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[%
SET bodyclass = 'mappage';
PROCESS "report/photo-js.html";
PROCESS "maps/${map.type}.html";
INCLUDE 'header.html', title = loc('Questionnaire');
%]
[% map_html %]
</div>
<div id="map_sidebar">
<h1>[% loc('Questionnaire') %]</h1>
<h2 class="questionnaire-report-header">[% loc('Your report') %]</h2>
<div class="questionnaire-report-reminder">
[% INCLUDE 'report/photo.html' object=problem %]
<h3 class="questionnaire-report-reminder__report-title">
<a href="/report/[% problem.id %]">[% problem.title | html %]</a>
</h3>
<p class="questionnaire-report-reminder__report-meta">[% problem.meta_line(c) | html %]</p>
[% IF updates.size %]
<p class="questionnaire-report-reminder__last-update-header">
<strong>[% loc('Last update') %]</strong>
<a href="/report/[% problem.id %]">[% loc('Show all updates') %]</a>
</p>
<p class="questionnaire-report-reminder__last-update">“[% updates.last.text | add_links %]”</p>
[% END %]
</div>
<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 %]">
[% IF errors %]
<ul class="error questionnaire-errors">
<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 class="segmented-control segmented-control--radio">
<input type="radio" name="been_fixed" id="been_fixed_yes" value="Yes"[% ' checked' IF been_fixed == 'Yes' %]>
<label class="btn" 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 class="btn" 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 class="btn" 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 class="segmented-control segmented-control--radio">
<input type="radio" name="reported" id="reported_yes" value="Yes"[% ' checked' IF reported == 'Yes' %]>
<label class="btn" for="reported_yes">[% loc('Reported before') %]</label>
<input type="radio" name="reported" id="reported_no" value="No"[% ' checked' IF reported == 'No' %]>
<label class="btn" 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).') %]</p>
<p><textarea class="form-control" name="update" rows="7" cols="30" placeholder="[% loc('What was your experience of getting the problem fixed?') %]">[% update | html %]</textarea></p>
[% IF c.cobrand.allow_photo_upload %]
<input type="hidden" name="upload_fileid" value="[% upload_fileid %]">
<label for="form_photo">
<span data-singular="[% loc('Photo') %]" data-plural="[% loc('Photos') %]">[% loc('Photo') %]</span>
</label>
[% IF field_errors.photo %]
<p class='form-error'>[% field_errors.photo %]</p>
[% END %]
<div id="form_photos">
[% IF upload_fileid %]
<p>[% loc('You have already attached photos to this update. Note that you can attach a maximum of 3 to this update (if you try to upload more, the oldest will be removed).') %]</p>
[% FOREACH id IN upload_fileid.split(',') %]
<img align="right" src="/photo/temp.[% id %]" alt="">
[% END %]
[% END %]
<input type="file" name="photo1" id="form_photo">
<label for="form_photo2">[% loc('Photo') %]</label>
<input type="file" name="photo2" id="form_photo2">
<label for="form_photo3">[% loc('Photo') %]</label>
<input type="file" name="photo3" id="form_photo3">
</div>
[% END %]
<div class="js-another-questionnaire">
<p>[% loc('Would you like to receive another questionnaire in 4 weeks, reminding you to check the status?') %]</p>
<p class="segmented-control segmented-control--radio">
<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>
<p><input type="submit" class="btn" name="submit" value="[% loc('Submit questionnaire') %]"></p>
</form>
</div>
[% INCLUDE 'footer.html' %]
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