{% extends "layouts/base.html" %}
{% load i18n %}
{% load static %}

{% block title %}{% if is_create %}Create{% else %}Edit{% endif %} Feedback - PX360{% endblock %}

{% block extra_css %}
<style>
    .page-header-gradient {
        background: linear-gradient(135deg, #005696 0%, #0069a8 50%, #007bbd 100%);
        color: white;
        padding: 1.5rem 2rem;
        border-radius: 1rem;
        margin-bottom: 1.5rem;
        box-shadow: 0 10px 15px -3px rgba(0, 86, 150, 0.2);
    }

    .form-section {
        background: #fff;
        border: 2px solid #e2e8f0;
        border-radius: 1rem;
        padding: 1.5rem;
        margin-bottom: 1.5rem;
        transition: all 0.3s ease;
    }
    .form-section:hover {
        border-color: #005696;
        box-shadow: 0 4px 12px rgba(0, 86, 150, 0.1);
    }

    .form-label {
        display: block;
        font-size: 0.875rem;
        font-weight: 600;
        color: #1e293b;
        margin-bottom: 0.5rem;
    }

    .form-control, .form-select {
        width: 100%;
        padding: 0.75rem 1rem;
        border: 2px solid #e2e8f0;
        border-radius: 0.75rem;
        font-size: 0.875rem;
        transition: all 0.2s ease;
    }
    .form-control:focus, .form-select:focus {
        outline: none;
        border-color: #005696;
        box-shadow: 0 0 0 3px rgba(0, 86, 150, 0.1);
    }

    .btn-primary {
        display: inline-flex;
        align-items: center;
        gap: 0.5rem;
        padding: 0.75rem 1.5rem;
        background: #005696;
        color: white;
        border-radius: 0.75rem;
        font-weight: 600;
        transition: all 0.2s ease;
        border: none;
        cursor: pointer;
    }
    .btn-primary:hover {
        background: #007bbd;
    }

    .btn-secondary {
        display: inline-flex;
        align-items: center;
        gap: 0.5rem;
        padding: 0.75rem 1.5rem;
        background: white;
        color: #64748b;
        border: 2px solid #e2e8f0;
        border-radius: 0.75rem;
        font-weight: 600;
        transition: all 0.2s ease;
    }
    .btn-secondary:hover {
        background: #f1f5f9;
        border-color: #005696;
    }

    .required-field::after {
        content: " *";
        color: #dc3545;
    }

    .form-help-text {
        font-size: 0.875rem;
        color: #64748b;
        margin-top: 0.25rem;
    }

    .rating-input {
        display: flex;
        gap: 10px;
        align-items: center;
        flex-direction: row-reverse;
        justify-content: flex-end;
    }
    .rating-input input[type="radio"] {
        display: none;
    }
    .rating-input label {
        font-size: 2rem;
        color: #ddd;
        cursor: pointer;
        transition: color 0.2s;
    }
    .rating-input input[type="radio"]:checked ~ label,
    .rating-input label:hover,
    .rating-input label:hover ~ label {
        color: #ffc107;
    }
</style>
{% endblock %}

{% block content %}
<div class="p-6 md:p-8 bg-gradient-to-br from-slate-50 to-blue-50 min-h-screen">
    <!-- Page Header -->
    <div class="page-header-gradient flex flex-col md:flex-row justify-between items-start md:items-center gap-4">
        <div>
            <nav aria-label="breadcrumb" class="mb-2">
                <ol class="flex items-center gap-2 text-sm text-white/80">
                    <li><a href="{% url 'feedback:feedback_list' %}" class="hover:text-white transition">{% trans "Feedback" %}</a></li>
                    <li><i data-lucide="chevron-right" class="w-4 h-4"></i></li>
                    <li class="text-white">{% if is_create %}Create{% else %}Edit{% endif %}</li>
                </ol>
            </nav>
            <h2 class="text-2xl font-bold flex items-center gap-2">
                <i data-lucide="message-circle-heart" class="w-8 h-8"></i>
                {% if is_create %}{% trans "Create New Feedback" %}{% else %}{% trans "Edit Feedback" %}{% endif %}
            </h2>
        </div>
        <div>
            <a href="{% url 'feedback:feedback_list' %}" class="inline-flex items-center gap-2 px-4 py-2 bg-white/20 text-white rounded-lg hover:bg-white/30 transition">
                <i data-lucide="x-circle" class="w-4 h-4"></i>
                {% trans "Cancel" %}
            </a>
        </div>
    </div>

