updated request sample

app/Http/Controllers/PhysiciansController.php

@@ -43,6 +43,9 @@ class PhysiciansController extends Controller
     public function orderProductsLigators(Request $request){
       return view('app.physicians.order-products.ligators');
     }
+    public function orderProductsSamples(Request $request){
+      return view('app.physicians.order-products.samples');
+    }
     public function orderProductsMarketing(Request $request){
       return view('app.physicians.order-products.marketing');
     }
@@ -163,9 +166,33 @@ class PhysiciansController extends Controller
       ]);
       return redirect()->back()->with('success', 'Your request has been submitted!');
     }
+    public function submitRequestSamples(Request $request){
+      $request->validate([
+        'company_name' => 'required|string',
+        'order_phyisician_name' => 'required|string',
+        'phone_number' => 'required|string',
+        'purchasing_contact_name' => 'required|string',
+        'email' => 'required|email',
+        'state' => 'required|string',
+        'city' => 'required|string',
+        'zip' => 'required|string',
+        'shipping_address' => 'required|string',
+        'g-recaptcha-response' => 'required|recaptcha'
+      ]);
 
+      $request['form_name'] = 'physician_request_sample';
+      $record = $this->saveWebForm($request);
+      //
+      $this->sendWebsiteEmailNotification([
+        'template' => 'physician-request-sample',
+        'subject' => 'Physician Request Sample',
+        'data' => (object) $request->all()
+      ]);
+      return redirect()->back()->with('orderIID', $record->iid)->with('success', 'Your sample has been submitted!');
+    }
     public function submitOrderLigators(Request $request){
       $request->validate([
+        'order_date' => 'required|string',
         'company_name' => 'required|string',
         'order_phyisician_name' => 'required|string',
         'phone_number' => 'required|string',

resources/views/app/physicians/index.blade.php

@@ -23,7 +23,7 @@
                         <p class="mb-3">The SNYDER HemBand makes outpatient banding easier than ever.</p>
                         <p class="mb-3">Get trained in less than 1 hour.</p>
                         <div class="d-sm-flex align-items-center my-4">
-                            <a href="{{ route('physicians.order-products-ligators') }}" class="btn btn-pry">Request Samples</a>
+                            <a href="{{ route('physicians.practice-support') }}" class="btn btn-pry">Learn More</a>
                             <a href="{{ route('physicians.get-trained') }}" class="btn btn-outline-pry ms-sm-4 ms-0">Get Trained</a>
                         </div>
                     </div>

resources/views/app/physicians/order-products.blade.php

@@ -31,7 +31,7 @@
     <div class="col-lg-8">
       <p>The Snyder HemBand System offers a suite of products to provide comprehensive hemorrhoid treatment for your practice. Click the buttons below to learn more about what we offer.</p>
       <div class="d-md-flex">
-        <a href="{{route('physicians.order-products-ligators')}}" class="d-flex align-items-center justify-content-center h-auto text-center text-white box-1 w-100">Request Samples</a>
+        <a href="{{route('physicians.order-products-ligators')}}" class="d-flex align-items-center justify-content-center h-auto text-center text-white box-1 w-100">Ligators</a>
         <a href="{{route('physicians.order-products-marketing')}}" class="d-flex align-items-center justify-content-center h-auto text-center text-white box-3 w-100">Marketing Materials</a>
         <a href="{{route('physicians.order-products-obp')}}" class="d-flex align-items-center justify-content-center h-auto text-center box-4 w-100">Anoscopes</a>
       </div>

resources/views/app/physicians/order-products/forms/place-order.blade.php

@@ -11,14 +11,30 @@
 
                 @if(session('success'))
               <div class="alert alert-success fade show" role="alert">
-                <p class="mb-1">Thank you. We have received your request.</p>
+                <p class="mb-1">Thank you. We have received your order.</p>
 
