@extends('layouts.v2.frontend-user-backend')

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

@section('content')
@include('frontend.forms.v2.End-Of-Life-Plan.stepIndicator')
    <form action="{{route('EndoflifePlanFormStore')}}" method="POST" id="signUpForm">
      @csrf
      <input type="hidden" id="stepInput" name="step" value="4-4-2">
      <div class="multiple-form dashboard-radio">
         @if(isset($endoflifePlanForm->cremation) &&  $endoflifePlanForm->cremation == "burial")
            <h4>Burial instructions</h4>
            <p>Would you like to leave specific instructions for your cremation now?</p>
            <span class="tooltiptext d-none">
               If you select No, you can add your specific instructions later, after printing or downloading this End-of-Life Plan.
            </span>
            <div class="form">
               <div class="row">
                  <div class="col-12">
                     @php 
                        $cremationBurialTypes = json_decode($endoflifePlanForm->cremation_burialin_type, true);
                     @endphp
                     <div class="dashboard-radio-form">
                        <div class="form-check">
                           <input id="burialin-y" class="form-check-input" name="burialin" type="radio" value="yes" {{ isset($cremationBurialTypes['burialin']) && $cremationBurialTypes['burialin'] === 'yes' ? 'checked' : '' }}>
                           <label for="burialin-y"><p>Yes</p></label>
                        </div>
                        <div class="form-check">
                           <input id="burialin-n" class="form-check-input" name="burialin" type="radio" value="no" {{ isset($cremationBurialTypes['burialin']) && $cremationBurialTypes['burialin'] === 'no' ? 'checked' : '' }}>
                           <label for="burialin-n"><p>No</p></label>
                        </div>
                     </div>

                     <div id="burialin-sec" class="form-check-list">
                        <p class="mt-5">What details do you want to provide? (Select all that apply.)</p>
                        <div class="form-check">
                           <label class="form-check-label" id="form-check-label-custom">
                                 <input {{ isset($cremationBurialTypes['type']) && in_array('Final Resting Place', $cremationBurialTypes['type']) ? 'checked' : '' }} type="checkbox" class="form-check-input" name="burialintype[]" value="Final Resting Place">
                                 <p>Final Resting Place</p>
                           </label>
                           <div class="tooltip d-none">
                                 <div class="iccon">?</div>
                                 <span class="tooltiptext">
                                 Your final resting place is where your body will be laid to rest, e.g. buried in an urn garden or cemetery plot.
                                 </span>
                           </div>
                        </div>
                        <div class="form-check">
                           <label class="form-check-label" id="form-check-label-custom">
                                 <input {{ isset($cremationBurialTypes['type']) &&  in_array('Urn', $cremationBurialTypes['type']) ? 'checked' : '' }} type="checkbox" class="form-check-input" name="burialintype[]" value="Urn">
                                 <p>Urn</p>
                           </label>
                        </div>
                        <div class="form-check">
                           <label class="form-check-label" id="form-check-label-custom">
                                 <input {{ isset($cremationBurialTypes['type']) &&  in_array('Grave Marker', $cremationBurialTypes['type']) ? 'checked' : '' }} type="checkbox" class="form-check-input" name="burialintype[]" value="Grave Marker">
                                 <p>Grave Marker</p>
                           </label>
                        </div>
                        <div class="form-check">
                           <label class="form-check-label" id="form-check-label-custom">
                                 <input {{ isset($cremationBurialTypes['type']) &&  in_array('Epitaph', $cremationBurialTypes['type']) ? 'checked' : '' }} type="checkbox" class="form-check-input" name="burialintype[]" value="Epitaph">
                                 <p>Epitaph</p>
                           </label>
                        </div>
                        <div class="form-check">
                           <label class="form-check-label" id="form-check-label-custom">
                                 <input {{ isset($cremationBurialTypes['type']) &&  in_array('Other', $cremationBurialTypes['type']) ? 'checked' : '' }} type="checkbox" class="form-check-input" name="burialintype[]" value="Other">
                                 <p>Other</p>
                           </label>
                        </div>
                     </div>
                     <div id="BurialTypesError" class="BurialTypesError a-status-error-message text-danger small fw-bold d-none mb-4"></div>
                  </div>
               </div>
            </div>
         @endif
         @if(isset($endoflifePlanForm->cremation) &&  $endoflifePlanForm->cremation == "columbarium")
            <h4>Columbarium Instructions</h4>
            <p>Would you like to leave specific instructions for your cremation now?</p>
            <span class="tooltiptext d-none">
               If you select No, you can add your specific instructions later, after printing or downloading this End-of-Life Plan.
            </span>
            <div class="form">
               <div class="row">
                  <div class="col-12">
                     @php 
                        $cremationColumbariumTypes = json_decode($endoflifePlanForm->cremation_columbarium_type, true);
                     @endphp
                     <div class="dashboard-radio-form">
                        <div class="form-check">
                           <input id="columbarium-y" class="form-check-input" name="columbarium" type="radio" value="yes" {{ isset($cremationColumbariumTypes['columbarium']) && $cremationColumbariumTypes['columbarium'] === 'yes' ? 'checked' : '' }}>
                           <label for="columbarium-y"><p>Yes</p></label>
                        </div>
                        <div class="form-check">
                           <input id="columbarium-n" class="form-check-input" name="columbarium" type="radio" value="no" {{ isset($cremationColumbariumTypes['columbarium']) && $cremationColumbariumTypes['columbarium'] === 'no' ? 'checked' : '' }}>
                           <label for="columbarium-n"><p>No</p></label>
                        </div>
                     </div>