    <div class="max-w-4xl mx-auto">
        <form method="post" id="feedbackForm">
            {% csrf_token %}
            
            <!-- Display form errors -->
            {% if form.non_field_errors %}
            <div class="bg-red-50 border border-red-200 text-red-700 px-4 py-3 rounded-lg mb-4">
                {{ form.non_field_errors }}
            </div>
            {% endif %}

            <!-- Patient/Contact Information -->
            <div class="form-section">
                <div class="flex items-center gap-2 mb-4 pb-3 border-b border-slate-100">
                    <i data-lucide="user" class="w-5 h-5 text-blue-600"></i>
                    <h3 class="text-lg font-bold text-slate-800">{% trans "Patient/Contact Information" %}</h3>
                </div>
                
                <!-- Anonymous Checkbox -->
                <div class="mb-4">
                    <div class="flex items-center gap-3">
                        {{ form.is_anonymous }}
                        <label class="text-sm font-medium text-slate-700" for="{{ form.is_anonymous.id_for_label }}">
                            {% trans "Submit as Anonymous Feedback" %}
                        </label>
                    </div>
                    {% if form.is_anonymous.errors %}
                    <div class="text-red-500 text-sm mt-1">{{ form.is_anonymous.errors }}</div>
                    {% endif %}
                </div>

                <!-- Patient Selection (shown when not anonymous) -->
                <div class="mb-4" id="patientField">
                    <label for="{{ form.patient.id_for_label }}" class="form-label">{% trans "Patient" %}</label>
                    {{ form.patient }}
                    {% if form.patient.help_text %}
                    <div class="form-help-text">{{ form.patient.help_text }}</div>
                    {% endif %}
                    {% if form.patient.errors %}
                    <div class="text-red-500 text-sm mt-1">{{ form.patient.errors }}</div>
                    {% endif %}
                </div>

                <!-- Anonymous Contact Fields (shown when anonymous) -->
                <div id="anonymousFields" style="display: none;">
                    <div class="mb-4">
                        <label for="{{ form.contact_name.id_for_label }}" class="form-label required-field">{% trans "Contact Name" %}</label>
                        {{ form.contact_name }}
                        {% if form.contact_name.errors %}
                        <div class="text-red-500 text-sm mt-1">{{ form.contact_name.errors }}</div>
                        {% endif %}
                    </div>

                    <div class="grid grid-cols-1 md:grid-cols-2 gap-4">
                        <div>
                            <label for="{{ form.contact_email.id_for_label }}" class="form-label">{% trans "Email" %}</label>
                            {{ form.contact_email }}
                            {% if form.contact_email.errors %}
                            <div class="text-red-500 text-sm mt-1">{{ form.contact_email.errors }}</div>
                            {% endif %}
                        </div>
                        <div>
                            <label for="{{ form.contact_phone.id_for_label }}" class="form-label">{% trans "Phone" %}</label>
                            {{ form.contact_phone }}
                            {% if form.contact_phone.errors %}
                            <div class="text-red-500 text-sm mt-1">{{ form.contact_phone.errors }}</div>
                            {% endif %}
                        </div>
                    </div>
                </div>
            </div>

            <!-- Feedback Details -->
            <div class="form-section">
                <div class="flex items-center gap-2 mb-4 pb-3 border-b border-slate-100">
                    <i data-lucide="message-square-text" class="w-5 h-5 text-blue-600"></i>
                    <h3 class="text-lg font-bold text-slate-800">{% trans "Feedback Details" %}</h3>
                </div>
                
                <!-- Feedback Type -->
                <div class="mb-4">
                    <label for="{{ form.feedback_type.id_for_label }}" class="form-label required-field">{% trans "Feedback Type" %}</label>
                    {{ form.feedback_type }}
                    {% if form.feedback_type.errors %}
                    <div class="text-red-500 text-sm mt-1">{{ form.feedback_type.errors }}</div>
                    {% endif %}
                </div>

