Preview: form.blade.php
Size: 5.17 KB
//proc/thread-self/root/home/getspomw/royalsquad.us/resources/views/frontend/common_form/form.blade.php
<form action="{{ route('appointments') }}" method="POST" class="appointment-form">
@csrf
<div class="row">
<div class="col-lg-6">
<div class="form-group">
<input class="form-control name-field" name="name" placeholder="Name" type="text">
@error('name', 'appointments')
<div class="error text-danger">{{ $message }}</div>
@enderror
</div>
</div>
<div class="col-lg-6">
<div class="form-group position-relative">
<input class="form-control email-field" name="email" placeholder="Email" type="email">
@error('email', 'appointments')
<div class="error text-danger">{{ $message }}</div>
@enderror
</div>
</div>
@php
$countryCodes = DB::table('codes')->orderByRaw("CASE WHEN code = '+1' THEN 0 ELSE 1 END")->get();
@endphp
<div class="col-lg-6">
<div class="form-group form_spacing_main">
<div class="input-group">
<div class="input-group-prepend">
<select class="form-control country-code main_optional_domain" name="country_code">
@foreach ($countryCodes as $code)
<option value="{{ $code->code }}">{{ $code->code }}</option>
@endforeach
</select>
</div>
<input class="form-control number-field" name="number" placeholder="Enter Number" type="text">
</div>
</div>
<div class="number-status" style="font-size: 13px;"></div>
</div>
<div class="col-lg-6">
<div class="form-group">
<input class="form-control subject-field" name="subject" placeholder="Enter Subject" type="text">
@error('subject', 'appointments')
<div class="error text-danger">{{ $message }}</div>
@enderror
</div>
</div>
<div class="col-lg-6">
<div class="form-group">
<select class="form-control dept-field" name="dept">
<option value="">Select Services</option>
<option value="virus_malware_removal">Virus & Malware Removal</option>
<option value="computer_tune_ups">Computer Tune-Ups</option>
<option value="email_services">Email Services</option>
<option value="wi-fi_connectivity">WiFi Connectivity</option>
<option value="data_backup_services">Data Backup Services</option>
<option value="program_errors_crashes">Program Errors & Crashes</option>
<option value="microsoft_windows">Microsoft Windows</option>
<option value="smartphones_tablets">Smartphones & Tablets</option>
<option value="apple_mac_os">Apple Mac OS</option>
<option value="printers_multifunctions">Printers & Multifunctions</option>
<option value="training_guidance">Training & Guidance</option>
<option value="software_applications">Software Applications</option>
<option value="antivirus_security_software">Antivirus & Security Software</option>
<option value="home_networking">Home Networking</option>
<option value="internet_connectivity">Internet Connectivity</option>
</select>
@error('dept', 'appointments')
<div class="error text-danger">{{ $message }}</div>
@enderror
</div>
</div>
<div class="col-lg-6">
<div class="form-group">
<select class="form-control service-field" name="service">
<option value="">IT Services</option>
<option value="web_development">Web Development</option>
<option value="app_development">App Development</option>
<option value="web_agency">Web Agency</option>
<option value="digital_marketing">Digital Marketing</option>
<option value="ui_ux_design">UI/UX Design</option>
</select>
@error('service', 'appointments')
<div class="error text-danger">{{ $message }}</div>
@enderror
</div>
</div>
<div class="col-lg-12 otp-field-wrapper mt-3" style="display: none;">
<div class="form-group">
<input class="form-control otp-field" name="otp" placeholder="Enter OTP" type="text">
@if (session('otp_error'))
<div class="error text-danger">{{ session('otp_error') }}</div>
@endif
</div>
</div>
<div class="otp-status" style="font-size: 13px;"></div>
<div class="col-lg-12">
<button type="submit" class="btn btn-theme effect btn-sm btn-standard button_effect submit-btn">
Submit Query
</button>
</div>
</div>
</form>
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