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

@section('title', '| Free Living Will')

@section('content')
@include('frontend.forms.v2.Living-Will.stepIndicator')

   <form action="{{route('LivingWillFormStore')}}" method="POST" id="signUpForm" class="multiple-form">
      @csrf
      <input type="hidden" id="stepInput" name="step" value="1-1">

            <div class="multiple-form dashboard-radio">
               <h4>Health care preferences</h4>
               <p>Do you want to list your health care preferences, so caregivers have instruction to follow?</p>
      
               <div class="form">
                  <div class="row">
                     <div class="col-12">
                        <div class="dashboard-radio-form">
                              <div class="form-check">
                                 <input id="healthCare-y" class="form-check-input" name="healthCare" value="yes" type="radio" {{ isset($livingWillForm->preferences) &&  $livingWillForm->preferences == "yes" ? 'checked' : ''}}>
                                 <label for="healthCare-y">
                                 <p>Yes</p>
                                 </label>
                              </div>
                              <div class="form-check">
                                 <input id="healthCare-n" class="form-check-input" name="healthCare" value="no" type="radio" {{ isset($livingWillForm->preferences) &&  $livingWillForm->preferences == "no" ? 'checked' : ''}}>
                                 <label for="healthCare-n">
                                 <p>No</p>
                                 </label>
                              </div>
                        </div>
                     </div>
                  </div>
               </div>
            </div>
            <!-- start previous / next buttons -->
            <div class="submit-button-multiple">
                  <button type="button" onclick="window.location.href = '{{ route('livingwill.create.step.one') }}'">Back</button>
                  <button type="submit" class="submit-btn">Save and Continue </button>
                  <button type="submit"  name="preview_submit" class="d-none" value="preview">{{env('PREVIEW_BUTTON_TEXT')}}</button>
                  <button type="button" class="skip-btn d-none">Skip Step</button>
            </div>
            <!-- end previous / next buttons -->
    </form>



@endsection
@section('page-js')
<script src="{{ url('frontend/assets/js/forms/living-will-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