                     <div id="columbarium-sec" class="form-check-list">
                        <p class="mt-5">What details do you want to provide? (Select all that apply.)</p>
                        <div class="form-check mb-3">
                           <label class="form-check-label" id="form-check-label-custom">
                                 <input {{ isset($cremationColumbariumTypes['type']) && in_array('Final Resting Place', $cremationColumbariumTypes['type']) ? 'checked' : '' }} type="checkbox" class="form-check-input" name="columbariumtype[]" value="Final Resting Place">
                                 <p>Final Resting Place</p>
                           </label>
                           <div class="tooltip d-none">
                                 <div class="iccon">?</div>
                                 <span class="tooltiptext">
                                 Your final resting place is where your body will be laid to rest, e.g. buried in an urn garden or cemetery plot.
                                 </span>
                           </div>
                        </div>
                        <div class="form-check mb-3">
                           <label class="form-check-label" id="form-check-label-custom">
                                 <input {{ isset($cremationColumbariumTypes['type']) &&  in_array('Urn', $cremationColumbariumTypes['type']) ? 'checked' : '' }} type="checkbox" class="form-check-input" name="columbariumtype[]" value="Urn">
                                 <p>Urn</p>
                           </label>
                        </div>

                        <div class="form-check mb-3">
                           <label class="form-check-label" id="form-check-label-custom">
                                 <input {{ isset($cremationColumbariumTypes['type']) &&  in_array('Epitaph', $cremationColumbariumTypes['type']) ? 'checked' : '' }} type="checkbox" class="form-check-input" name="columbariumtype[]" value="Epitaph">
                                 <p>Epitaph</p>
                           </label>
                        </div>
                        <div class="form-check mb-3">
                           <label class="form-check-label" id="form-check-label-custom">
                                 <input {{ isset($cremationColumbariumTypes['type']) &&  in_array('Other', $cremationColumbariumTypes['type']) ? 'checked' : '' }} type="checkbox" class="form-check-input" name="columbariumtype[]" value="Other">
                                 <p>Other</p>
                           </label>
                        </div>
                     </div>
                     <div id="BurialTypesError" class="BurialTypesError a-status-error-message text-danger small fw-bold d-none mb-4"></div>
                  </div>
               </div>
            </div>
         @endif
         @if(isset($endoflifePlanForm->cremation) &&  $endoflifePlanForm->cremation == "loved")
            <h4>Instructions</h4>
            <p>Would you like to leave specific instructions for your cremation now?</p>
            <span class="tooltiptext d-none">
               If you select No, you can add your specific instructions later, after printing or downloading this End-of-Life Plan.
            </span>
            <div class="form">
               <div class="row">
                  <div class="col-12">
                     @php 
                        $cremationInstructions = json_decode($endoflifePlanForm->cremation_instructions_type, true);
                     @endphp
                     <div class="dashboard-radio-form">
                        <div class="form-check">
                           <input id="instructions-y" class="form-check-input" name="instructions" type="radio" value="yes" {{ isset($cremationInstructions['instructions']) && $cremationInstructions['instructions'] === 'yes' ? 'checked' : '' }}>
                           <label for="instructions-y"><p>Yes</p></label>
                        </div>
                        <div class="form-check">
                           <input id="instructions-n" class="form-check-input" name="instructions" type="radio" value="no" {{ isset($cremationInstructions['instructions']) && $cremationInstructions['instructions'] === 'no' ? 'checked' : '' }}>
                           <label for="instructions-n"><p>No</p></label>
                        </div>
                     </div>
                     <div id="instructions-sec" class="form-check-list">
                        <p class="mt-5">What details do you want to provide? (Select all that apply.)</p>
                        <div class="form-check mb-3">
                           <label class="form-check-label" id="form-check-label-custom">
                                 <input {{ isset($cremationInstructions['type']) && in_array('Recipient', $cremationInstructions['type']) ? 'checked' : '' }} type="checkbox" class="form-check-input" name="instructionstype[]" value="Recipient">
                                 <p>Recipient</p>
                           </label>
                        </div>
                        <div class="form-check mb-3">
                           <label class="form-check-label" id="form-check-label-custom">
                                 <input {{ isset($cremationInstructions['type']) &&  in_array('Urn', $cremationInstructions['type']) ? 'checked' : '' }} type="checkbox" class="form-check-input" name="instructionstype[]" value="Urn">
                                 <p>Urn</p>
                           </label>
                        </div>
                        <div class="form-check mb-3">
                           <label class="form-check-label" id="form-check-label-custom">
                                 <input {{ isset($cremationInstructions['type']) &&  in_array('Other', $cremationInstructions['type']) ? 'checked' : '' }} type="checkbox" class="form-check-input" name="instructionstype[]" value="Other">
                                 <p>Other</p>
                           </label>
                        </div>
                     </div>