-                <p class="mb-1">Your request # is: {{ session('orderIID') }}</p>
+                <p class="mb-1">Your order # is: {{ session('orderIID') }}</p>
+
+                <p class="mb-1">We will be sending you an email shortly with secure payment options.</p>
               </div>
               @endif
 
 
             </div>
+            <div class="col-lg-6 form-group mb-4">
+                <label>Order Date: <span class="text-danger">*</span> </label>
+                <input type="text" name="order_date" class="form-control bg-white rounded-0 py-3" readonly value="{{date('m/d/Y')}}">
+                @error('order_date')
+                  <small class="text-warning">{{$message}}</small>
+                @enderror
+            </div>
+            <div class="col-lg-6 form-group mb-4">
+                <label>PO # (Optional):</label>
+                <input type="text" class="form-control rounded-0 py-3" name="postal_code" value="{{ old('postal_code') }}">
+                @error('postal_code')
+                  <small class="text-warning">{{$message}}</small>
+                @enderror
+            </div>
         </div>
         <div class="row">
             <div class="col-lg-6 form-group mb-4">
@@ -121,6 +137,9 @@
                     <tr>
                         <th>Ref No</th>
                         <th>Item</th>
+                        <th>Quantity</th>
+                        <th>Price / Unit</th>
+                        <th>Total Amount</th>
                     </tr>
                 </thead>
                 <tbody>
@@ -128,11 +147,26 @@
                         <td class="p-3 v-center">DS905727</td>
                         <td class="p-3 v-center">
                             <div class="">
+                                <div class="mb-4">
+                                    <img src="{{asset('img/snyder.png')}}" class="w-100" alt="">
+                                </div>
                                 <p>Snyder HemBand<sup>TM</sup> disposable hemorrhoidal ligator with integrated obturator.</p>
                                 <p>1 individual package.</p>
                                 <p>Includes 3 latex bands. Latex-free bands available upon request.</p>
                             </div>
                         </td>
+                        <td class="p-3 v-center">
+                            <input type="number" name="quantity" min="1" required v-model="quantity" class="form-control rounded-0 text-center" value="">
+                            @error('quantity')
+                                <small class="text-warning">{{$message}}</small>
+                            @enderror
+                        </td>
+                        <td class="p-3 v-center">$70.00 per unit</td>
+                        <td class="p-3 v-center">
+                            <div class="d-flex align-items-baseline">
+                                <span>$</span> <input type="text" name="total" disabled class="form-control border-0 bg-transparent text-center rounded-0 border-bottom border-dark" :value="quantity * 70 || ''">
+                            </div>
+                        </td>
                     </tr>
                     <tr v-if="quantity">
                         <td colspan="5">
@@ -144,11 +178,34 @@
                     </tr>
                 </tbody>
             </table>
+            <small><em>Prices are inclusive of all taxes. Prices valid in the U.S. only.</em></small>
+        </div>
+        <div class="form-group mb-4">
+            <p class="mb-2">Delivery Options</p>
+            <div class="form-check">
+                <label class="ms-2 mb-2 pointer">
+                    <input type="radio" required class="form-check-input" name="delivery_option" value="FedFedEx Standard Overnight (Next business day by 3PM) - FREE OF CHARGE">
+                    <span>FedFedEx Standard Overnight (Next business day by 3PM) - FREE OF CHARGE</span>
+                </label>
+                <label class="ms-2 mb-2 pointer">
+                    <input type="radio" required class="form-check-input" name="delivery_option" value="FedEx Priority Overnight (Next business day by 10AM) - $40.00">
+                    <span>FedEx Priority Overnight (Next business day by 10AM) - $40.00</span>
+                </label>
+                <label class="ms-2 mb-2 pointer">
+                    <input type="radio" required class="form-check-input" name="delivery_option" value="FedEx First Overnight (Next business day by 8AM) - $150.00">
+                    <span>FedEx First Overnight (Next business day by 8AM) - $150.00</span>
+                </label>
+            </div>
+            <small><em>* Priority and First Overnight shipping rates apply to a box of 20 units. Shipping rates may vary, subject to order quantity. FedEx does not deliver to PO Box/APO addresses. Some FedEx services are not available in all areas. Please note that all orders placed after 1pm EST will be processed next business day. No Saturday or Sunday delivery.</em> </small>
+        </div>
+        <div class="form-group mb-4">
+            <p class="mb-2">Payment Method</p>
+            <p><b>After you submit this form, you will receive an invoice with secure payment options.</b></p>
         </div>
         <div class="form-check mb-4">
+            <input class="form-check-input" type="checkbox" name="agrees_to_terms" required />
             <label class="form-check-label pointer">
-              <input class="form-check-input" type="checkbox" name="agrees_to_terms" required />
-                By submitting this request, I confirm that I am a physician or otherwise duly licensed healthcare practitioner authorized to provide hemorrhoid ligation treatment services in the United States.
+                By submitting this order, buyer has read, understands, and agrees to MDE Medical's <a target="_blank" href="{{route('terms')}}">Terms and Conditions</a>. Any overdue payments shall bear interest at a rate equal to the lesser of: (i) 1.5% per month, or (ii) the maximum amount permitted by law, assessed from the date payment was initially due.
             </label>
         </div>
         <div class="form-group mb-4">

