{{--
    * @category : "Free Living Will"  Form's Step-Preview Page
    * @author :  Gurupriya Solanki
    * @updated date : 30 May 2024
    * @company  :  Birbals Inc
    * @description : This is a preview page for "Free Living Will" form's Steps Where User can see their all filled step's forms data and can pay to receive Attorney And Document. If payment has been successfully done then Admin will upload this document by Admin panel for particular user to send email with attachment.
    * Client end send the edit request if their intial payment has done and now they want to update their details then have to click on edit button from preview page then  request will send to Admin. After approval by Admin client will receive an email and fron dashboard they will "Edit" Button Client has to click on that button to start update process. After update their data they have to pay as well to submit their updated details.
    * Data is coming  from  - app\Http\Controllers\Forms\LivingWillController.php  And calling function name is "createSteppreview"
    * Send Updated Will Document on Vtiger CRM and update path in  last payment record in payments table  For Free Edit
---}}

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

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

@section('content')
@include('frontend.forms.v2.Living-Will.stepIndicator')
 {{-- start --}}
 <style>
    #pre .card{
        padding: 8px!important;
        border-radius: 8px;
        border-left: 5px solid #4e4d4d;
    }
    #pre .card-body{
        padding-top: 12px!important;
        padding-left: 2px!important;
        padding-bottom: 2px!important;
    }
</style>

<div class="container">
    <div class="multiple-form review-detailss">
        <h5>Living Will form summary</h5>
        <div class="form">
            <div class="row">
                <div class="col-12">

                    @if(session('error')){{--To show error if deduct by controller--}}
                    <div class="alert alert-danger">
                        {{ session('error') }}
                    </div>
                    @endif
                    @if(session('info')) {{--To show information if deduct by controller--}}
                        <div class="alert alert-info">
                            {{ session('info') }}
                        </div>
                    @endif

                    <div class="review-details" id="previewData">
                        <div class="header-review">
                            <h3>Living Will</h3>
                            <p>Living well means finding balance, taking control, and creating a life you can truly afford to enjoy
                                A revocable living trust is a flexible legal tool that helps you manage your assets during your lifetime and ensures a smooth transfer to your beneficiaries while avoiding probate.</p>
                        </div>
                        <hr>
                        <div class="reviews-section">
                            <div class="details-list">
                                <div class="detail-item d-none">
                                    <span><strong>ID</strong></span>
                                    <span>{{ $livingWillForm['id'] }}</span>
                                </div>
                                <div class="detail-item">
                                    <span>Do you want to appoint someone to <br>make your health care decisions if <br>you are unable to?</span>
                                    <span>{{ $livingWillForm['health_care_decisions'] ?? "Not specified" }}</span>
                                </div>
                                <div class="detail-item">
                                    <span> Do you want to list your health care <br> preferences so caregivers have <br>instruction to follow?</span>
                                    <span>{{ $livingWillForm['preferences'] ?? "Not specified" }}</span>
                                </div>
                            </div>
                            <hr>
                            <div class="details-list">
                                <h4>Location</h4>
                                <div class="detail-item">
                                    <span>What state do you live in?</span>
                                    <span>{{ $livingWillForm['live_state'] ?? "Not specified"}}</span>
                                </div>
                            </div>
                            <hr>
                            <div class="details-list">
                                <h4>Care Choices</h4>
                                <div class="detail-item">
                                    <span>Sustaining Treatment</span>
                                    <span>
                                        @if($livingWillForm['sustaining_treatment'] == 'yes')
                                            I want to receive this treatment
                                        @elseif($livingWillForm['sustaining_treatment'] == 'no')
                                            I do NOT want to receive this treatment
                                        @else
                                            Not specified
                                        @endif
                                    </span>
                                </div>
                                <div class="detail-item">
                                    <span>Artificially Provided Food and Water</span>
                                    <span>
                                        @if($livingWillForm['artificially_food'] == 'yes')
                                            I want to receive this treatment
                                        @elseif($livingWillForm['artificially_food'] == 'no')
                                            I do NOT want to receive this treatment
                                        @else
                                            Not specified
                                        @endif
    
