<div class="col-lg-6  ">
    <div class="form-group">
        <label for="name_care_giver_azienda" class=" required col-md-12 col-form-label "><?php echo e(__('Nome ')); ?></label>

        <div class="col-md-12">
            <input type="text" autocomplete="off"
                   class="form-control <?php echo e($errors->has('name_care_giver_azienda') ? ' is-invalid' : ''); ?>"
                   name="name_care_giver_azienda" value="<?php echo e(old('name_care_giver_azienda')); ?>">

            <?php if($errors->has('name_care_giver_azienda')): ?>
                <span class="invalid-feedback" role="alert">
                <strong><?php echo e($errors->first('name_care_giver_azienda')); ?></strong>
            </span>
            <?php endif; ?>
        </div>
    </div>
</div>
<div class="col-lg-6 ">
    <div class="form-group ">
        <label for="surname_care_giver_azienda" class="required col-md-12 col-form-label "><?php echo e(__('Cognome ')); ?></label>

        <div class="col-md-12">
            <input type="text" autocomplete="off"
                   class="form-control<?php echo e($errors->has('surname_care_giver_azienda') ? ' is-invalid' : ''); ?>"
                   name="surname_care_giver_azienda" value="<?php echo e(old('surname_care_giver_azienda')); ?>">

            <?php if($errors->has('surname_care_giver_azienda')): ?>
                <span class="invalid-feedback" role="alert">
                <strong><?php echo e($errors->first('surname_care_giver_azienda')); ?></strong>
            </span>
            <?php endif; ?>
        </div>
    </div>
</div>
<div class="col-lg-12 ">
    <div class="form-group ">
        <label for="email_care_giver_azienda" class=" required col-md-12 col-form-label "><?php echo e(__('Indirizzo E-mail ')); ?>

            <small>(Assicurati di digitare correttamente la tua e-mail)</small>
        </label>
        <div class="col-md-12">
            <input type="text" autocomplete="off"
                   class="form-control <?php echo e($errors->has('email_care_giver_azienda') ? ' is-invalid' : ''); ?>"
                   name="email_care_giver_azienda" value="<?php echo e(old('email_care_giver_azienda')); ?>">
            <?php if($errors->has('email_care_giver_azienda')): ?>
                <span class="invalid-feedback" role="alert">
                <strong><?php echo e($errors->first('email_care_giver_azienda')); ?></strong>
            </span>
            <?php endif; ?>
        </div>
    </div>
</div>
<div class="col-lg-6 fields_care_giver_azienda">
    <div class="form-group ">
        <label for="password_care_giver_azienda" class="required col-md-12 col-form-label "><?php echo e(__('Password')); ?>

            <small>(La password deve avere almeno 8 caratteri)</small>
        </label>

        <div class="col-md-12" style="display:flex">
            <input type="password"
                   class="form-control<?php echo e($errors->has('password_care_giver_azienda') ? ' is-invalid' : ''); ?> password"
                   name="password_care_giver_azienda" autocomplete="off">
            <?php if($errors->has('password_care_giver_azienda')): ?>
                <span class="invalid-feedback" role="alert">
                <strong><?php echo e($errors->first('password_care_giver_azienda')); ?></strong>
            </span>
            <?php endif; ?>
            <span class="toggle_pwd icofont-eye-blocked field_icon"></span>
        </div>
    </div>
</div>
<div class="col-lg-6 fields_care_giver_azienda" style="width:100%">
    <div class="form-group  ">
        <label for="password_care_giver_azienda_confirmation"
               class="required col-md-12 col-form-label "><?php echo e(__('Conferma Password')); ?></label>
        <div class="col-md-12" style="display:flex">
            <input type="password"
                   class="form-control <?php echo e($errors->has('password_care_giver_azienda_confirmation') ? ' is-invalid' : ''); ?> password "
                   name="password_care_giver_azienda_confirmation" autocomplete="false" style="width:100%">
            <?php if($errors->has('password_care_giver_azienda_confirmation')): ?>
                <span class="invalid-feedback" role="alert">
                <strong><?php echo e($errors->first('password_care_giver_azienda_confirmation')); ?></strong>
            </span>
            <?php endif; ?>
        </div>
    </div>
</div>
<div class="col-lg-6">
    <div class="form-group">
        <label for="tel_referent" class=" col-md-12 col-form-label">Telefono
            <small>(Facoltativo ma sarà più facile tenerci in contatto)</small>
        </label>
        <div class="col-md-12">
            <input id="tel_referent" autocomplete="off" type="tel"
                   class="form-control <?php echo e($errors->has('tel_referent') ? ' is-invalid' : ''); ?>" name="tel_referent"
                   value="<?php echo e(old('tel_referent')); ?>">
            <?php if($errors->tel_referent): ?>
                <span class="invalid-feedback" role="alert">
                <strong><?php echo e($errors->first('tel_referent')); ?></strong>
            </span>
            <?php endif; ?>
        </div>
    </div>
</div>