                     <div class="instructionstype_error a-status-error-message text-danger small fw-bold d-none mb-4"></div>

                  </div>
               </div>
            </div>
         @endif
         @if(isset($endoflifePlanForm->cremation) &&  $endoflifePlanForm->cremation == "scattered")
            <h4>Scattering of Ashes</h4>
            <p>Where do you want your ashes to be scattered?</p>

            <div class="form">
               <div class="row">
                  <div class="col-12">
                     <div class="form-group mb-3">
                        <input type="text" class="form-control modified-input" name="scattering_ashes" id="scattering_ashes" value="{{ isset($endoflifePlanForm->scattering_ashes) ? $endoflifePlanForm->scattering_ashes : ''}}">
                        <small  class="form-text text-muted">e.g. I request that my ashes be scattered onto the pond on my family's property in Hanover, NH.</small>   
                     </div>
                  </div>
               </div>
            </div>

            <div class="faq-box d-none">
               <div class="title">Frequently Asked Questions</div>
               <p>Can my ashes be scattered anywhere?</p>
               <span class="tooltiptext">
               Laws regarding the spreading of ashes can vary by state, county, and city, so before making any decisions, it's wise to consult your local laws.
               <br>
               <br>
               In general, if you want to scatter ashes on privately owned land, you must have permission of the owner. If you want your ashes scattered at a location of personal significance, such as a national park or a public facility, then you need to request permission and likely obtain a permit.
               <br>
               <br>
               Ashes can also be scattered from an airplane although this also requires a permit.
               <br>
               <br>
               Scattering ashes at sea must be done at least three nautical miles from shore, in water at least 600 feet deep and must be reported to the Environmental Protection Agency within 30 days.
               </span>
            </div>
                  
         @endif
         @if(isset($endoflifePlanForm->cremation) &&  $endoflifePlanForm->cremation == "rother")
            <h4>Remains Wishes</h4>
            <p>What would you like done with your ashes?</p>

            <div class="form">
               <div class="row">
                  <div class="col-12">
                     <div class="form-group mb-3">
                        <input type="text" id="cremation_remains_wishes" name="cremation_remains_wishes" value="{{isset($endoflifePlanForm->cremation_remains_wishes) ? $endoflifePlanForm->cremation_remains_wishes : "" }}">
                        <small id="cityHelp" class="form-text text-muted">e.g. I request that my ashes be buried in the garden of my family's cottage.</small>
                     </div>
                  </div>
               </div>
            </div>

            <div class="faq-box d-none">
               <div class="title">Frequently Asked Questions</div>
               <p>What can I do with my ashes?</p>
               <span class="tooltiptext">
               Laws regarding the spreading or burial of ashes can vary by state, county, and city, so before making any decisions, it's wise to consult your local laws.
               <br>
               <br>
               There are a number of different and creative things you can do with your ashes, so it is worth doing some research to find the option that suits you best.
               </span>
            </div>
         @endif
         <!-- start previous / next buttons -->
         <div id="buttonsection" class="submit-button-multiple">
            <button type="button" onclick="window.location.href = '{{ route('endoflifePlan.create.step.four_4_1') }}'">Back</button>
            <button type="submit" class="submit-btn">Save and Continue</button>
            <button type="submit" class="d-none" name="preview_submit" value="preview">{{env('PREVIEW_BUTTON_TEXT')}}</button>
            <button type="button" class="skip-btn d-none">Skip Step</button>
         </div>
         <!-- end previous / next buttons -->
      </div>
    </form>	  
</div>

@endsection
@section('page-js')
<script src="{{ url('frontend/assets/js/forms/end-of-life-plan-multi-step.js') }}?v={{ time() }}"></script>
<script src="{{ url('frontend/assets/js/forms/custom.js?v=10.3') }}"></script>
<script src="{{ url('v2/js/form-validation.js') }}?v={{ time() }}"></script>
@endsection