                                    </span>
                                </div>
                                <hr>
                                <p class="mb-0">Care if Permanently Unconscious</p>
                                <div class="detail-item">
                                    <span>Life Sustaining Treatment</span>
                                    <span>
                                        @if($livingWillForm['p_sustaining_treatment'] == 'yes')
                                            I want to receive this treatment
                                        @elseif($livingWillForm['p_sustaining_treatment'] == 'no')
                                            I do NOT want to receive this treatment
                                        @else
                                            Not specified
                                        @endif
                                    </span>
                                </div>
                                <div class="detail-item">
                                    <span>Artificially Provided Food and Water</span>
                                    <span>
                                     
                                        @if($livingWillForm['p_artificially_food'] == 'yes')
                                            I want to receive this treatment
                                        @elseif($livingWillForm['p_artificially_food'] == 'no')
                                            I do NOT want to receive this treatment
                                        @else
                                            Not specified
                                        @endif
                                    </span>
                                </div>
                            </div>
                            <hr>
                            <div class="details-list">
                                <h4>Your Info</h4>
                                <p class="mb-0">Who is this Living Will being created for?</p>

                                        @php
                                            $yourInfo = json_decode($livingWillForm['your_information'], true);
                                        @endphp
                                        <div class="detail-item">
                                            <span>Name</span> 
                                            <span>{{ $yourInfo['name'] ?? 'Not specified' }}</span> 
                                        </div>

                                        <div class="detail-item">
                                            <span>Street Address1</span> 
                                            <span>{{ $yourInfo['street_1'] ?? 'Not specified' }}</span> 
                                        </div>
                                        <div class="detail-item">
                                            <span>Street Address2</span> 
                                            <span>{{ $yourInfo['street_2'] ?? 'Not specified' }}</span> 
                                        </div>
                                        <div class="detail-item">
                                            <span>City</span> 
                                            <span>{{ $yourInfo['city'] ?? 'Not specified' }}</span> 
                                        </div>
                                        <div class="detail-item">
                                            <span>State</span> 
                                            <span>{{ $yourInfo['state_name'] ?? 'Not specified' }}</span> 
                                        </div>
                                        <div class="detail-item">
                                            <span>Country</span> 
                                            <span>{{ $yourInfo['country_name'] ?? 'Not specified' }}</span> 
                                        </div>
                                        <div class="detail-item">
                                            <span>Zip Code</span> 
                                            <span>{{ $yourInfo['zip_code'] ?? 'Not specified' }}</span> 
                                        </div>
                                        <div class="detail-item">
                                            <span>Birthdate</span>  
                                            <span>{{ $yourInfo['bdate'] ?? 'Not specified' }}</span> 
                                        </div>
                                        <div class="detail-item">
                                            <span>Gender</span> 
                                            <span>{{ $yourInfo['gender'] ?? 'Not specified' }}</span> 
                                        </div>
                        
                            </div>
                            @if($livingWillForm['health_care_decisions'] == 'yes')
                                <hr>
                                <div class="details-list">
                                    <h4>Proxy</h4>
                                    <p class="mb-0">If I need someone to speak for me</p>
    