<!--
<div class="col-lg-12">
    <div class="form-group">
        <label for="municipality_caregiver_azienda" class=" col-md-12 col-form-label">Il luogo in cui vivi o cerchi servizi
            <small>
                    ( in questo modo potremo sostenerti nella ricerca)
            </small>
        </label>
        <div id="locationFieldCargiver" class="col-md-12">
            <input id="caregiver_azienda"
                   class="form-control <?php echo e($errors->has('municipality_caregiver_azienda') ? ' is-invalid' : ''); ?> <?php echo e($errors->has('state_care_giver_aziendas') ? ' is-invalid' : ''); ?>"
                   placeholder="Cercalo qui" autocomplete="off"
                   name="address_google_caregiver_azienda"
                   value="<?php echo e(old('address_google_caregiver_azienda')); ?>"
                   type="text"/>
            <?php if($errors->municipality_caregiver_azienda): ?>
                <span class="invalid-feedback" role="alert">
                <strong><?php echo e($errors->first('municipality_caregiver_azienda')); ?></strong>
            </span>
            <?php endif; ?>
            <?php if($errors->state_care_giver_aziendas): ?>
                <span class="invalid-feedback" role="alert">
                <strong><?php echo e($errors->first('state_care_giver_aziendas')); ?></strong>
            </span>
            <?php endif; ?>
        </div>
    </div>
</div>
!-->

<div class="col-lg-12">
    <div class="form-group">
    <label for="municipality_care_giver_azienda" class=" col-md-12 col-form-label">Il luogo in cui vivi o cerchi servizi
            <small>
                    ( in questo modo potremo sostenerti nella ricerca)
            </small>
        </label>        <div class="col-md-12">
            <select
                class="form-control js-example-basic-multiple city    <?php echo e($errors->has('municipality_care_giver_azienda') ? ' is-invalid' : ''); ?>"
                data-id="municipality_care_giver_azienda" name="municipality_care_giver_azienda" style="width:100% ">
                <option value="" disabled selected>Seleziona</option>
            </select>
            <?php if($errors->municipality_care_giver_azienda): ?>
                <span class="invalid-feedback" role="alert">
                <strong><?php echo e($errors->first('municipality_care_giver_azienda')); ?></strong>
            </span>
            <?php endif; ?>
        </div>
    </div>
</div>
<!--
<div class="col-lg-6 " style='display: none'>
    <div class="form-group">
        <label for="municipality_caregiver_azienda" class="required col-md-12 col-form-label">Dove vivi? (scrivi l'indirizzo
            completo e le celle sotto si completano automaticamente)</label>
        <div class="col-md-12">
            <input type="text" autocomplete="off" id="municipality_caregiver_azienda" readonly="" pattern="[a-zA-Z]+"
                   class="form-control" name="municipality_caregiver_azienda" value="<?php echo e(old('municipality_caregiver_azienda')); ?>">
        </div>
    </div>
</div>
<div class="col-lg-6 " style='display: none'>
    <div class="form-group">
        <label for="state_care_giver_aziendas" class="required col-md-12 col-form-label">Provincia</label>
        <div class="col-md-12" style="pointer-events: none; ">
            <select id="state_care_giver_aziendas" class="form-control states" name="state_care_giver_aziendas" style="width:100% ">
            </select>
        </div>
    </div>
</div>
!-->
























