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<fieldset class="extra-metadata-option js-metadata-option">
<legend class="visuallyhidden">Option [% j %]</legend>
<div class="row">
<div class="col">
<label for="metadata-[% i %]-values-[% j %]-key">[% loc('Internal key') %]</label>
<input type="text" class="form-control" name="metadata[[% i %]].values[[% j %]].key" id="metadata-[% i %]-values-[% j %]-key" value="[% option.key | html %]">
</div>
<div class="col">
<label for="metadata-[% i %]-values-[% j %]-name">[% loc('Displayed label') %]</label>
<input type="text" class="form-control" name="metadata[[% i %]].values[[% j %]].name" id="metadata-[% i %]-values-[% j %]-name" value="[% option.name | html %]">
</div>
</div>
<div class="row">
<div class="col">
<p class="form-check">
<input type="checkbox" name="metadata[[% i %]].values[[% j %]].disable" value="1" id="metadata-[% i %]-values-[% j %]-disable" data-toggle-visibility="#js-disable-form-message-box-[% i %]-[% j %]" [% ' checked' IF option.disable %]>
<label for="metadata-[% i %]-values-[% j %]-disable">[% loc('Disable form when this option is selected') %]</label>
</p>
<p class="form-group [% 'hidden-js' IF NOT option.disable %]" id="js-disable-form-message-box-[% i %]-[% j %]">
<label for="disabled-message-[% i %]-[% j %]">[% loc('Message to show when form is disabled (HTML permitted)') %]</label>
<textarea id="disabled-message-[% i %]-[% j %]" name="metadata[[% i %]].values[[% j %]].disable_message" class="form-control">[% option.disable_message OR meta.datatype_description | html %]</textarea>
</p>
</div>
<div class="col">
<button type="button" class="js-metadata-option-remove">[% loc('Remove option') %]</button>
</div>
</div>
</fieldset>
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