easyappointments/application/views/pages/booking/booking_step_3.php
2021-11-23 08:41:37 +01:00

118 lines
5.3 KiB
PHP

<div id="wizard-frame-3" class="wizard-frame" style="display:none;">
<div class="frame-container">
<h2 class="frame-title"><?= lang('customer_information') ?></h2>
<div class="row frame-content">
<div class="col-12 col-md-6">
<div class="form-group">
<label for="first-name" class="control-label">
<?= lang('first_name') ?>
<span class="text-danger">*</span>
</label>
<input type="text" id="first-name" class="required form-control" maxlength="100"/>
</div>
<div class="form-group">
<label for="last-name" class="control-label">
<?= lang('last_name') ?>
<span class="text-danger">*</span>
</label>
<input type="text" id="last-name" class="required form-control" maxlength="120"/>
</div>
<div class="form-group">
<label for="email" class="control-label">
<?= lang('email') ?>
<span class="text-danger">*</span>
</label>
<input type="text" id="email" class="required form-control" maxlength="120"/>
</div>
<?php if ($show_field['phone-number']) : ?>
<div class="form-group">
<label for="phone-number" class="control-label">
<?= lang('phone_number') ?>
<?= $require_phone_number === '1' ? '<span class="text-danger">*</span>' : '' ?>
</label>
<input type="text" id="phone-number" maxlength="60"
class="<?= $require_phone_number === '1' ? 'required' : '' ?> form-control"/>
</div>
<?php endif; ?>
</div>
<div class="col-12 col-md-6">
<?php if ($show_field['address']) : ?>
<div class="form-group">
<label for="address" class="control-label">
<?= lang('address') ?>
</label>
<input type="text" id="address" class="form-control" maxlength="120"/>
</div>
<?php endif; ?>
<?php if ($show_field['city']): ?>
<div class="form-group">
<label for="city" class="control-label">
<?= lang('city') ?>
</label>
<input type="text" id="city" class="form-control" maxlength="120"/>
</div>
<?php endif; ?>
<?php if ($show_field['zip-code']) : ?>
<div class="form-group">
<label for="zip-code" class="control-label">
<?= lang('zip_code') ?>
</label>
<input type="text" id="zip-code" class="form-control" maxlength="120"/>
</div>
<?php endif; ?>
<?php if ($show_field['notes']) : ?>
<div class="form-group">
<label for="notes" class="control-label">
<?= lang('notes') ?>
</label>
<textarea id="notes" maxlength="500" class="form-control" rows="1"></textarea>
</div>
<?php endif; ?>
</div>
</div>
</div>
<?php if ($display_terms_and_conditions): ?>
<div class="form-check mb-3">
<input type="checkbox" class="required form-check-input" id="accept-to-terms-and-conditions">
<label class="form-check-label" for="accept-to-terms-and-conditions">
<?= strtr(lang('read_and_agree_to_terms_and_conditions'),
[
'{$link}' => '<a href="#" data-bs-toggle="modal" data-bs-target="#terms-and-conditions-modal">',
'{/$link}' => '</a>'
])
?>
</label>
</div>
<?php endif ?>
<?php if ($display_privacy_policy): ?>
<div class="form-check mb-3">
<input type="checkbox" class="required form-check-input" id="accept-to-privacy-policy">
<label class="form-check-label" for="accept-to-privacy-policy">
<?= strtr(lang('read_and_agree_to_privacy_policy'),
[
'{$link}' => '<a href="#" data-bs-toggle="modal" data-bs-target="#privacy-policy-modal">',
'{/$link}' => '</a>'
])
?>
</label>
</div>
<?php endif ?>
<div class="command-buttons">
<button type="button" id="button-back-3" class="btn button-back btn-outline-secondary"
data-step_index="3">
<i class="fas fa-chevron-left me-2"></i>
<?= lang('back') ?>
</button>
<button type="button" id="button-next-3" class="btn button-next btn-dark"
data-step_index="3">
<?= lang('next') ?>
<i class="fas fa-chevron-right ms-2"></i>
</button>
</div>
</div>