                <!-- Title -->
                <div class="mb-4">
                    <label for="{{ form.title.id_for_label }}" class="form-label required-field">{% trans "Title" %}</label>
                    {{ form.title }}
                    {% if form.title.errors %}
                    <div class="text-red-500 text-sm mt-1">{{ form.title.errors }}</div>
                    {% endif %}
                </div>

                <!-- Message -->
                <div class="mb-4">
                    <label for="{{ form.message.id_for_label }}" class="form-label required-field">{% trans "Message" %}</label>
                    {{ form.message }}
                    <div class="form-help-text">{% trans "Please provide detailed feedback" %}</div>
                    {% if form.message.errors %}
                    <div class="text-red-500 text-sm mt-1">{{ form.message.errors }}</div>
                    {% endif %}
                </div>

                <!-- Category and Subcategory -->
                <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-4">
                    <div>
                        <label for="{{ form.category.id_for_label }}" class="form-label required-field">{% trans "Category" %}</label>
                        {{ form.category }}
                        {% if form.category.errors %}
                        <div class="text-red-500 text-sm mt-1">{{ form.category.errors }}</div>
                        {% endif %}
                    </div>
                    <div>
                        <label for="{{ form.subcategory.id_for_label }}" class="form-label">{% trans "Subcategory" %}</label>
                        {{ form.subcategory }}
                        {% if form.subcategory.errors %}
                        <div class="text-red-500 text-sm mt-1">{{ form.subcategory.errors }}</div>
                        {% endif %}
                    </div>
                </div>

                <!-- Rating -->
                <div class="mb-4">
                    <label class="form-label">{% trans "Rating (Optional)" %}</label>
                    <div class="rating-input">
                        <input type="radio" name="rating" value="5" id="rating5" {% if form.rating.value == 5 %}checked{% endif %}>
                        <label for="rating5"><i data-lucide="star" class="w-8 h-8 fill-current"></i></label>
                        <input type="radio" name="rating" value="4" id="rating4" {% if form.rating.value == 4 %}checked{% endif %}>
                        <label for="rating4"><i data-lucide="star" class="w-8 h-8 fill-current"></i></label>
                        <input type="radio" name="rating" value="3" id="rating3" {% if form.rating.value == 3 %}checked{% endif %}>
                        <label for="rating3"><i data-lucide="star" class="w-8 h-8 fill-current"></i></label>
                        <input type="radio" name="rating" value="2" id="rating2" {% if form.rating.value == 2 %}checked{% endif %}>
                        <label for="rating2"><i data-lucide="star" class="w-8 h-8 fill-current"></i></label>
                        <input type="radio" name="rating" value="1" id="rating1" {% if form.rating.value == 1 %}checked{% endif %}>
                        <label for="rating1"><i data-lucide="star" class="w-8 h-8 fill-current"></i></label>
                    </div>
                    <div class="form-help-text">{% trans "Rate your experience from 1 to 5 stars" %}</div>
                    {% if form.rating.errors %}
                    <div class="text-red-500 text-sm mt-1">{{ form.rating.errors }}</div>
                    {% endif %}
                </div>

                <!-- Priority -->
                <div class="mb-4">
                    <label for="{{ form.priority.id_for_label }}" class="form-label">{% trans "Priority" %}</label>
                    {{ form.priority }}
                    {% if form.priority.errors %}
                    <div class="text-red-500 text-sm mt-1">{{ form.priority.errors }}</div>
                    {% endif %}
                </div>
            </div>

            <!-- Organization Information -->
            <div class="form-section">
                <div class="flex items-center gap-2 mb-4 pb-3 border-b border-slate-100">
                    <i data-lucide="building-2" class="w-5 h-5 text-blue-600"></i>
                    <h3 class="text-lg font-bold text-slate-800">{% trans "Organization Information" %}</h3>
                </div>
                
                {% if not form.hospital.is_hidden %}
                <!-- Hospital -->
                <div class="mb-4">
                    <label for="{{ form.hospital.id_for_label }}" class="form-label required-field">{% trans "Hospital" %}</label>
                    {{ form.hospital }}
                    {% if form.hospital.errors %}
                    <div class="text-red-500 text-sm mt-1">{{ form.hospital.errors }}</div>
                    {% endif %}
                </div>
                {% else %}
                    {{ form.hospital }}
                {% endif %}

