Peter Muturi 2 lat temu
rodzic
commit
3963b3546f

+ 3 - 3
resources/views/app/contact.blade.php

@@ -24,8 +24,8 @@
 <div class="bg-light border-bottom">
   <div class="container py-5">
     <div class="row justify-content-center">
-      <div class="col-lg-8">
-        <h5 class="header mb-3">Contact Us</h5>
+      <div class="col-lg-8 bg-grey p-lg-5 p-4">
+        <h5 class="header mb-4">Contact Us</h5>
         <form class="" action="{{ route('submit-contact') }}" method="post" autocomplete="off">
           @csrf
           <div class="row">
@@ -93,7 +93,7 @@
                 <small class="text-danger"><i class="fas fa-exclamation-triangle mr-2"></i>Invalid</small>
               @enderror
             </div>
-          <button type="submit" class="btn btn-pry w-100 py-3">Submit message</button>
+          <button type="submit" class="btn btn-pry w-100 py-3">SUBMIT</button>
         </form>
       </div>
     </div>

+ 23 - 19
resources/views/app/physicians/contact-us.blade.php

@@ -26,8 +26,8 @@
 <div class="bg-light">
   <div class="container py-5">
     <div class="row justify-content-center">
-      <div class="col-lg-8">
-        <h5 class="header mb-3">Contact Us</h5>
+      <div class="col-lg-8 bg-grey p-lg-5 p-4">
+        <h5 class="header mb-4">Contact Us</h5>
         <form class="" action="{{ route('physicians.submit-contact-us') }}" method="post" autocomplete="off">
           @csrf
 
@@ -43,9 +43,9 @@
           </div>
           @endif
 
-          <label for="">Full Name <span class="text-danger">*</span> </label>
           <div class="row">
             <div class="col-lg-4 form-group mb-4">
+              <label for="">Prefix <span class="text-danger">*</span> </label>
               <select class="form-control rounded-0 py-3" required name="name_prefix">
                 <option value="">Select Prefix</option>
                 <option value="Dr.">Dr.</option>
@@ -60,13 +60,15 @@
               @enderror
             </div>
             <div class="col-lg-4 form-group mb-4">
-              <input type="text" class="form-control rounded-0 py-3" required name="name_first" placeholder="First Name" value="{{ old('name_first') }}">
+              <label for="">First Name <span class="text-danger">*</span> </label>
+              <input type="text" class="form-control rounded-0 py-3" required name="name_first" value="{{ old('name_first') }}">
               @error('name_first')
                 <small class="text-warning">{{$message}}</small>
               @enderror
             </div>
             <div class="col-lg-4 form-group mb-4">
-              <input type="text" class="form-control rounded-0 py-3" required name="name_last" placeholder="Last Name" value="{{ old('name_last') }}">
+              <label for="">Last Name <span class="text-danger">*</span> </label>
+              <input type="text" class="form-control rounded-0 py-3" required name="name_last" value="{{ old('name_last') }}">
               @error('name_last')
                 <small class="text-warning">{{$message}}</small>
               @enderror
@@ -83,22 +85,24 @@
             <label>Email <span class="text-danger">*</span> </label>
             <input type="email" class="form-control rounded-0 py-3" required name="email" value="{{ old('email') }}">
             @error('email')
-                <small class="text-warning">{{$message}}</small>
-              @enderror
-          </div>
-          <div class="form-group mb-4">
-            <label>Phone <span class="text-danger">*</span> </label>
-            <input type="tel" class="form-control rounded-0 py-3 phone" required name="phone" value="{{ old('phone') }}">
-            @error('phone')
-                <small class="text-warning">{{$message}}</small>
-              @enderror
+            <small class="text-warning">{{$message}}</small>
+            @enderror
           </div>
-          <div class="form-group mb-4">
-            <label>Zip / Postal Code <span class="text-danger">*</span> </label>
-            <input type="text" class="form-control rounded-0 py-3 zip" required phone name="zip" value="{{ old('zip') }}">
-            @error('zip')
-                <small class="text-warning">{{$message}}</small>
+          <div class="row">
+            <div class="col-lg-6 form-group mb-4">
+              <label>Phone <span class="text-danger">*</span> </label>
+              <input type="tel" class="form-control rounded-0 py-3 phone" required name="phone" value="{{ old('phone') }}">
+              @error('phone')
+                  <small class="text-warning">{{$message}}</small>
+                @enderror
+            </div>
+            <div class="col-lg-6 form-group mb-4">
+              <label>Zip / Postal Code <span class="text-danger">*</span> </label>
+              <input type="text" class="form-control rounded-0 py-3 zip" required phone name="zip" value="{{ old('zip') }}">
+              @error('zip')
+              <small class="text-warning">{{$message}}</small>
               @enderror
+            </div>
           </div>
           <div class="form-group mb-4">
             <label>How Can We Help You?<span class="text-danger">*</span></label>