resources/views/app/physicians/order-products/ligators.blade.php

@@ -1,14 +1,14 @@
 @extends('layouts.physicians')
 @section('content')
 
-<div class="bg-light d-lg-block d-none">
+<div class="bg-light">
   <div class="container pt-3">
     <nav class="mb-0">
       <ol class="breadcrumb">
         <li class="breadcrumb-item"><a href="{{route('index')}}"><u>Home</u></a></li>
         <li class="breadcrumb-item"><a href="{{route('physicians.index')}}"><u>Physicians</u></a></li>
         <li class="breadcrumb-item"><a href="{{route('physicians.order-products')}}"><u>Order Products</u></a></li>
-        <li class="breadcrumb-item active" aria-current="page">Request Samples</li>
+        <li class="breadcrumb-item active" aria-current="page">Ligators</li>
       </ol>
     </nav>
   </div>
@@ -18,7 +18,7 @@
   <div class="container">
     <div class="row justify-content-center">
       <div class="col-lg-7 text-center">
-        <h5 class="title m-0">Request Samples</h5>
+        <h5 class="title m-0">Ligators</h5>
       </div>
     </div>
   </div>
@@ -30,15 +30,9 @@
       @include('app.physicians.order-products.sidenav')
     </div>
     <div class="col-lg-8">
-      <div class="d-flex flex-column">
-        <div class="order-lg-1 order-2">
-          <h4 class="header">Order Snyder HemBand Samples Today!</h4>
-          <p class="mt-3 mb-4">If you are a licensed healthcare practitioner in the United States, you’re eligible to request Snyder HemBand samples using this online form. You may also email us at <u><a href="mailto:support@hemband.com">support@hemband.com</a></u> for assistance.</p>
-        </div>
-        <div class="mb-4 order-lg-2 order-1">
-            <img src="{{asset('img/snyder.png')}}" class="w-100" alt="">
-        </div>
-      </div>
+      <h4 class="header">Order Snyder HemBand Ligators Today</h4>
+      <p class="mt-3 mb-4">If you are a licensed healthcare practitioner in the United States, you’re eligible to order the Snyder HemBand using this online form. You may also use <u><a href="https://23496735.fs1.hubspotusercontent-na1.net/hubfs/23496735/HemBand%20with%20Integrated%20Obturator%20-%20Order%20Form.pdf" target="_blank">this PDF-based form</a></u> to order via fax or email.</p>
+
      @include('app.physicians.order-products.forms.place-order')
 
