{% extends "public/content.html" %}
{% load recaptcha2 %}

{% block headtitle %}
    {% if content_block %}
        {{ content_block.name }}
    {% else %}
        Contact Study Submission
    {% endif %}
{% endblock %}

{% block headscript %}
    {% recaptcha_init %}

    <script>
        $(document).ready(function(){
            if ($('#id_speciality').val() == 'Other'){
                $('.field_speciality_other').show();
            } else {
                $('.field_speciality_other').hide();
            }
            if ($('#id_role').val() == 'Other'){
                $('.field_role_other').show();
            } else {
                $('.field_role_other').hide();
            }

            $('#id_speciality').change(function(){
                if($(this).val() == 'Other'){
                    $('.field_speciality_other').show();
                } else {
                    $('.field_speciality_other').hide();
                }
            });

            $('#id_role').change(function(){
                if($(this).val() == 'Other'){
                    $('.field_role_other').show();
                } else {
                    $('.field_role_other').hide();
                }
            });

        });


    </script>

{% endblock %}

{% block title %}

    <ul class="breadcrumb">
        <li><a href="/">Home</a></li>
        <li><a href="/contact-study/">Contact Study</a></li>
        <li class="active">Submission Form</li>
    </ul>

    {% if content_block %}
        <h1>{{ content_block.name }}</h1>
    {% else %}
        <h1>Contact Study Submission</h1>
    {% endif %}

{% endblock %}

{% block content %}

    {% if content_block %}
        {{ content_block.content|safe }}
    {% endif %}

    <form action="" method="post" class="form form-horizontal">{% csrf_token %}
        {% include "public/partials/form.html" with form=form %}
        <div class="clear"></div>
        <div class="form-group form-actions">
            <div class="col-lg-offset-4 col-lg-4">
                <input type="submit" class="btn btn-primary" value="Submit" />
            </div>
        </div>
    </form>

{% endblock %}