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[%
pre_map = INCLUDE 'report/_main.html';
PROCESS "maps/${map.type}.html";
INCLUDE 'header.html', title = loc('Questionnaire')
%]
[% map_html %]
[% INCLUDE 'report/updates.html' %]
</div>
<div id="side">
<h1>[% loc('Questionnaire') %]</h1>
<form method="post" action="/questionnaire/submit" id="questionnaire"
[%- IF c.cobrand.allow_photo_upload -%]
enctype="multipart/form-data"
[%- END -%]
>
<input type="hidden" name="token" value="[% token | html %]">
<p>
[% loc('The details of your problem are available on the right hand side of this page.') %]
[% loc('Please take a look at the updates that have been left.') IF updates %]
</p>
[% IF errors %]
<ul class="error">
<li>[% errors.join("</li>\n<li>") %]</li>
</ul>
[% END %]
<p>
[% loc('An update marked this problem as fixed.') IF problem.is_fixed %]
[% loc('Has this problem been fixed?') %]
</p>
<p>
<input type="radio" name="been_fixed" id="been_fixed_yes" value="Yes"[% ' checked' IF been_fixed == 'Yes' %]>
<label for="been_fixed_yes">[% loc('Yes') %]</label>
<input type="radio" name="been_fixed" id="been_fixed_no" value="No"[% ' checked' IF been_fixed == 'No' %]>
<label for="been_fixed_no">[% loc('No') %]</label>
<input type="radio" name="been_fixed" id="been_fixed_unknown" value="Unknown"[% ' checked' IF been_fixed == 'Unknown' %]>
<label for="been_fixed_unknown">[% loc('Don’t know') %]</label>
</p>
[% UNLESS answered_ever_reported %]
<p>[% loc('Have you ever reported a problem to a council before, or is this your first time?') %]</p>
<p>
<input type="radio" name="reported" id="reported_yes" value="Yes"[% ' checked' IF reported == 'Yes' %]>
<label for="reported_yes">[% loc('Reported before') %]</label>
<input type="radio" name="reported" id="reported_no" value="No"[% ' checked' IF reported == 'No' %]>
<label for="reported_no">[% loc('First time') %]</label>
</p>
[% END %]
<p>[% loc('If you wish to leave a public update on the problem, please enter it here
(please note it will not be sent to the council). For example, what was
your experience of getting the problem fixed?') %]</p>
<p><textarea name="update" style="max-width:90%" rows="7" cols="30">[% update | html %]</textarea></p>
[% IF c.cobrand.allow_photo_upload %]
<div id="fileupload_normalUI">
[% IF upload_fileid %]
<p>[% loc('You have already attached a photo to this report, attaching another one will replace it.') %]</p>
<input type="hidden" name="upload_fileid" value="[% upload_fileid %]">
[% END %]
<label for="form_photo">[% loc('Photo:') %]</label>
<input type="file" name="photo" id="form_photo">
</div>
[% END %]
[% IF c.cobrand.moniker != 'emptyhomes' %]
<div id="another_qn">
<p>[% loc('Would you like to receive another questionnaire in 4 weeks, reminding you to check the status?') %]</p>
<p>
<input type="radio" name="another" id="another_yes" value="Yes"[% ' checked' IF another == 'Yes' %]>
<label for="another_yes">[% loc('Yes') %]</label>
<input type="radio" name="another" id="another_no" value="No"[% ' checked' IF another == 'No' %]>
<label for="another_no">[% loc('No') %]</label>
</p>
</div>
[% END %]
<p><input type="submit" name="submit" value="[% loc('Submit questionnaire') %]"></p>
</form>
</div>
[% INCLUDE 'footer.html' %]
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