{% set title = 'Formulaire de réclamation' %}
{% set hasReCaptcha = true %}
{% extends 'Default/base-form.html.twig' %}
{% import 'Admin/macros.html.twig' as adminMacros %}

{% block content %}
<div id="" class='bg-gray {{desktop("gpadding")}} {{mobile("")}}'>
    <div class="fill hoverflow gpadding {{desktop('flex col vt-60-in')}} {{mobile('vt-30-in')}}">

        {{include('Default/notice.html.twig')}}

        <div class="bg-white shadow hoverflow nsiaform las w100">
            {{form_start(form,{attr:{id:form.vars.id}})}}
            <div class=" {{desktop('vt-40-in hz-60-in')}}">
                {{form_row(form.sex)}}
                {{form_row(form.lname)}}
                {{form_row(form.fname)}}
                {{adminMacros.os_radio(form.hasAccount)}}
                {{form_row(form.accountNumber)}}
                {{form_row(form.accountName)}}
                {{form_row(form.email)}}
                {{form_row(form.type,{attr:{class:"os-trigger",'data-target1':"#"~form.cardNumber.vars.id, 'data-target2':"#"~form.otherType.vars.id}})}}
                <div>
                    {{form_label(form.cardNumber)}}
                    <p>Les 6 premiers chiffres et 4 derniers chiffres de votre numéro de carte</p>
                    {{form_widget(form.cardNumber)}}
                </div>
                {{form_rest(form)}}
            </div>
            <div class="text-center bottom-40-in">
            <p class="h6 medium">Délai de traitement règlementaire : 30 jours maximum</p>
            </div>
            <div class='bg-warning flex col center middle {{desktop("vt-40-in hz-40-in")}} {{mobile("center")}}'>
                <div class="g-recaptcha" data-sitekey="{{os_param('recaptcha')['key']}}"></div>
                <button type='submit' data-target='#{{form.vars.id}}' class="anim-btn relative flex col center bg-success noborder radius-5 {{desktop('top-15')}}">
                    <span class="upper semibold h6 vt-10-in hz-30-in white">Envoyer</span>
                </button>
            </div>
            {{form_end(form)}}
        </div>
    </div>
</div>
{% endblock %}