<%= errors_summary_for @medical_release %> <%= bootstrap_form_with model: [@account, @project, @contract_template, @medical_release], local: true, validation_context: :native do |form| %>

<%= t ".instructions_html", name: @project.name %>

<%= card_field_set_tag t(".legal.heading") do %>

<%= @contract_template.body %>

<% if @contract_template.fee? %>

Fee <%= number_to_currency @contract_template.fee %>

<% end %> <% end %>

<% if (1..10).map {|n| @contract_template.public_send("question_#{n}_text").presence }.compact.any? %> <%= card_field_set_tag t(".questionnaire.heading") do %> <% (1..10).each do |n| %> <% if @contract_template.public_send("question_#{n}_text").present? %>

<%= form.text_area "question_#{n}_answer", wrapper_class: "col-sm-12", label: @contract_template.public_send("question_#{n}_text") %>

<% end %> <% end %> <% end %>

<% end %> <%= card_field_set_tag t(".personal_info.heading") do %>

<%= t ".personal_info.instructions" %>

<%= form.text_field :person_first_name, required: true, wrapper_class: "col-sm-6" %> <%= form.text_field :person_last_name, required: true, wrapper_class: "col-sm-6" %> <%= form.phone_field :person_phone, wrapper_class: "col-sm-6" %> <%= form.email_field :person_email, wrapper_class: "col-sm-6" %>

<%= render "shared/address_fields", form: form, subject: "person" %> <% end %>

<%= card_field_set_tag t(".photo.heading") do %> <%= render "shared/photos_dropzone_fields", form: form, release: @medical_release %> <% end %> <%= card_field_set_tag t(".signature.heading") do %> <%= render "shared/signature_fields", form: form %> <% end %>

<%= form.button t("shared.submit_release_short"), class: "btn btn-block btn-lg btn-success", data: { disable_with: t("shared.disable_with") } %>

<% end %>