                <!-- Department -->
                <div class="mb-4">
                    <label for="{{ form.department.id_for_label }}" class="form-label">{% trans "Department" %}</label>
                    {{ form.department }}
                    <div class="form-help-text">{% trans "Select the department related to this feedback (optional)" %}</div>
                    {% if form.department.errors %}
                    <div class="text-red-500 text-sm mt-1">{{ form.department.errors }}</div>
                    {% endif %}
                </div>

                <!-- Physician -->
                <div class="mb-4">
                    <label for="{{ form.physician.id_for_label }}" class="form-label">{% trans "Physician" %}</label>
                    {{ form.physician }}
                    <div class="form-help-text">{% trans "Select the physician mentioned in this feedback (optional)" %}</div>
                    {% if form.physician.errors %}
                    <div class="text-red-500 text-sm mt-1">{{ form.physician.errors }}</div>
                    {% endif %}
                </div>

                <!-- Encounter ID -->
                <div class="mb-4">
                    <label for="{{ form.encounter_id.id_for_label }}" class="form-label">{% trans "Encounter ID" %}</label>
                    {{ form.encounter_id }}
                    <div class="form-help-text">{% trans "Related encounter ID if applicable (optional)" %}</div>
                    {% if form.encounter_id.errors %}
                    <div class="text-red-500 text-sm mt-1">{{ form.encounter_id.errors }}</div>
                    {% endif %}
                </div>
            </div>

            <!-- Form Actions -->
            <div class="flex justify-between items-center">
                <a href="{% url 'feedback:feedback_list' %}" class="btn-secondary">
                    <i data-lucide="x-circle" class="w-4 h-4"></i>
                    {% trans "Cancel" %}
                </a>
                <button type="submit" class="btn-primary">
                    <i data-lucide="check-circle" class="w-4 h-4"></i>
                    {% if is_create %}{% trans "Create Feedback" %}{% else %}{% trans "Update Feedback" %}{% endif %}
                </button>
            </div>
        </form>
    </div>
</div>
{% endblock %}

{% block extra_js %}
<script>
document.addEventListener('DOMContentLoaded', function() {
    const anonymousCheckbox = document.getElementById('{{ form.is_anonymous.id_for_label }}');
    const patientField = document.getElementById('patientField');
    const anonymousFields = document.getElementById('anonymousFields');
    
    function toggleAnonymousFields() {
        if (anonymousCheckbox.checked) {
            patientField.style.display = 'none';
            anonymousFields.style.display = 'block';
        } else {
            patientField.style.display = 'block';
            anonymousFields.style.display = 'none';
        }
    }
    
    // Initial state
    toggleAnonymousFields();
    
    // Listen for changes
    anonymousCheckbox.addEventListener('change', toggleAnonymousFields);
    
    // Rating stars interaction
    const ratingLabels = document.querySelectorAll('.rating-input label');
    ratingLabels.forEach(label => {
        label.addEventListener('mouseenter', function() {
            const rating = this.previousElementSibling.value;
            highlightStars(rating);
        });
    });
    
    document.querySelector('.rating-input').addEventListener('mouseleave', function() {
        const checkedInput = document.querySelector('.rating-input input:checked');
        if (checkedInput) {
            highlightStars(checkedInput.value);
        } else {
            resetStars();
        }
    });
    
    function highlightStars(rating) {
        ratingLabels.forEach((label, index) => {
            if (5 - index <= rating) {
                label.style.color = '#ffc107';
            } else {
                label.style.color = '#ddd';
            }
        });
    }
    
    function resetStars() {
        ratingLabels.forEach(label => {
            label.style.color = '#ddd';
        });
    }
    
    // Form validation
    const form = document.getElementById('feedbackForm');
    form.addEventListener('submit', function(e) {
        const isAnonymous = anonymousCheckbox.checked;
        const patient = document.getElementById('{{ form.patient.id_for_label }}').value;
        const contactName = document.getElementById('{{ form.contact_name.id_for_label }}').value;
        
        if (!isAnonymous && !patient) {
            e.preventDefault();
            alert('Please select a patient or mark as anonymous.');
            return false;
        }
        
        if (isAnonymous && !contactName) {
            e.preventDefault();
            alert('Please enter a contact name for anonymous feedback.');
            return false;
        }
    });

    // Initialize Lucide icons
    lucide.createIcons();
});
</script>
{% endblock %}