       <p>However, if you or your practice have not received training on the Snyder HemBand System, you can request training online and we will contact you shortly to schedule.</p>

resources/views/app/physicians/order-products/samples.blade.php

@@ -0,0 +1,215 @@
+@extends('layouts.physicians')
+@section('content')
+
+<div class="bg-light d-lg-block d-none">
+  <div class="container pt-3">
+    <nav class="mb-0">
+      <ol class="breadcrumb">
+        <li class="breadcrumb-item"><a href="{{route('index')}}"><u>Home</u></a></li>
+        <li class="breadcrumb-item"><a href="{{route('physicians.index')}}"><u>Physicians</u></a></li>
+        <li class="breadcrumb-item"><a href="{{route('physicians.order-products')}}"><u>Order Products</u></a></li>
+        <li class="breadcrumb-item active" aria-current="page">Request Samples</li>
+      </ol>
+    </nav>
+  </div>
+</div>
+
+<div class="bg-grey py-5">
+  <div class="container">
+    <div class="row justify-content-center">
+      <div class="col-lg-7 text-center">
+        <h5 class="title m-0">Request Samples</h5>
+      </div>
+    </div>
+  </div>
+</div>
+
+<div class="container py-5">
+  <div class="row">
+    <div class="col-lg-3 d-lg-block d-none">
+      @include('app.physicians.order-products.sidenav')
+    </div>
+    <div class="col-lg-8">
+      <div class="d-flex flex-column">
+        <div class="order-lg-1 order-2">
+          <h4 class="header">Order Snyder HemBand Samples Today!</h4>
+          <p class="mt-3 mb-4">If you are a licensed healthcare practitioner in the United States, you’re eligible to request Snyder HemBand samples using this online form. You may also email us at <u><a href="mailto:support@hemband.com">support@hemband.com</a></u> for assistance.</p>
+        </div>
+        <div class="mb-4 order-lg-2 order-1">
+            <img src="{{asset('img/snyder.png')}}" class="w-100" alt="">
+        </div>
+      </div>
+      <div class="bg-light border p-4 mb-4" id="formComponent">
+          <form class="" action="{{ route('physicians.submit-request-samples') }}" method="post" autocomplete="off">
+              @csrf
+              <div class="row">
+                  <div class="col-12">
+                      @if($errors->any())
+                      <div class="alert alert-danger fade show" role="alert">
+                          There were errors found!
+                      </div>
+                      @endif
+
+                      @if(session('success'))
+                    <div class="alert alert-success fade show" role="alert">
+                      <p class="mb-1">Thank you. We have received your request.</p>
+
+                      <p class="mb-1">Your request # is: {{ session('orderIID') }}</p>
+                    </div>
+                    @endif
+
+
+                  </div>
+              </div>
+              <div class="row">
+                  <div class="col-lg-6 form-group mb-4">
+                      <label>Company name: <span class="text-danger">*</span></label>
+                      <input type="text" class="form-control rounded-0 py-3" name="company_name" required value="{{ old('company_name') }}">
+                      @error('company_name')
+                        <small class="text-warning">{{$message}}</small>
+                      @enderror
+                  </div>
+                  <div class="col-lg-6 form-group mb-4">
+                      <label>Group NPI:</label>
+                      <input type="text" class="form-control rounded-0 py-3" name="group_npi" value="{{ old('group_npi') }}">
+                      @error('group_npi')
+                        <small class="text-warning">{{$message}}</small>
+                      @enderror
+                  </div>
+              </div>
+              <div class="row">
+                  <div class="col-lg-6 form-group mb-4">
+                      <label>Order physician name: <span class="text-danger">*</span></label>
+                      <input type="text" class="form-control rounded-0 py-3" name="order_phyisician_name" required value="{{ old('order_phyisician_name') }}">
+                      @error('order_phyisician_name')
+                        <small class="text-warning">{{$message}}</small>
+                      @enderror
+                  </div>
+                  <div class="col-lg-6 form-group mb-4">
+                      <label>Physician NPI:</label>
+                      <input type="text" class="form-control rounded-0 py-3" name="physician_npi" value="{{ old('physician_npi') }}">
+                      @error('physician_npi')
+                        <small class="text-warning">{{$message}}</small>
+                      @enderror
+                  </div>
+              </div>
+              <div class="row">
+                  <div class="col-lg-5 form-group mb-4">
+                      <label>Purchasing contact name: <span class="text-danger">*</span></label>
+                      <input type="text" class="form-control rounded-0 py-3" name="purchasing_contact_name" required value="{{ old('purchasing_contact_name') }}">
+                      @error('purchasing_contact_name')
+                        <small class="text-warning">{{$message}}</small>
+                      @enderror
+                  </div>
+                  <div class="col-lg-3 form-group mb-4">
+                      <label>Phone Number: <span class="text-danger">*</span></label>
+                      <input type="tel" class="form-control rounded-0 py-3 phone" required name="phone_number" value="{{ old('phone_number') }}">
+                      @error('phone_number')
+                        <small class="text-warning">{{$message}}</small>
+                      @enderror
+                  </div>
+                  <div class="col-lg-4 form-group mb-4">
+                      <label>Email: <span class="text-danger">*</span></label>