                                        @php
                                            $proxy = json_decode($livingWillForm['proxy'], true);
                                        @endphp
                                        <div class="detail-item">
                                            <span>Proxy Name</span>
                                            <span>{{ $proxy['proxy_name'] ?? 'Not specified' }}</span>
                                        </div>
                                        <div class="detail-item">
                                            <span>Proxy Street</span>
                                            <span>{{ $proxy['proxy_street'] ?? 'Not specified' }}</span>
                                        </div>
                                        <div class="detail-item">
                                            <span> Proxy Town</span>
                                            <span>{{ $proxy['proxy_town'] ?? 'Not specified' }}</span>
                                        </div>
                                        <div class="detail-item">
                                            <span>Proxy State</span>
                                            <span>{{ $proxy['proxy_state_name'] ?? 'Not specified' }}</span>
                                        </div>
                                        <div class="detail-item">
                                            <span>Proxy Country</span>
                                            <span>{{ $proxy['proxy_country_name'] ?? 'Not specified' }}</span>
                                        </div>
                                        <div class="detail-item">
                                            <span>Proxy Zip Code</span>
                                            <span>{{ $proxy['proxy_zip_code'] ?? 'Not specified' }}</span>
                                        </div>
                                        <div class="detail-item">
                                            <span>Proxy Relationship</span>
                                            <span>{{ $proxy['proxy_relationship'] ?? 'Not specified' }}</span>
                                        </div>
                                </div>
                                <hr>
                                <div class="details-list">
                                    <p class="mb-0">Alternate Health Care Proxy</p>
                                        @php
                                            $alternateProxy = json_decode($livingWillForm['alternate_proxy'], true);
                                        @endphp
                                            <div class="detail-item">
                                                <span>Alternative Name </span>
                                                <span>{{ $alternateProxy['alternative_name'] ?? 'Not specified' }}</span>
                                            </div>
                                            <div class="detail-item">
                                                <span>Alternative Street</span>
                                                <span>{{ $alternateProxy['alternative_street'] ?? 'Not specified' }}</span>
                                            </div>
                                            <div class="detail-item">
                                                <span>Alternative Town</span>
                                                <span>{{ $alternateProxy['alternative_town'] ?? 'Not specified' }}</span>
                                            </div>
                                            <div class="detail-item">
                                                <span>Alternative Country</span>
                                                <span>{{ $alternateProxy['alternative_country_name'] ?? 'Not specified' }}</span>
                                            </div>
                                            <div class="detail-item">
                                                <span>Alternative State</span>
                                                <span>{{ $alternateProxy['alternative_state_name'] ?? 'Not specified' }}</span>
                                            </div>
                                            <div class="detail-item">
                                                <span>Alternative Zip Code</span>
                                                <span>{{ $alternateProxy['alternative_zip_code'] ?? 'Not specified' }}</span>
                                            </div>
                                            <div class="detail-item">
                                                <span>Alternative Phone</span>
                                                <span>{{ $alternateProxy['alternative_phone'] ?? 'Not specified' }}</span>
                                            </div>
                                            <div class="detail-item">
                                                <span>Alternative Relationship</span>
                                                <span>{{ $alternateProxy['alternative_relationship'] ?? 'Not specified' }}</span>
                                            </div>
                                            <div class="detail-item">
                                                <span>How much authority do you want <br> your health care proxy to have?</span>
                                                <span>{{ $livingWillForm['proxy_authority'] }}</span>
                                            </div>
                                            <hr>
                                            <p class="mb-0">Instructions for Health Care Proxy</p>
                                            <div class="detail-item">
                                                <span>Have access to my medical records</span>
                                                <span>
                                                    @if(!empty($livingWillForm['medical_records']))
                                                    yes
                                                    @else
                                                    No
                                                    @endif
                                                </span>
                                            </div>
                                            @if($livingWillForm['proxy_authority'] != "Must follow my listed directions but is also able to make decisions not covered in this document")
                                                <div class="detail-item">
                                                    <span>Decide if I need tube feeding</span>
                                                    <span>
                                                        @if(!empty($livingWillForm['tube_feeding']))
                                                        Yes
                                                        @else
                                                        No
                                                        @endif
                                                    </span>
                                                </div>
                                            @endif
                                
                                </div>
                            @endif
                            <hr>
                            <div class="details-list">
                                <h4>Final Details</h4>
                               
                                    @php
                                    $contacts = json_decode($livingWillForm['contacts'], true);
                                    @endphp
                                        @if (is_array($contacts))
                                    
                                        @foreach ($contacts as $contact)
                                        <div class="detail-item">
                                            <span>Name</span> 
                                            <span>{{ $contact['full_name'] ?? 'Not specified' }}</span> 
                                        </div>
                                        <div class="detail-item">
                                            <span>Phone Number</span> 
                                            <span>{{ $contact['phone_number'] ?? 'Not specified' }}</span> 
                                        </div>
                                        @endforeach
                                    
                                    @else
                                        <div class="detail-item">
                                            <span>Contacts</span> 
                                            @if($livingWillForm['contact_status'] == "no") 
                                            <span>No</span> 
                                            @else
                                            <span>Not specified</span> 
                                            @endif
                                        </div>
                                    @endif
                            </div>
                            <hr>
                            <div class="details-list">
                                <p class="mb-0">Signing Details</p>
                                
