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@@ -10,11 +10,60 @@
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</nav>
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</div>
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</div>
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-<div class="container py-5">
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- <div class="row justify-content-center">
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- <div class="col-lg-7 text-center">
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- <h5 class="subtitle">Comparing treatment options</h5>
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- <p>Hemorrhoids get treated at doctors' offices with different treatment options. Synder Hemband ligation treatment is the most effective, fast, and painless treatment compared to other treatments. It has the least complications and hemorrhoids are less likely to come back than other treatments.</p>
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+<div class="container py-5 my-4">
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+ <div class="row">
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+ <div class="col-lg-6 bg-grey p-lg-5 p-4">
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+ <h4 class="subtitle">Get in touch with us:</h4>
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+ <p class="mb-4">Send us Message and we will get back to you!</p>
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+ <form class="" action="" method="post">
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+ @csrf
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+ <div class="row mb-4">
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+ <div class="col-lg-6 form-group">
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+ <input type="text" class="form-control rounded-0 py-3" name="fname" placeholder="First Name" required value="">
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+ </div>
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+ <div class="col-lg-6 form-group">
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+ <input type="text" class="form-control rounded-0 py-3" name="lname" placeholder="Last Name" required value="">
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+ </div>
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+ </div>
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+ <div class="form-group mb-4">
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+ <input type="email" class="form-control rounded-0 py-3" name="email" placeholder="Email Address" required value="">
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+ </div>
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+ <div class="form-group mb-4">
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+ <input type="text" class="form-control rounded-0 py-3" name="subject" placeholder="Subject" required value="">
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+ </div>
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+ <div class="form-group mb-4">
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+ <textarea name="message" class="form-control rounded-0" required placeholder="Message" rows="6"></textarea>
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+ </div>
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+ <button type="submit" class="btn btn-pry w-100 py-3">Submit message</button>
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+ </form>
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+ </div>
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+ <div class="col-lg-5 offset-lg-1">
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+ <iframe src="https://www.google.com/maps/embed?pb=!1m18!1m12!1m3!1d7319.087334623804!2d-75.68153637595971!3d39.66958345452699!2m3!1f0!2f0!3f0!3m2!1i1024!2i768!4f13.1!3m3!1m2!1s0x89c700d1a9f368ed%3A0xe0065e295c0b7653!2s258%20Chapman%20Rd%2C%20Newark%2C%20DE%2019702%2C%20USA!5e0!3m2!1sen!2ske!4v1665057570431!5m2!1sen!2ske" height="350" class="w-100" style="border:0;" allowfullscreen="" loading="lazy" referrerpolicy="no-referrer-when-downgrade"></iframe>
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+ <div class="row mt-5">
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+ <div class="col-lg-6">
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+ <h5 class="header m-0">Our Office</h5>
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+ <hr class="w-75 my-3">
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+ <div class="">
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+ 258 Chapman Road, <br>
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+ Suite 101-A, <br>
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+ Newark, DE 19702
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+ </div>
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+ </div>
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+ <div class="col-lg-6">
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+ <h5 class="header m-0">Contact</h5>
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+ <hr class="w-75 my-3">
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+ <h5 class="mb-2">General questions</h5>
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+ <div class="mb-4">
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+ <a class="text-dark" href="mailto:info@snyderhemband.com">info@snyderhemband.com</a> <br>
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+ <a class="text-dark" href="tel:+1-833-444-8448">+1-833-444-8448</a>
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+ </div>
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+ <h5 class="mb-2">For physicians</h5>
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+ <div class="mb-4">
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+ <a class="text-dark" href="mailto:phy@snyderhemband.com">phy@snyderhemband.com</a> <br>
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+ <a class="text-dark" href="tel:+1-833-444-8448">+1-833-444-8448</a>
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+ </div>
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+ </div>
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+ </div>
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</div>
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</div>
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</div>
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