+                      <input type="email" class="form-control rounded-0 py-3" required name="email" value="{{ old('email') }}">
+                      @error('email')
+                        <small class="text-warning">{{$message}}</small>
+                      @enderror
+                  </div>
+              </div>
+              <div class="row">
+                  <div class="col-lg-6 form-group mb-4">
+                      <label>Shipping Address: <span class="text-danger">*</span></label>
+                      <input type="text" class="form-control rounded-0 py-3" name="shipping_address" required value="{{ old('shipping_address') }}">
+                      @error('shipping_address')
+                        <small class="text-warning">{{$message}}</small>
+                      @enderror
+                  </div>
+                  <div class="col-lg-6 form-group mb-4">
+                      <label>Line 2:</label>
+                      <input type="text" class="form-control rounded-0 py-3" name="line_2" value="{{ old('line_2') }}">
+                      @error('line_2')
+                        <small class="text-warning">{{$message}}</small>
+                      @enderror
+                  </div>
+              </div>
+              <div class="row">
+                  <div class="col-lg-5 form-group mb-4">
+                      <label>City: <span class="text-danger">*</span></label>
+                      <input type="text" class="form-control rounded-0 py-3" name="city" required value="{{ old('city') }}">
+                      @error('city')
+                        <small class="text-warning">{{$message}}</small>
+                      @enderror
+                  </div>
+                  <div class="col-lg-3 form-group mb-4">
+                      <label>State: <span class="text-danger">*</span></label>
+                      <input type="text" class="form-control rounded-0 py-3" name="state" value="{{ old('state') }}">
+                      @error('state')
+                        <small class="text-warning">{{$message}}</small>
+                      @enderror
+                  </div>
+                  <div class="col-lg-4 form-group mb-4">
+                      <label>Zip: <span class="text-danger">*</span></label>
+                      <input type="text" class="form-control rounded-0 py-3 zip" name="zip" value="{{ old('zip') }}">
+                      @error('zip')
+                        <small class="text-warning">{{$message}}</small>
+                      @enderror
+                  </div>
+              </div>
+              <div class="mb-4 table-responsive">
+                  <p class="mb-1">Item(s) Ordered</p>
+                  <table class="table table-bordered table-sm">
+                      <thead class="bg-info bg-opacity-10">
+                          <tr>
+                              <th>Ref No</th>
+                              <th>Item</th>
+                          </tr>
+                      </thead>
+                      <tbody>
+                          <tr>
+                              <td class="p-3 v-center">DS905727</td>
+                              <td class="p-3 v-center">
+                                  <div class="">
+                                      <p>Snyder HemBand<sup>TM</sup> disposable hemorrhoidal ligator with integrated obturator.</p>
+                                      <p>1 individual package.</p>
+                                      <p>Includes 3 latex bands. Latex-free bands available upon request.</p>
+                                  </div>
+                              </td>
+                          </tr>
+                      </tbody>
+                  </table>
+              </div>
+              <div class="form-check mb-4">
+                  <label class="form-check-label pointer">
+                    <input class="form-check-input" type="checkbox" name="agrees_to_terms" required />
+                      By submitting this request, I confirm that I am a physician or otherwise duly licensed healthcare practitioner authorized to provide hemorrhoid ligation treatment services in the United States.
+                  </label>
+              </div>
+              <div class="form-group mb-4">
+                  {!! htmlFormSnippet() !!}
+                  @error('g-recaptcha-response')
+                  <small class="text-danger"><i class="fas fa-exclamation-triangle mr-2"></i>Invalid</small>
+                  @enderror
+              </div>
+              <div class="d-sm-flex btn-fw">
+                  <button type="button" class="btn btn-outline-pry px-5 py-2 me-sm-3 mb-sm-0 mb-3 d-block" data-bs-toggle="modal" data-bs-target="#confirmClearForm">Clear Form</button>
+                  <button type="submit" class="btn btn-pry px-5 py-2 d-block">Submit Order</button>
+              </div>
+              <div class="modal fade" id="confirmClearForm" data-bs-backdrop="static" data-bs-keyboard="false" tabindex="-1" aria-labelledby="confirmClearFormLabel" aria-hidden="true">
+                  <div class="modal-dialog modal-dialog-centered">
+                      <div class="modal-content">
+                          <div class="modal-body">
+                              <p>Are you sure you want to clear this form?</p>
+                              <div class="">
+                                  <button type="button" class="btn btn-outline-dark me-2 px-4" data-bs-dismiss="modal">No</button>
+                                  <a href="{{route('physicians.order-products-ligators')}}" class="btn btn-danger px-4">Yes</a>
+                              </div>
+                          </div>
+                      </div>
+                  </div>
+              </div>
+          </form>
+      </div>
+    </div>
+  </div>
+</div>
+@endsection

