133 lines
5.9 KiB
HTML
133 lines
5.9 KiB
HTML
{% extends "layouts/base.html" %}
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{% load i18n %}
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{% block title %}{% if is_create %}{% trans "New Suggestion" %}{% else %}{% trans "Edit Suggestion" %}{% endif %} - PX360{% endblock %}
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{% block extra_css %}
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<style>
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.page-header-gradient {
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background: linear-gradient(135deg, #005696 0%, #0069a8 50%, #007bbd 100%);
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color: white;
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padding: 1.5rem 2rem;
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border-radius: 1rem;
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margin-bottom: 1.5rem;
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box-shadow: 0 10px 15px -3px rgba(0, 86, 150, 0.2);
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}
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.section-card {
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background: white;
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border-radius: 1rem;
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border: 2px solid #e2e8f0;
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box-shadow: 0 4px 6px -1px rgba(0, 0, 0, 0.1);
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overflow: hidden;
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transition: all 0.3s ease;
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}
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.section-card:hover {
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border-color: #005696;
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box-shadow: 0 10px 25px -5px rgba(0, 86, 150, 0.15);
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}
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.section-header {
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padding: 1rem 1.5rem;
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border-bottom: 2px solid #e2e8f0;
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background: linear-gradient(to right, #f8fafc, #f1f5f9);
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display: flex;
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align-items: center;
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gap: 0.75rem;
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}
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.section-icon {
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width: 40px;
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height: 40px;
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border-radius: 0.75rem;
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display: flex;
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align-items: center;
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justify-content: center;
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}
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</style>
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{% endblock %}
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{% block content %}
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<div class="page-header-gradient">
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<div class="flex justify-between items-center">
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<div>
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<div class="flex items-center gap-2 text-blue-100 text-sm mb-2">
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<a href="{% url 'feedback:feedback_list' %}" class="hover:text-white transition">{% trans "Suggestions" %}</a>
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<i data-lucide="chevron-right" class="w-3 h-3"></i>
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<span class="text-white">{% trans "New" %}</span>
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</div>
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<h1 class="text-2xl font-bold">{% if is_create %}{% trans "New Suggestion" %}{% else %}{% trans "Edit Suggestion" %}{% endif %}</h1>
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</div>
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<a href="{% url 'feedback:feedback_list' %}" class="inline-flex items-center px-4 py-2.5 bg-white text-navy font-medium rounded-xl hover:bg-blue-50 transition">
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<i data-lucide="arrow-left" class="w-4 h-4 me-2"></i>{% trans "Back" %}
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</a>
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</div>
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</div>
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<div class="section-card">
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<div class="section-header">
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<div class="section-icon bg-cyan-500/10">
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<i data-lucide="lightbulb" class="w-5 h-5 text-cyan-600"></i>
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</div>
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<h5 class="text-lg font-semibold text-gray-800">{% trans "Suggestion Details" %}</h5>
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</div>
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{% if messages %}
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<div class="px-6 pt-4">
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{% for message in messages %}
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<div class="{% if message.tags == 'error' %}bg-red-50 border-red-200 text-red-700{% else %}bg-green-50 border-green-200 text-green-700{% endif %} border rounded-lg px-4 py-3 text-sm mb-2">
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{{ message }}
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</div>
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{% endfor %}
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</div>
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{% endif %}
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<form method="post" class="p-6">
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{% csrf_token %}
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{% if communication_request %}
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<input type="hidden" name="comm_req" value="{{ communication_request.id }}">
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{% endif %}
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<div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-5">
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<div>
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<label class="block text-sm font-semibold text-navy mb-2">{% trans "Your Name" %} <span class="text-red-500">*</span></label>
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<input type="text" name="contact_name" required placeholder="{% trans 'Your full name' %}" value="{{ prefill.contact_name|default:'' }}"
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class="w-full px-4 py-3 border-2 border-slate-200 rounded-xl text-navy focus:outline-none focus:ring-2 focus:ring-navy/20 focus:border-navy">
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</div>
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<div>
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<label class="block text-sm font-semibold text-navy mb-2">{% trans "Phone Number" %} <span class="text-red-500">*</span></label>
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<input type="tel" name="contact_phone" maxlength="20" required
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pattern="(\+?966|0)?5[0-9]{8}" inputmode="tel"
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placeholder="{% trans '05XXXXXXXX or +9665XXXXXXXX' %}" value="{{ prefill.contact_phone|default:'' }}"
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class="w-full px-4 py-3 border-2 border-slate-200 rounded-xl text-navy focus:outline-none focus:ring-2 focus:ring-navy/20 focus:border-navy">
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</div>
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</div>
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<input type="hidden" name="hospital" value="{{ selected_hospital_id }}">
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<div class="mb-5">
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<label class="block text-sm font-semibold text-navy mb-2">{% trans "Title" %} <span class="text-red-500">*</span></label>
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<input type="text" name="title" placeholder="{% trans 'Brief title for this suggestion' %}" value="{{ prefill.title|default:'' }}"
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class="w-full px-4 py-3 border-2 border-slate-200 rounded-xl text-navy focus:outline-none focus:ring-2 focus:ring-navy/20 focus:border-navy">
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</div>
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<div class="mb-5">
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<label class="block text-sm font-semibold text-navy mb-2">{% trans "Message" %} <span class="text-red-500">*</span></label>
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<textarea name="message" rows="5" required placeholder="{% trans 'Describe your suggestion in detail...' %}"
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class="w-full px-4 py-3 border-2 border-slate-200 rounded-xl text-navy focus:outline-none focus:ring-2 focus:ring-navy/20 focus:border-navy resize-none">{{ prefill.message|default:'' }}</textarea>
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</div>
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<div class="text-center pt-4 border-t border-slate-100">
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<button type="submit" class="px-8 py-3.5 bg-navy text-white rounded-xl font-bold hover:bg-navy/90 transition inline-flex items-center gap-2">
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<i data-lucide="{% if is_create %}send{% else %}check{% endif %}" class="w-5 h-5"></i> {% if is_create %}{% trans "Submit Suggestion" %}{% else %}{% trans "Save Changes" %}{% endif %}
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</button>
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</div>
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</form>
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</div>
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{% endblock %}
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{% block extra_js %}
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<script>
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document.addEventListener('DOMContentLoaded', function() {
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lucide.createIcons();
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});
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</script>
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{% endblock %}
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