doctype html
html lang="en"
  head
    meta charset="utf-8"

    title= content_for?(:title) ? yield(:title) : "Renalware v#{Renalware::VERSION}"

    = stylesheet_link_tag "renalware/application", media: :all
    = stylesheet_link_tag "renalware/print/pathology_request_forms", media: :all
    = javascript_include_tag "renalware/modernizr"

    = csrf_meta_tag

  body.overflow
    .row
      h4 Pathology Request CRS Form Preview

    .row
      .large-4.columns
        = simple_form_for request_html_form_params,
                          url: pathology_requests_new_request_path,
                          html: { autocomplete: "off" },
                          as: :request do |f|
          = f.input :patient_ids, as: :hidden_array
          = f.input :clinic_id,
              collection: all_clinics,
              input_html: { class: "small-input" },
              include_blank: false
          = f.input :consultant_id,
            collection: all_consultants,
            input_html: { class: "small-input" },
            include_blank: false
          = f.input :telephone, input_html: { class: "small-input" }
          = f.input :template,
              collection: all_templates,
              input_html: { class: "small-input" },
              label_method: ->(value) { I18n.t(value, scope: "renalware.pathology.request.template") },
              include_blank: false
          = f.button :submit, "Update Forms"

        = simple_form_for request_html_form_params,
                          url: pathology_requests_requests_path(format: :pdf),
                          html: { autocomplete: "off" },
                          as: :request do |f|
          = f.input :patient_ids, as: :hidden_array
          = f.input :clinic_id, as: :hidden
          = f.input :consultant_id, as: :hidden
          = f.input :telephone, as: :hidden
          = f.input :template, as: :hidden
          = f.button :submit, "Print Forms",
                     data: { confirm: "Are you sure you want to print this form? Printing will result in a request being logged which will effect the patholgoy algorithm's results." }

    hr.page_break

    = render partial: "renalware/pathology/requests/requests/request_form/#{request_html_form_params.template}",
             locals: { requests: requests, format: :html }

    = javascript_include_tag "renalware/application"