resources/views/app/physicians/order-products/sidenav.blade.php

@@ -2,8 +2,9 @@
 $segment = Request::segment(3);
  ?>
 <div class="mt-lg-4">
+  <p><a class="sublinks {{$segment == 'request-samples' ? 'active' : ''}}" href="{{route('physicians.order-products-samples')}}">- REQUEST SAMPLES</a></p>
   <p><a class="sublinks {{!$segment ? 'active' : ''}}" href="{{route('physicians.order-products')}}">- ORDER PRODUCTS</a></p>
-  <p><a class="sublinks {{$segment == 'ligators' ? 'active' : ''}}" href="{{route('physicians.order-products-ligators')}}">- REQUEST SAMPLES</a></p>
+  <p><a class="sublinks {{$segment == 'ligators' ? 'active' : ''}}" href="{{route('physicians.order-products-ligators')}}">- LIGATORS</a></p>
   <p><a class="sublinks {{$segment == 'marketing-materials' ? 'active' : ''}}" href="{{route('physicians.order-products-marketing')}}">- MARKETING MATERIALS</a></p>
   <p><a class="sublinks {{$segment == 'obp' ? 'active' : ''}}" href="{{route('physicians.order-products-obp')}}">- ANOSCOPES</a></p>
 </div>

resources/views/emails/physician-order-ligators.blade.php

@@ -8,6 +8,8 @@
         $data = $details['data'];
     ?>
 
+    <div><b>Order Date:</b>{{ $data->order_date }}</div>
+    <div><b>Postal Code:</b>{{ $data->postal_code }}</div>
     <div><b>Company Name:</b>{{ $data->company_name }}</div>
     <div><b>Group Npi:</b>{{ $data->group_npi }}</div>
     <div><b>Order Phyisician Name:</b>{{ $data->order_phyisician_name }}</div>
@@ -20,6 +22,7 @@
     <div><b>City:</b>{{ $data->city }}</div>
     <div><b>State:</b>{{ $data->state }}</div>
     <div><b>Zip:</b>{{ $data->zip }}</div>
+    <div><b>Quantity:</b>{{ $data->quantity }}</div>
     <div><b>Memo:</b>{{ $data->memo }}</div>
     <div><b>Delivery Option:</b>{{ $data->delivery_option }}</div>
     <div><b>Agrees To Terms:</b>{{ $data->agrees_to_terms }}</div>

