344 lines
8.3 KiB
HTML
344 lines
8.3 KiB
HTML
{{ template "sync/base.html" . }}
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{{ define "title" }}Login{{ end }}
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{{ define "extraheader" }}
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<style>
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body {
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background-color: #f8f9fa;
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}
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.page-container {
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max-width: 800px;
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margin: 0 auto;
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padding: 20px;
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}
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.content-card {
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background-color: white;
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border-radius: 15px;
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box-shadow: 0 2px 10px rgba(0, 0, 0, 0.1);
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padding: 25px;
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margin-bottom: 20px;
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}
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.logo-area {
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text-align: center;
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margin-bottom: 20px;
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}
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.logo-placeholder {
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height: 50px;
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max-width: 200px;
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margin: 0 auto;
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}
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.progress-container {
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margin: 30px 0 20px;
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}
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.progress {
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height: 8px;
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}
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.calendar-section {
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margin-bottom: 30px;
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}
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.dates-container {
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display: flex;
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overflow-x: auto;
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gap: 10px;
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padding-bottom: 10px;
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margin-bottom: 20px;
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}
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.date-card {
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min-width: 110px;
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border: 1px solid #dee2e6;
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border-radius: 8px;
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padding: 10px;
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text-align: center;
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cursor: pointer;
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transition: all 0.2s;
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}
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.date-card:hover {
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border-color: #0d6efd;
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background-color: #f8f9fa;
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}
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.date-card.selected {
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border-color: #0d6efd;
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background-color: #e6f2ff;
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box-shadow: 0 0 0 1px #0d6efd;
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}
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.date-card .month {
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font-size: 0.8rem;
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text-transform: uppercase;
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color: #6c757d;
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font-weight: 600;
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}
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.date-card .day {
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font-size: 1.5rem;
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font-weight: 700;
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line-height: 1.2;
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}
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.date-card .weekday {
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font-size: 0.8rem;
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color: #6c757d;
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}
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.time-slots {
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display: grid;
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grid-template-columns: repeat(auto-fill, minmax(150px, 1fr));
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gap: 10px;
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margin-bottom: 20px;
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}
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.time-slot {
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border: 1px solid #dee2e6;
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border-radius: 6px;
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padding: 10px;
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text-align: center;
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cursor: pointer;
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transition: all 0.2s;
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}
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.time-slot:hover {
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border-color: #0d6efd;
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background-color: #f8f9fa;
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}
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.time-slot.selected {
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border-color: #0d6efd;
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background-color: #e6f2ff;
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box-shadow: 0 0 0 1px #0d6efd;
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}
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.time-slot.unavailable {
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background-color: #f8f9fa;
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color: #adb5bd;
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cursor: not-allowed;
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text-decoration: line-through;
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}
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.form-section {
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margin-top: 30px;
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padding-top: 20px;
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border-top: 1px solid #dee2e6;
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}
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.section-title {
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margin-bottom: 20px;
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display: flex;
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align-items: center;
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}
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.section-title i {
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margin-right: 10px;
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color: #0d6efd;
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}
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.selected-date-time {
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background-color: #e8f4f8;
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border-left: 4px solid #0d6efd;
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padding: 15px;
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border-radius: 5px;
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margin-bottom: 20px;
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}
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</style>
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{{ end }}
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{{ define "content" }}
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<div class="page-container">
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<!-- Logo -->
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<div class="logo-area">
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<img
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src="https://placehold.co/200x50/e9ecef/adb5bd?text=County+Vector+Control"
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alt="County Vector Control"
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class="logo-placeholder"
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/>
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</div>
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<!-- Progress Bar -->
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<div class="progress-container">
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<div class="d-flex justify-content-between mb-1">
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<span class="text-muted small">Schedule Follow-up</span>
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<span class="text-muted small">4 of 4</span>
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</div>
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<div class="progress">
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<div
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class="progress-bar"
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role="progressbar"
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style="width: 100%"
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aria-valuenow="100"
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aria-valuemin="0"
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aria-valuemax="100"
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></div>
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</div>
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</div>
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<!-- Main Content -->
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<div class="content-card">
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<h1 class="h4 mb-3">Schedule a Follow-up Inspection</h1>
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<p>
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Please select a convenient date and time for our inspector to visit your
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property.
