survey-questions.blade.php 6.0 KB

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  1. @extends('layouts.app')
  2. @section('content')
  3. <link rel="stylesheet" href="{{ asset('css/nouislider.min.css') }}" />
  4. <script src="{{ asset('js/nouislider.min.js') }}"></script>
  5. <style>
  6. .form-group label {
  7. font-weight: 500;
  8. }
  9. .form-group label span {
  10. font-weight: 400;
  11. }
  12. </style>
  13. <div class="bg-light">
  14. <div class="container pt-3">
  15. <nav class="mb-0">
  16. <ol class="breadcrumb">
  17. <li class="breadcrumb-item"><a href="{{route('index')}}"><u>Home</u></a></li>
  18. <li class="breadcrumb-item active" aria-current="page">Survey Questions</li>
  19. </ol>
  20. </nav>
  21. </div>
  22. </div>
  23. <div class="bg-grey py-5">
  24. <div class="container">
  25. <div class="row justify-content-center">
  26. <div class="col-lg-7 text-center">
  27. <h5 class="subtitle">Survey Questions</h5>
  28. </div>
  29. </div>
  30. </div>
  31. </div>
  32. <div class="container py-5">
  33. <div class="row justify-content-center">
  34. <div id="surveyQuestionsComponent" class="col-md-12">
  35. <form action="{{ route('submit-survey-questions') }}" method="POST">
  36. @csrf
  37. <div class="row mb-3">
  38. <div class="col-12">
  39. <div class="bg-light border p-3">
  40. <div class="row">
  41. <div class="col-md-4">
  42. <div class="form-group">
  43. <label>Name<sup class="text-danger">*</sup></label>
  44. <input type="text" class="form-control" name="name" required />
  45. </div>
  46. </div>
  47. <div class="col-md-4">
  48. <div class="form-group">
  49. <label>Email</label>
  50. <input type="email" class="form-control" name="email" />
  51. <small class="text-muted">(to receive digital gift card)</small>
  52. </div>
  53. </div>
  54. <div class="col-md-4">
  55. <div class="form-group">
  56. <label>Cell Number</label>
  57. <input type="text" class="form-control" name="cellNumber" />
  58. </div>
  59. </div>
  60. <div class="col-md-12">
  61. <div class="form-group">
  62. <label>Practice Address</label>
  63. <input type="text" class="form-control" name="practiceAddress" />
  64. </div>
  65. </div>
  66. </div>
  67. </div>
  68. </div>
  69. </div>
  70. <div class="row mb-3">
  71. <div class="col-12 question">
  72. <div class="form-group">
  73. <label>Are you a gastroenterologist?</label>
  74. <div class="d-flex flex-column">
  75. <label><input type="radio" name="are_you_a_gastroenterologist" v-model="form.are_you_a_gastroenterologist" value="YES" /> <span>Yes</span></label>
  76. <label><input type="radio" name="are_you_a_gastroenterologist" v-model="form.are_you_a_gastroenterologist" value="NO" /> <span>No</span></label>
  77. </div>
  78. </div>
  79. <div v-if="form.are_you_a_gastroenterologist == 'NO'" class="form-group">
  80. <label>Your speciality?<sup class="text-danger">*</sup></label>
  81. <input type="text" class="form-control" name="your_specialty" required />
  82. </div>
  83. </div>
  84. </div>
  85. <div class="row mb-3">
  86. <div class="col-12 question">
  87. <div class="form-group">
  88. <label>Years in practice</label>
  89. <div id="rangeSlider" class="noUiSlider"></div>
  90. </div>
  91. </div>
  92. </div>
  93. <div class="row mt-3">
  94. <div class="col-12">
  95. <button type="submit" class="btn btn-pry w-100 py-3">SUBMIT</button>
  96. </div>
  97. </div>
  98. </form>
  99. </div>
  100. </div>
  101. </div>
  102. <script>
  103. var surveyQuestionsComponent = new Vue({
  104. el: '#surveyQuestionsComponent',
  105. data: {
  106. form: {
  107. are_you_a_gastroenterologist: null
  108. }
  109. },
  110. methods: {
  111. initRangeSlider: function() {
  112. var slider = document.getElementById('rangeSlider');
  113. var format = {
  114. to: function(value) {
  115. return Math.round(value);
  116. },
  117. from: function(value) {
  118. return Math.round(value);
  119. }
  120. };
  121. noUiSlider.create(slider, {
  122. start: 0,
  123. connect: 'lower',
  124. range: {
  125. 'min': 0,
  126. 'max': 70
  127. },
  128. step: 1,
  129. tooltips: true,
  130. format: format
  131. });
  132. slider.noUiSlider.on('update', function(values, handle) {
  133. console.log({
  134. values
  135. });
  136. });
  137. },
  138. init: function() {
  139. this.initRangeSlider();
  140. }
  141. },
  142. mounted: function() {
  143. this.init();
  144. }
  145. });
  146. </script>
  147. @endsection