                                @php
                                    $signingDetails = json_decode($livingWillForm['signing_details'], true);
                                @endphp
                            
                                <div class="detail-item">
                                    <span>Signing</span>
                                    <span>{{ $signingDetails['signing'] ?? 'Not specified' }}</span>
                                </div>
                                <div class="detail-item">
                                    <span>Date</span>
                                    <span>{{ $signingDetails['date'] ?? 'Not specified' }}</span>
                                </div>
                                <div class="detail-item">
                                    <span>City</span>
                                    <span>{{ $signingDetails['city'] ?? 'Not specified' }}</span>
                                </div>
                                <hr>
                                <div class="detail-item">
                                    <span>Created At</span>
                                    <span>{{ isset($livingWillForm['created_at']) ? date('m/d/Y h:i A', strtotime($livingWillForm['created_at'])) : 'Not specified' }} (EST)</span>
                                </div>
                                <div class="detail-item">
                                    <span>Updated At</span>
                                    <span>{{ isset($livingWillForm['updated_at']) ? date('m/d/Y h:i A', strtotime($livingWillForm['updated_at'])) : 'Not specified' }} (EST)</span>
                                </div>
                            </div>
                        </div>
                    </div>

                    <div id="buttonsection">
                        <div class="submit-button-multiple {{ !$record_completion ? 'update-button-section' : '' }}">
        
                            {{--START = 
                            *If payment has been done then client can not able to edit form. But they  have to click in "Edit" Button from Preview page. The Request will be send to Admin. If Admin Approve their Edit Request then Client will receive And email And Can see the Edit Button on Dashboard. When Client is click on that button then edit_status will be 1 in db table. then Client can start the update process. And they have to have to for submit their details.
                            * To update edit_status, edit_count check the function - upadateStatusIfClickOnEdit in app\Classes\HandleUserEditFormRequest.php which is callling in index function for every form controller.
                            --}}
                            {{-- @if (isset($livingWillForm['currentStep']))
                                @php 
                                    $currentStepRouteLWF = "livingwill.create.step." . $livingWillForm['currentStep'];
                                @endphp
                            @else
                                @php 
                                    $currentStepRouteLWF = "livingwill.create.step.one";
                                @endphp
                            @endif --}}
                            @php 
                                $currentStepRouteLWF = "livingwill.resetForm";
                            @endphp
    
                            @if (($livingWillForm['payment_status'] !== 'succeeded' && $livingWillForm['payment_status'] !== 'paid')  || (($livingWillForm->edit_request_data) && ($livingWillForm->edit_request_data->approve_status == "1") && ($livingWillForm->edit_request_data->edit_status !== "0") &&  ($livingWillForm->edit_request_data->payment_status !== 'succeeded' && $livingWillForm->edit_request_data->payment_status !== 'paid')))
                            {{---To saving will document data  START--}}
                            <button type="button" onclick="window.location.href = '{{ route($currentStepRouteLWF) }}'">Edit Details</button>
                            <form action="{{route('LivingWillFormStore')}}" method="POST" id="signUpForm">
                                @csrf
                                    <input type="hidden" id="stepInput" name="step" value="preview">
                                    <button type="submit">Save</button>
                            </form>
                             {{---To saving will document data  END--}}
    
                            {{--Open Payment Process Separate Page----START--}}
                            {{---To Check if payment has  not done  and  status is NULL or empty then paynow buttun will show--}}
                            {{-- it will redirect to payment process page after  take  required data from here and post it to that page --}}
                            
                                <form method="POST" action="{{ route('payNowProcessForm') }}" id="payNowProcessForm">
                                    @csrf
                                    <input type="hidden" name="form_data_id" value="{{ $livingWillForm['id'] }}">
                                    <input type="hidden" name="form_type_name" value="{{ config('formData.formTypeName.Living_Will') }}">
                                    <input type="hidden" name="payment_title" value="Free Living Will">
                                    <input type="hidden" name="form_price" value="{{ $LivingWillFormPrice->price }}">
                                    <input type="hidden" name="payment_status" value="{{ $livingWillForm['payment_status'] }}">
    
