= field_set_tag t(".fieldsets.dates") do
   = f.input :diagnosis_date, as: :date_picker, wrapper: :horizontal_datepicker
   = f.input :treatment_start_date, as: :date_picker, wrapper: :horizontal_datepicker
   = f.input :treatment_end_date, as: :date_picker, wrapper: :horizontal_datepicker

.row
  .large-12.columns
    = field_set_tag t(".fieldsets.outcomes") do
      = f.input :episode_types,
                collection: Renalware::PD::PeritonitisEpisodeTypeDescription.pluck(:term, :id),
                include_blank: t("collection.blank_option"),
                input_html: { data: { placeholder: t("collection.blank_option_for_multiple") } },
                as: :multiple_select,
                include_hidden: false,
                selected: f.object.episode_types.map(&:peritonitis_episode_type_description_id)
      = f.input :catheter_removed, as: :inline_radio_buttons
.row
  .large-12.columns
    = field_set_tag t(".fieldsets.causes") do
      = f.input :line_break, as: :boolean, boolean_style: :inline
      = f.input :exit_site_infection, as: :boolean, boolean_style: :inline
      = f.input :diarrhoea, as: :boolean, boolean_style: :inline
      = f.input :abdominal_pain, as: :boolean, boolean_style: :inline

      = f.association :fluid_description,
                      collection: Renalware::PD::FluidDescription.pluck(:description, :id),
                      include_blank: t(".fluid_description.blank_option"),
                      wrapper: :horizontal_medium

.row
  .large-12.columns
    .row
      = field_set_tag t(".fieldsets.white_cell_count") do
          = f.input :white_cell_total, wrapper: :horizontal_tiny
          = f.input :white_cell_neutro, wrapper: :horizontal_tiny
          = f.input :white_cell_lympho, wrapper: :horizontal_tiny
          = f.input :white_cell_degen, wrapper: :horizontal_tiny
          = f.input :white_cell_other, wrapper: :horizontal_tiny

.row
  .large-12.columns
    = field_set_tag t(".fieldsets.comments") do
      = f.input :notes,
                as: :text,
                input_html: { cols: 50, rows: 6 },
                wrapper: :vertical_form