resources/views/emails/physician-request-sample.blade.php

@@ -0,0 +1,29 @@
+<!DOCTYPE html>
+<html>
+<head>
+    <title>{{ $details['subject'] }}</title>
+</head>
+<body>
+    <?php
+        $data = $details['data'];
+    ?>
+
+    <div><b>Company Name:</b>{{ $data->company_name }}</div>
+    <div><b>Group Npi:</b>{{ $data->group_npi }}</div>
+    <div><b>Order Phyisician Name:</b>{{ $data->order_phyisician_name }}</div>
+    <div><b>Physician Npi:</b>{{ $data->physician_npi }}</div>
+    <div><b>Purchasing Contact Name:</b>{{ $data->purchasing_contact_name }}</div>
+    <div><b>Phone Number:</b>{{ $data->phone_number }}</div>
+    <div><b>Email:</b>{{ $data->email }}</div>
+    <div><b>Shipping Address:</b>{{ $data->shipping_address }}</div>
+    <div><b>Line 2:</b>{{ $data->line_2 }}</div>
+    <div><b>City:</b>{{ $data->city }}</div>
+    <div><b>State:</b>{{ $data->state }}</div>
+    <div><b>Zip:</b>{{ $data->zip }}</div>
+    <div><b>Memo:</b>{{ $data->memo }}</div>
+    <div><b>Delivery Option:</b>{{ $data->delivery_option }}</div>
+    <div><b>Agrees To Terms:</b>{{ $data->agrees_to_terms }}</div>
+
+
+</body>
+</html>

resources/views/layouts/physicians.blade.php

@@ -44,7 +44,7 @@
                               <a class="nav-link" href="{{ route('physicians.contact-us') }}">Contact Us</a>
                             </li>
                             <li class="nav-item d-lg-block d-none">
-                                <a class="btn px-4 py-2 rounded-0 btn-pry" href="{{ route('physicians.order-products-ligators') }}">Order Now</a>
+                                <a class="btn px-4 py-2 rounded-0 btn-pry" href="{{ route('physicians.order-products-samples') }}">Request Samples</a>
                             </li>
                         </ul>
                     </div>

routes/web.php

@@ -38,8 +38,9 @@ Route::prefix('/physicians/')->name('physicians.')->group(function () {
     Route::get('/practice-support/directory-listing', [PhysiciansController::class, 'practiceSupportDirectoryListing'])->name('practice-support-directory');
     Route::post('/practice-support/submit-directory-listing', [PhysiciansController::class, 'submitPracticeSupportDirectoryListing'])->name('submit-practice-support-directory-listing-request');
     Route::get('/order-products', [PhysiciansController::class, 'orderProducts'])->name('order-products');
-    // Route::get('/order-products/ligators', [PhysiciansController::class, 'orderProductsLigators'])->name('order-products-ligators');
-    Route::get('/order-products/request-samples', [PhysiciansController::class, 'orderProductsLigators'])->name('order-products-ligators');
+    Route::get('/order-products/request-samples', [PhysiciansController::class, 'orderProductsSamples'])->name('order-products-samples');
+    Route::post('/submit-request-samples', [PhysiciansController::class, 'submitRequestSamples'])->name('submit-request-samples');
+    Route::get('/order-products/ligators', [PhysiciansController::class, 'orderProductsLigators'])->name('order-products-ligators');
     Route::post('/submit-order-ligators', [PhysiciansController::class, 'submitOrderLigators'])->name('submit-order-ligators');
     Route::get('/order-products/marketing-materials', [PhysiciansController::class, 'orderProductsMarketing'])->name('order-products-marketing');
     Route::post('/order-products/submit-marketing-materials-request', [PhysiciansController::class, 'submitOrderProductsMarketing'])->name('submit-order-products-marketing');