                                    {{--START - After intial payment now if client want to update their details then they to pay again.Payment Form will be same only price will be changed  So thats why only button name  has changed--}}
                                     @if(($livingWillForm->edit_request_data && $livingWillForm->edit_request_data->approve_status == '1') || ($livingWillForm['edit_status'] > 0))
                                        @php 
                                            $paynow = "Submit"; // Payment for updating details
                                            $edit_submit_modal_id = "edit_submit_disclaimer"; // Showing Edit Disclaimer Message before "payment process form" by this Modal id
                                        @endphp
                                    @else
                                        @php 
                                            $paynow = 'Pay Now'; // Initial Payment
                                            $edit_submit_modal_id = '';
                                        @endphp
                                    @endif
                                    {{--END - After intial payment now if client want to update their details then they to pay again.Payment Form will be same only price will be changed--}}
                                    @if(!$record_completion)
                                        <button class="disabled-btn submit-btn-colour"  type="button" id="pay_button_block">{{$paynow}}</button>
                                    @else
                                        <button 
                                            id="{{$edit_submit_modal_id }}" 
                                            type="submit" 
                                            class="submit-btn-colour pay_nowBtn"
                                        >
                                            {{$paynow}}
                                        </button>
                                    @endif

                                </form>
                            {{--Open Payment Process Separate Page----END--}}
                            @else
                            <button type="button" onclick="window.location.href = '{{ route('userhomePage') }}'" class="pay_nowBtn">Go to Dashboard</button>
                                {{-- 
                                /*
                                * Author: Gurupriya Solanki
                                * Updated date: 24 May 2024
                                * Description: Free Edit Save
                                * Send Updated Will Document on Vtiger CRM and update path in  last payment record in payments table  For Free Edit Save
                                * After payment has done we are sending document to Vtiger CRM and updating path in payments table by payment Controller. But As we have Free Edit Functionlity and At that time we  dont have "Pay Now" option so We are updating the pdf by "Save" Button. Vtiger Storing as new latest pdf and path will update in payment table.
                                */    
                                --}}
                                @if($livingWillForm->free_edit_option_show == true)
                                    {{---To saving will document data  START--}}
                                    <button type="button" onclick="window.location.href = '{{ route($currentStepRouteLWF) }}'" class="btn btn-light btn-lg back-btn">Edit Details</button>
                                    <form action="{{route('LivingWillFormStore')}}" method="POST" id="signUpForm">
                                        @csrf
                                            <input type="hidden" id="stepInput" name="step" value="preview">
    
                                            {{--for unique identify to call vtiger function in controller--}}
                                            <input type="hidden" id="updateWillDocumentPDF" name="updateWillDocumentPDF" value="true">
                                            
                                            <button type="submit" class="btn btn-light btn-lg">Save</button>
                                    </form>
                                    {{---To saving will document data  END--}}
                                @else
                                    {{-- 
                                    /*
                                    * Author: Vidhi Shah
                                    * Updated date: 26th Mar 2024
                                    * Description: Add edit option for paid forms
                                    */    
                                    --}}
                                    <button type="button" id="edit_button">Edit</button>
                                @endif
                            @endif
                            {{--END = If payment has been done then client can not able to edit form --}}
                        </div>

                        {{--
                        /**
                            * Author : Gurupriya Solanki
                            * Description : After Approve Form Edit Request User can Cancel that request
                            * Created Date : 15 Jan 2025
                            */
                        --}}
                        @if($livingWillForm->cancel_edit_request_data  && ($livingWillForm->cancel_edit_request_data->payment_status !== 'succeeded' && $livingWillForm->cancel_edit_request_data->payment_status !== 'paid') && $livingWillForm->cancel_edit_request_data->approve_status == 1 )
                            <div class="row mt-5">
                                <div class="col-md-12">
                                    <p class="fw-bold opacity-100">*To cancel the edit request, 
                                    <a class="profile_edit_request_link" id="cancel_form_edit_request">
                                    Click Here
                                    </a>
                                    </p>
                                </div>
                            </div>
                        @endif
                    </div>


