|
@@ -1,44 +1,38 @@
|
|
|
@extends ('app.admin.surveys.partials.form-layout')
|
|
|
-
|
|
|
+@section('header')
|
|
|
+ <span>Hi {{ $entity->displayName() }}</span>
|
|
|
+@endsection
|
|
|
@section('content')
|
|
|
-<div class="card">
|
|
|
- <div class="card-header">
|
|
|
- Hi {{ $entity->displayName() }}
|
|
|
+<form action="{{ route('view-survey-form-submit', $survey->access_key) }}" method="POST">
|
|
|
+ @csrf
|
|
|
+ <div class="row">
|
|
|
+ <div class="col-md-4">
|
|
|
+ <div class="form-group">
|
|
|
+ <label>First Name</label>
|
|
|
+ <input type="text" class="form-control" name="nameFirst" value="{{ $survey->getFieldValue('nameFirst') }}" />
|
|
|
+ </div>
|
|
|
+ </div>
|
|
|
+ <div class="col-md-4">
|
|
|
+ <div class="form-group">
|
|
|
+ <label>Middle Name</label>
|
|
|
+ <input type="text" class="form-control" name="nameMiddle" value="{{ $survey->getFieldValue('nameMiddle') }}" />
|
|
|
+ </div>
|
|
|
+ </div>
|
|
|
+ <div class="col-md-4">
|
|
|
+ <div class="form-group">
|
|
|
+ <label>Last Name</label>
|
|
|
+ <input type="text" class="form-control" name="nameLast" value="{{ $survey->getFieldValue('nameLast') }}" />
|
|
|
+ </div>
|
|
|
+ </div>
|
|
|
+ <div class="col-md-12">
|
|
|
+ <div class="form-group">
|
|
|
+ <label>Explain your sleep issue</label>
|
|
|
+ <textarea class="form-control" name="description">{{ $survey->getFieldValue('description') }}</textarea>
|
|
|
+ </div>
|
|
|
</div>
|
|
|
- <div class="card-body">
|
|
|
- <form action="{{ route('view-survey-form-submit', $survey->access_key) }}" method="POST">
|
|
|
- @csrf
|
|
|
- <div class="row">
|
|
|
- <div class="col-md-4">
|
|
|
- <div class="form-group">
|
|
|
- <label>First Name</label>
|
|
|
- <input type="text" class="form-control" name="nameFirst" value="{{ $survey->getFieldValue('nameFirst') }}" />
|
|
|
- </div>
|
|
|
- </div>
|
|
|
- <div class="col-md-4">
|
|
|
- <div class="form-group">
|
|
|
- <label>Middle Name</label>
|
|
|
- <input type="text" class="form-control" name="nameMiddle" value="{{ $survey->getFieldValue('nameMiddle') }}" />
|
|
|
- </div>
|
|
|
- </div>
|
|
|
- <div class="col-md-4">
|
|
|
- <div class="form-group">
|
|
|
- <label>Last Name</label>
|
|
|
- <input type="text" class="form-control" name="nameLast" value="{{ $survey->getFieldValue('nameLast') }}" />
|
|
|
- </div>
|
|
|
- </div>
|
|
|
- <div class="col-md-12">
|
|
|
- <div class="form-group">
|
|
|
- <label>Explain your sleep issue</label>
|
|
|
- <textarea class="form-control" name="description">{{ $survey->getFieldValue('description') }}</textarea>
|
|
|
- </div>
|
|
|
- </div>
|
|
|
- <div class="col-md-12">
|
|
|
- <button class="btn btn-sm btn-primary">Submit</button>
|
|
|
- </div>
|
|
|
- </div>
|
|
|
-
|
|
|
- </form>
|
|
|
+ <div class="col-md-12">
|
|
|
+ <button class="btn btn-sm btn-primary px-5 py-2">Submit</button>
|
|
|
</div>
|
|
|
-</div>
|
|
|
+ </div>
|
|
|
+</form>
|
|
|
@endsection
|