<div class="col-lg-12">
    <div class="form-group">
        <label for="pathology" class="required col-md-12 col-form-label">Condizione, disturbo o disabilità per cui
            cerchi sostegno (puoi indicare più opzioni)</label>
        <div class="col-md-12">
            <select
                class="form-control js-example-basic-multiple pathology    <?php echo e($errors->has('pathology') ? ' is-invalid' : ''); ?>"
                data-id="pathology" name="pathology[]" style="width:100% " multiple="multiple">
            </select>
            <?php if($errors->pathology): ?>
                <span class="invalid-feedback" role="alert">
                <strong><?php echo e($errors->first('pathology')); ?></strong>
            </span>
            <?php endif; ?>
        </div>
    </div>
</div>
<div class="col-lg-12 select_care_giver_azienda">
    <div class="form-group">
        <label for="municipality_care_giver" class=" col-md-12 col-form-label">
            Seleziona l'azienda di appartenenza
        </label>
        <div class="col-md-12">

            <select
                class="form-control js-example-basic-multiple   <?php echo e($errors->has('azienda_non_selezionata') ? ' is-invalid' : ''); ?>"
                data-id="azienda" name="azienda"
                style="width:100% ">
                <option value="" selected>Seleziona</option>
                <?php $__currentLoopData = $aziende; $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $a): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
                    <option value="<?php echo e($a->slug); ?>"  ><?php echo e($a->nome); ?></option>
                <?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
            </select>
            <?php if($errors->azienda_non_selezionata): ?>
                <span class="invalid-feedback" role="alert">
                <strong><?php echo e($errors->first('azienda_non_selezionata')); ?></strong>
            </span>
            <?php endif; ?>
        </div>
    </div>
</div>
<div class="modal" id="add_shipping_row_caregiver_azienda">
    <div class="modal-dialog">
        <div class="modal-content">
            <!-- Modal Header -->
            <div class="modal-header">
                <h4 class="modal-title">Aggiungi per chi cerchi sostegno</h4>
                <button type="button" class="close" data-dismiss="modal">&times;</button>
            </div>

            <!-- Modal body -->
            <div class="modal-body">
                <div class="col-lg-12  ">
                    <div class="form-group">
                        <label class=" required col-md-12 col-form-label ">
                            Per chi stai cercando sostegno?
                        </label>
                        <select class=" form-control " name="modal_caregiver_aziendas_for" id="modal_caregiver_aziendas_for">
                            <option value="me">Per me</option>
                            <option value="figlio">Per mio figlio</option>
                            <option value="figlia">Per mia figlia</option>
                            <option value="padre">Per mio padre </option>
                            <option value="madre">Per mia madre</option>
                            <option value="sorella">Per mia sorella</option>
                            <option value="fratello">Per mio fratello</option>
                            <option value="marito">Per il mio compagno/marito</option>
                            <option value="moglie">Per la mia compagna/moglie</option>
                            <option value="parente">Per un parente</option>
                            <option value="amico">Per un amico</option>
                        </select>
                    </div>
                </div>
                <div class="col-lg-12  ">
                    <div class="form-group">
                        <label class=" required col-md-12 col-form-label ">
                            Genere
                        </label>
                        <select class=" form-control " id="modal_caregiver_aziendas_name">
                            <option value="maschio">Maschio</option>
                            <option value="femmina">Femmina</option>
                            <option value="altro">Altro</option>
                        </select>
                    </div>
                </div>








            </div>

            <!-- Modal footer -->
            <div class="modal-footer">
                <button type="button" class="btn btn-info" data-dismiss="modal">Chiudi</button>
                <button type="button" class="btn btn-success btn-save-modal" data-dismiss="modal">Salva</button>
            </div>

