160 lines
8.7 KiB
Plaintext
160 lines
8.7 KiB
Plaintext
<div class="card shadow-sm">
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<div class="card-body">
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<%= errors_summary_for @medical_release %>
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<%= bootstrap_form_with model: [@account, @project, @contract_template, @medical_release], local: true, validation_context: :native do |form| %>
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<div class="alert alert-warning font-weight-bold"><%= t ".instructions_html", name: @project.name %></div>
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<%= card_field_set_tag t(".legal.heading") do %>
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<%= @contract_template.body %>
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<% if @contract_template.fee? %>
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<p>
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Fee <span class="font-weight-bold text-success"><%= number_to_currency @contract_template.fee %></span>
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</p>
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<% end %>
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<% end %>
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<hr>
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<% unless @contract_template.guardian_clause.blank? %>
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<%= form.form_group :minor do %>
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<%= form.check_box :minor, label: t("helpers.label.medical_release.minor"), data: { behavior: "update-required-status", target: "[data-ujs-target=guardian-fields]", toggle: "collapse" } %>
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<% end %>
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<%= card_field_set_tag t(".guardian_clause.heading") do %>
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<p><%= @contract_template.guardian_clause %></p>
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<% end %>
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<hr>
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<% end %>
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<% if (1..MedicalRelease::NUMBER_OF_CUSTOM_FIELDS).map {|n| @contract_template.public_send("question_#{n}_text").presence }.compact.any? %>
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<%= card_field_set_tag t(".questionnaire.heading") do %>
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<% (1..MedicalRelease::NUMBER_OF_CUSTOM_FIELDS).each do |n| %>
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<% if @contract_template.public_send("question_#{n}_text").present? %>
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<div class="form-row">
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<%= form.text_area "question_#{n}_answer", required: true, wrapper_class: "col-sm-12", label: @contract_template.public_send("question_#{n}_text") %>
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</div>
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<% end %>
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<% end %>
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<% if @contract_template.questionnaire_legal_text.present? %>
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<%= @contract_template.questionnaire_legal_text %>
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<% end %>
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<% end %>
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<hr>
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<% end %>
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<%= card_field_set_tag t(".personal_info.heading") do %>
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<div class="alert alert-warning font-weight-bold"><%= t ".personal_info.instructions" %></div>
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<div class="form-row">
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<%= form.text_field :person_first_name, required: true, wrapper_class: "col-sm-6" %>
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<%= form.text_field :person_last_name, required: true, wrapper_class: "col-sm-6" %>
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<%= form.phone_field :person_phone, wrapper_class: "col-sm-6" %>
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<%= form.email_field :person_email, wrapper_class: "col-sm-6" %>
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</div>
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<%= render "shared/address_fields", form: form, subject: "person" %>
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<% end %>
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<hr>
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<%= card_field_set_tag t(".photo.heading") do %>
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<%= render "shared/photos_dropzone_fields", form: form, release: @medical_release %>
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<% end %>
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<% unless @contract_template.guardian_clause.blank? %>
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<div class="<%= class_string("collapse" => !@medical_release.minor?) %>" data-ujs-target="guardian-fields">
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<%= card_field_set_tag t(".guardian_info.heading") do %>
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<div class="form-row">
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<%= form.text_field :guardian_first_name, required: @medical_release.minor?, wrapper_class: "col-sm-3", data: { required_tag: "guardian" } %>
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<%= form.text_field :guardian_last_name, required: @medical_release.minor?, wrapper_class: "col-sm-3", data: { required_tag: "guardian" } %>
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<%= form.phone_field :guardian_phone, required: @medical_release.minor?, wrapper_class: "col-sm-6", data: { required_tag: "guardian" } %>
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<%= form.text_field :guardian_email, required: @medical_release.minor?, wrapper_class: "col-sm-6", data: { required_tag: "guardian" } %>
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</div>
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<%= render "shared/address_fields", form: form, subject: "guardian", required: @medical_release.minor?, data: { required_tag: "guardian" } %>
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<% end %>
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<hr>
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<%= card_field_set_tag t(".guardian_photo.heading") do %>
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<div class="alert alert-warning font-weight-bold"><%= t ".guardian_photo.instructions" %></div>
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<div class="text-center">
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<div class="d-inline-block mb-2" data-behavior="guardian-photo-preview" data-file-input="[data-ujs-target=guardian-photo-input]">
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<div class="align-items-center d-flex photo-preview img-thumbnail justify-content-center">
