@extends('layouts.frontend')

@section('title', '| FREE END-OF-LIFE PLAN')

@section('content')
@include('frontend.forms.End-Of-Life-Plan.stepIndicator')
 <!-- start -->
<div class="container">
    <form action="{{route('EndoflifePlanFormStore')}}" method="POST" id="signUpForm">
      @csrf
      <input type="hidden" id="stepInput" name="step" value="6-1">
      <div class="card">
         <div class="card-body">
            <!-- step 1 -->
            <div class="step" style="display: block">
               <div class="row">
                  <div class="col-md-8">
                     <div class="card-title">Final Instructions</div>
                     <div class="card-sub-title">Do you have any additional end-of-life wishes?</div>
                     <div class="custom-button-yn mb-5">
                        <input id="instructions-y" name="final-instructions" value="yes" type="radio"  {{ !empty($endoflifePlanForm->final_instructions)  ? 'checked' : '' }}>
                        <label for="instructions-y">Yes</label>
                        <input id="instructions-n" name="final-instructions" value="no" type="radio"  {{ empty($endoflifePlanForm->final_instructions) ? 'checked' : '' }}>
                        <label for="instructions-n">No</label>
                     </div>
                     <div id="instructions-sectionb">
                        <div id="instructions-container">
                            @if (empty($endoflifePlanForm->final_instructions))
                              <div class="card list mb-3" id="child">
                                 <div class="card-header d-flex justify-content-between">
                                    <div class="card-title m-0">Describe your wishes in complete sentences:</div>
                                    <a class="r-button" onclick="removetList(this)">
                                    <span class="fas fa-times"></span>
                                    <span class="remove">Remove</span>
                                    </a>
                                 </div>
                                 <div class="card-body">
                                    <div class="form-group mb-3">
                                       {{-- <label for="name">Write your message in complete sentences:</label> --}}
                                       <input type="text" class="form-control modified-input" name="another_message[]">
                                       <small id="nameHelp" class="form-text text-muted">e.g. I would like a memorial bench to be set up in my honor at the Arnold Arboretum, Boston, MA.</small>
                                    </div>
                                 </div>
                              </div>
                           @else
                              @foreach(json_decode($endoflifePlanForm->final_instructions) as $amsg)
                                 <div class="card list mb-3" id="child">
                                    <div class="card-header d-flex justify-content-between">
                                        <div class="card-title m-0">Describe your wishes in complete sentences:</div>
                                        <a class="r-button" onclick="removetList(this)">
                                        <span class="fas fa-times"></span>
                                        <span class="remove">Remove</span>
                                        </a>
                                     </div>
                                    <div class="card-body">
                                       <div class="form-group mb-3">
                                          <label for="name">Write your message in complete sentences:</label>
                                          <input type="text" class="form-control modified-input" name="another_message[]" value="{{ $amsg->message }}">
                                          <small id="nameHelp" class="form-text text-muted">e.g. I would like a memorial bench to be set up in my honor at the Arnold Arboretum, Boston, MA.</small>
                                       </div>
                                    </div>
                                 </div>
                              @endforeach
                           @endif
                        </div>
                        <div class="add-child">
                           <a href="#" id="add-thoughts-button" onclick="clone('instructions-container')">
                           <span class="fas fa-plus"></span>        
                           Add another message
                           </a>
                        </div>
                     </div>
                  </div>
               </div>
            </div>
            <!-- start previous / next buttons -->
            <div id="buttonsection">
               <div class="form-footer d-flex justify-content-between">
                  <div>
                  <button type="button" onclick="window.location.href = '{{ route('endoflifePlan.create.step.six') }}'" class="btn btn-light btn-lg back-btn">Back</button>
                  <button type="submit" class="btn btn-light btn-lg">Save and Continue</button>
               </div>
               <button type="submit" class="btn btn-light btn-lg" name="preview_submit" value="preview">{{env('PREVIEW_BUTTON_TEXT')}}</button>
                  <button type="button" class="btn btn-light btn-lg skip-btn d-none">Skip Step</button>
               </div>
            </div>
            <!-- end previous / next buttons -->
         </div>
      </div>
</div>
@endsection
@section('page-js')
<script src="{{ url('frontend/assets/js/forms/end-of-life-plan-multi-step.js?v=10.1.1') }}"></script>
<script src="{{ url('frontend/assets/js/forms/custom.js?v=10.3') }}"></script>

@endsection