        </div>
    </div>
</div>
<?php $__env->startPush('footersection'); ?>

    <script type="text/javascript" charset="utf-8">
        var counter = 0;
        $(function () {
            $('.btn-save-modal').on("click", function () {
                //console.log(counter);
                addNewShippingRow();
                // addNewInitAutoComplete(counter);
            });
            $(".addrow").on("click", function () {
                $('.btn-save-modal').show();
                $('#modal_caregiver_aziendas_for').val('');
                $('#modal_caregiver_aziendas_name').val('');
                $('#modal_caregiver_aziendas_born').val('');
                $('#modal_caregiver_aziendas_city').val('');
                $('#add_shipping_row_caregiver_azienda').modal();
            });
            $("table.shipping-settings").on("click", ".ibtnDel", function (event) {
                console.log(counter);
                $(this).closest("tr").remove();
                counter--;
            });
            $("#recipient_type").change(function () {
                saveTextRecipients($(this).val());
            });


        });

        function show_detail(c) {


            $('#modal_caregiver_aziendas_for').val($('#shipping_table_roles tr:nth-child(' + c + ') select[name*="modal_caregiver_aziendas_for"]').val());
            $('#modal_caregiver_aziendas_name').val($('#shipping_table_roles tr:nth-child(' + c + ') select[name*="care_giver_azienda_name"]').val());
         //   $('#modal_caregiver_aziendas_born').val($('#shipping_table_roles tr:nth-child(' + c + ') input[name*="care_giver_azienda_born"]').val());
            console.log($('#shipping_table_roles tr:nth-child(' + c + ') input[name*="care_giver_azienda_born"]').val());
            $('#modal_caregiver_aziendas_city').val($('#shipping_table_roles tr:nth-child(' + c + ') input[name*="care_giver_azienda_city"]').val());
            $('.btn-save-modal').hide();
            $('#add_shipping_row_caregiver_azienda').modal();
            // addNewInitAutoComplete(counter);
        }

        function addNewShippingRow() {

            var selected_for = $('#modal_caregiver_aziendas_for').val();
            var selected_name = $('#modal_caregiver_aziendas_name').val();
            var selected_born = $('#modal_caregiver_aziendas_born').val();
            var selected_city = $('#modal_caregiver_aziendas_city').val();
            var obj = {
                "me": "Per me",
                "figlio": "Per mio figlio",
                "figlia": "Per mia figlia",
                "padre": "Per mio padre",
                "madre": "Per mia madre",
                "sorella": "Per mia sorella",
                "marito": "Per il mio compagno/marito",
                "moglie": "Per il mio compagna/moglie",
                "parente": "Per un parente",
                "amico": "Per un amico",
                "fratello": "Per mio fratello",
            };
            var obj2 = {
                "maschio": "Maschio",
                "femmina": "Femmina",
                "altro": "altro",
            };
            var newRow = $("<tr class='field'>"), cols = '', options = '';
            $('#add_shipping_row_caregiver_azienda').modal();
            cols += '<td > <select class="form-control product_selection_pool" required  name="care_giver_azienda_for[]">' +
                '   <option value="" selected >Seleziona...</option> ';
            $.each(obj, function (index, value) {
                if (selected_for == index) {
                    cols += '<option value="' + index + '" selected  >' + value + '</option> ';
                } else {
                    cols += '<option value="' + index + '"  >' + value + '</option> ';
                }
            });
            cols += '</select>' +
                '</td>';
            cols += '<td > <select class="form-control product_selection_pool" required name="care_giver_azienda_name[]">' +
                '   <option value="" selected >Seleziona...</option> ';
            $.each(obj2, function (index, value) {
                if (selected_name == index) {
                    cols += '<option value="' + index + '" selected  >' + value + '</option> ';
                } else {
                    cols += '<option value="' + index + '"  >' + value + '</option> ';
                }
            });
            cols += '</select>' +
                '</td>';
          //  cols += '<td><input type="date"  required name="care_giver_azienda_born[]" class="form-control " value="' + selected_born + '"></td>';
            cols += '<td style="    display: flex;">' +
                '<button type="button" class="ibtnDel btn btn-md btn-danger"><i class="icofont-trash"></i></button></td>';
            newRow.append(cols);
            $("table.shipping-settings").append(newRow);
            counter++;
        }

    </script>

<?php $__env->stopPush(); ?>
<?php /**PATH /var/www/linkabili/resources/views/auth/_parts/caregiver_azienda.blade.php ENDPATH**/ ?>