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</p>
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<!-- Calendar Section -->
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<div class="calendar-section">
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<div class="section-title">
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<i class="bi bi-calendar-date"></i>
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<h5 class="mb-0">Select Date</h5>
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</div>
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<!-- Date Selection -->
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<div class="dates-container">
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<div class="date-card">
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<div class="month">Jun</div>
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<div class="day">20</div>
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<div class="weekday">Tue</div>
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</div>
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<div class="date-card">
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<div class="month">Jun</div>
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<div class="day">21</div>
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<div class="weekday">Wed</div>
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</div>
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<div class="date-card selected">
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<div class="month">Jun</div>
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<div class="day">22</div>
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<div class="weekday">Thu</div>
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</div>
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<div class="date-card">
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<div class="month">Jun</div>
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<div class="day">23</div>
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<div class="weekday">Fri</div>
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</div>
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<div class="date-card">
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<div class="month">Jun</div>
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<div class="day">26</div>
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<div class="weekday">Mon</div>
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</div>
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<div class="date-card">
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<div class="month">Jun</div>
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<div class="day">27</div>
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<div class="weekday">Tue</div>
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</div>
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<div class="date-card">
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<div class="month">Jun</div>
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<div class="day">28</div>
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<div class="weekday">Wed</div>
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</div>
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<div class="date-card">
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<div class="month">Jun</div>
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<div class="day">29</div>
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<div class="weekday">Thu</div>
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</div>
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<div class="date-card">
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<div class="month">Jun</div>
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<div class="day">30</div>
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<div class="weekday">Fri</div>
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</div>
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<div class="date-card">
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<div class="month">Jul</div>
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<div class="day">03</div>
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<div class="weekday">Mon</div>
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</div>
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</div>
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<!-- Time Slot Selection -->
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<div class="section-title">
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<i class="bi bi-clock"></i>
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<h5 class="mb-0">Select Time</h5>
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</div>
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<div class="time-slots">
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<div class="time-slot unavailable">8:00 AM</div>
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<div class="time-slot unavailable">9:00 AM</div>
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<div class="time-slot selected">10:00 AM</div>
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<div class="time-slot">11:00 AM</div>
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<div class="time-slot">1:00 PM</div>
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<div class="time-slot">2:00 PM</div>
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<div class="time-slot">3:00 PM</div>
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<div class="time-slot">4:00 PM</div>
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</div>
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<!-- Selected Date & Time Summary -->
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<div class="selected-date-time">
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<div class="d-flex justify-content-between align-items-center">
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<strong>Selected Appointment:</strong>
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<span>Thursday, June 22, 2023 at 10:00 AM</span>
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</div>
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</div>
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</div>
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<!-- Contact Information Form -->
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<div class="form-section">
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<div class="section-title">
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<i class="bi bi-person-lines-fill"></i>
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<h5 class="mb-0">Contact Information</h5>
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</div>
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<form>
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<div class="row g-3">
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<div class="col-md-6">
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<label for="fullName" class="form-label">Full Name</label>
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<input type="text" class="form-control" id="fullName" required />
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</div>
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<div class="col-md-6">
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<label for="phone" class="form-label">Phone Number</label>
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<input
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type="tel"
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class="form-control"
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id="phone"
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placeholder="(555) 555-5555"
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required
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/>
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</div>
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<div class="col-12">
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<label for="email" class="form-label">Email Address</label>
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<input type="email" class="form-control" id="email" required />
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</div>
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<div class="col-12">
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<label for="notes" class="form-label"
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>Additional Notes (Optional)</label
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>
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<textarea
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class="form-control"
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id="notes"
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rows="3"
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placeholder="Any special instructions or information for the inspector"
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></textarea>
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</div>
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<div class="col-12">
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<div class="form-check">
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<input
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class="form-check-input"
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type="checkbox"
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id="reminders"
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checked
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/>
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<label class="form-check-label" for="reminders">
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Send me text reminders about my appointment
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</label>
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</div>
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</div>
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</div>
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<!-- Information -->
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<div class="alert alert-secondary mt-4">
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<small
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>Our inspector will need access to view your pool area. If you
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won't be home during the appointment, please provide access
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instructions in the notes.</small
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>
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</div>
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<!-- Action Buttons -->
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<div class="d-flex justify-content-between mt-4">
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<a
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href="{{ .URLs.ReportContribute }}"
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class="btn btn-outline-secondary"
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>
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<i class="bi bi-arrow-left me-2"></i> Back
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</a>
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<a href="{{ .URLs.ReportConfirmation }}" class="btn btn-success">
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<i class="bi bi-calendar-check me-2"></i> Confirm Appointment
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</a>
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</div>
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</form>
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</div>
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</div>
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<!-- Help Text -->
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<div class="text-center text-muted small">
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<p>
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If you need assistance, please contact Vector Control at (555) 123-4567
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</p>
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</div>
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</div>
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{{ end }}
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