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<span><%= t ".photo.no_photo" %></span>
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</div>
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</div>
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<div class="d-inline-block text-left">
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<% if @medical_release.guardian_photo.attached? %>
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<%= javascript_tag nonce: true do %>
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App.PhotoPreview.set("[data-behavior=guardian-photo-preview]", "<%= url_for(@medical_release.guardian_photo.variant(auto_orient: true, resize: '200x200')) %>");
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<% end %>
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<% end %>
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<div class="hidden-file-input">
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<%= form.hidden_field :guardian_photo, value: form.object.guardian_photo.signed_id if @medical_release.guardian_photo.attached? %>
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<%= form.file_field :guardian_photo, required: @medical_release.minor?, hide_label: true, data: { ujs_target: "guardian-photo-input" }, accept: @medical_release.class.face_photo_acceptable_content_types.join(","), direct_upload: true %>
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</div>
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<%= button_tag t(".photo.take_photo"), type: "button", class: "btn btn-lg btn-primary take-photo-button", data: { behavior: "take-guardian-photo" } %>
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</div>
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<p class="p-2 font-weight-bold">
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<%= fa_icon "arrow-up", text: t(".photo.camera_instructions_html") %><br>
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<small class="text-muted"><%= t ".photo.warning" %></small>
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</p>
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</div>
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<% end %>
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<hr>
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<%= card_field_set_tag t(".guardian_2_info.heading") do %>
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<div class="form-row">
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<%= form.text_field :guardian_2_first_name, wrapper_class: "col-sm-3" %>
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<%= form.text_field :guardian_2_last_name, wrapper_class: "col-sm-3" %>
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<%= form.phone_field :guardian_2_phone, wrapper_class: "col-sm-6" %>
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</div>
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<div class="form-row">
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<%= form.text_field :guardian_2_email, wrapper_class: "col-sm-6" %>
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</div>
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<%= render "shared/address_fields", form: form, subject: "guardian_2" %>
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<% end %>
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<hr>
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<%= card_field_set_tag t(".guardian_2_photo.heading") do %>
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<div class="alert alert-warning font-weight-bold"><%= t ".guardian_2_photo.instructions" %></div>
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<div class="text-center">
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<div class="d-inline-block mb-2" data-behavior="guardian-photo-preview" data-file-input="[data-ujs-target=guardian-2-photo-input]">
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<div class="align-items-center d-flex photo-preview img-thumbnail justify-content-center">
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<span><%= t ".photo.no_photo" %></span>
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</div>
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</div>
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<div class="d-inline-block text-left">
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<% if @medical_release.guardian_2_photo.attached? %>
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<%= javascript_tag nonce: true do %>
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App.PhotoPreview.set("[data-behavior=guardian-photo-preview]", "<%= url_for(@medical_release.guardian_2_photo.variant(auto_orient: true, resize: '200x200')) %>");
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<% end %>
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<% end %>
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<div class="hidden-file-input">
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<%= form.hidden_field :guardian_2_photo, value: form.object.guardian_2_photo.signed_id if @medical_release.guardian_2_photo.attached? %>
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<%= form.file_field :guardian_2_photo, hide_label: true, data: { ujs_target: "guardian-2-photo-input" }, accept: @medical_release.class.face_photo_acceptable_content_types.join(","), direct_upload: true %>
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</div>
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<%= button_tag t(".photo.take_photo"), type: "button", class: "btn btn-lg btn-primary take-photo-button", data: { behavior: "take-guardian-2-photo" } %>
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</div>
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<p class="p-2 font-weight-bold">
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<%= fa_icon "arrow-up", text: t(".photo.camera_instructions_html") %><br>
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<small class="text-muted"><%= t ".photo.warning" %></small>
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</p>
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</div>
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<% end %>
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<hr>
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</div>
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<% end %>
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<%= card_field_set_tag t(".signature.heading") do %>
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<%= render "shared/signature_fields", form: form, signature_legal_text: @contract_template.signature_legal_text %>
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<% end %>
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<div class="mt-5">
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<%= form.button t("shared.submit_release_short"), class: "btn btn-block btn-lg btn-success", data: { disable_with: t("shared.disable_with") } %>
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</div>
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<% end %>
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</div>
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</div>
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