@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="6-1">
      <div class="multiple-form dashboard-radio">
         <h4>Final instructions</h4>
         <p>Do you have any additional end-of-life wishes?</p>

         <div class="form">
            <div class="row">
               <div class="col-12">
                  <div class="dashboard-radio-form">
                     <div class="form-check">
                        <input id="instructions-y" class="form-check-input" name="final-instructions" value="yes" type="radio"   {{ isset($endoflifePlanForm->final_instructions_status) &&  $endoflifePlanForm->final_instructions_status == "yes" ? 'checked' : ''}}>
                        <label for="instructions-y"><p>Yes</p></label>
                     </div>
                     <div class="form-check">
                        <input id="instructions-n" class="form-check-input" name="final-instructions" value="no" type="radio"   {{ isset($endoflifePlanForm->final_instructions_status) &&  $endoflifePlanForm->final_instructions_status == "no" ? 'checked' : ''}}>
                        <label for="instructions-n"><p>No</p></label>
                     </div>
                  </div>
               </div>
            </div>
            <div class="row">
               <div id="instructions-sectionb" class="child-card-holder">
                  <div id="instructions-container">
                      @if (empty($endoflifePlanForm->final_instructions))
                        <div class="card list mb-3" id="child">
                           <div class="card-header">
                              <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 validate_text" name="another_message[]" id="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 $index => $amsg)
                           <div class="card list mb-3" id="child">
                              <div class="card-header">
                                  <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="{{ $amsg->message }}" id="another_message_{{$index}}">
                                    <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 class="add-another" href="#" id="add-thoughts-button" onclick="clone('instructions-container')">
                             
                     Add another message
                     </a>
                  </div>
               </div>
            </div>
         </div>
         <!-- start previous / next buttons -->
         <div id="buttonsection" class="submit-button-multiple">
            <button type="button" onclick="window.location.href = '{{ route('endoflifePlan.create.step.six') }}'">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>	 
@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