                </div>
            </div>
        </div>
    </div>




<div class="sign-up-form-mb">
    <div  id="signUpForm">
        <div class="card-body" id="previewData">
            {{-- step 1 --}}
            <div class="step text-capitalize" style="display: block" id="pre">
                <div class="row">
                    <div class="col-md-12">





        
                        </div>
                    </div>
                </div>

  
             </div>

        
         </div>

  


      </div>

</div>
</div>
@include('frontend.modals.paynowPopup')
{{-- Showing Message when click on Edit Button in  Modal: Starts here--}}
@include('frontend.modals.editRequestOptionPopup')
{{-- Showing Message when click on Edit Button in  Modal: Ends here--}}

{{-- Showing  Disclaimer  when click on Edit Submit Button in  Modal: Starts here--}}
@include('frontend.modals.editSubmitDisclaimerPopup')
{{-- ShowingDisclaimer  Message when click on Edit  Submit Button in  Modal: Ends here--}}

{{--
/**
* Author : Gurupriya Solanki
* Description : After Approve Form Edit Request User can Cancel that request
* Created Date : 15 Jan 2025
*/    
Showing Confirmation to Cancel edit Request Modal: Starts here--}}
@include('frontend.modals.cancelFormEditRrequest')
{{--Showing Confirmation to Cancel edit Request Modal: Ends here--}}
@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/common.js') }}?v={{ time() }}"></script>
<script>
    $("#pay_button_block").on("click", function(event) {
        $('#payblock').modal('show');
    });
</script>
@if($livingWillForm->edit_request_data)
{{-- 
/*
* Author: Vidhi Shah
* Updated date: 26th Mar 2024
* Description: Add edit option for paid forms
*/    
--}}
<script>


    /* Notification to admin on click event of "Edit" button for edit form reuquest deature */
    $("#edit_button").on("click", function(event) {
        /* Ajax call for sending admin email for user request */
        notifyAdminforEditRequest("living-will","{{ $livingWillForm['id'] }}")

    });
</script>
@else
{{--
/*
* Author: Gurupriya Solanki
* Company: Birbals Inc.
* Created date: 18 April 2024
* Description: This Modal Pop is showing when Client is click on Edit button to show Disclaimer. Then after confirm Edit request will send to Admin and sending email as well. If Request is already sent then this modal will not show
*/
--}}
<script>
     $("#edit_button").on("click", function(event) {

        // Show the modal when the edit button is clicked
        $('#editRequestDisclaimerMessageModal').modal('show');
    });

   // Function to handle the "Yes" button click in the modal
   $("#proceedWithDisclaimer").on("click", function(event) {
        // Close the modal
        $('#editRequestDisclaimerMessageModal').modal('hide');
        
        /* Ajax call for sending admin email for user request */
        notifyAdminforEditRequest("living-will","{{ $livingWillForm['id'] }}")
    });
</script>
@endif

{{--
    /**
    * Author : Gurupriya Solanki
    * Description : After Approve Form Edit Request User can Cancel that request
    * Created Date : 15 Jan 2025
    */
--}}
@if($livingWillForm->cancel_edit_request_data  && ($livingWillForm->cancel_edit_request_data->payment_status !== 'succeeded' && $livingWillForm->cancel_edit_request_data->payment_status !== 'paid') && $livingWillForm->cancel_edit_request_data->approve_status == 1)
<script>
     $("#cancel_form_edit_request").on("click", function(event) {
        // Show the modal when the edit button is clicked
        $('#cancelEditFormRequestConfirmationModal').modal('show');
    });
   // Function to handle the "Yes" button click in the modal
   $("#submitWithCancelEditRequestConfirmation").on("click", function(event) {
        // Close the modal
        $('#cancelEditFormRequestConfirmationModal').modal('hide');
        
        /* Ajax call for sending admin email for user request */
        submitCancelFormEditRequestForm("living-will","{{ $livingWillForm['id'] }}","{{ $livingWillForm->cancel_edit_request_data->request_id}}")
    });
</script>
@endif
@endsection