: Initiate a requisition for "My Facilities"

Short description: 

User Tasks
1. User provides "program" if assigned to more than one
2. User provides facility if assigned to more than one
3. User indicates if the requisition is an 'emergency' requisition OR a regular requisition
4. User selects period, which will update page URL to the state for OLMIS-908 Dead (currently `/create-rnr/:rnr/:facility/:program`)

Acceptance Criteria:

1. user can select 'my facility' or a facility from my supervised facilities (depending on user profile) supervised facilities option will be shown in the UI, to match v2 UI, but disabled
2. If user is only associated with 1 facility, this selection should be pre-populated/selected
3. user can select which program (from all programs my facility or supervised facilities serves) to requisition for
4. if a user is only associated with 1 program, program selection to be automatically made
5. "type" is defacto as "regular" for that scheduling period and "emergency" otherwise
6. facility, program and type are required before proceeding (proceeding is not allowed without period)
7. the user cannot change his/her assigned facility (if only assigned one)
8. if a user is not associated with a facility, an error message is shown
9. if a user is not associated with a program, an error message is shown
10. if no periods are returned, an error message is shown