@extends('V2.layouts.onBoarding')

@section('content')
    <div class="content_wrapper">
        <div class="inner_title">
            <h3>Which of these smoking-related health issues are you currently facing?<span>*</span></h3>
            <p>Select all that apply</p>
            <span class="error_msg"></span>
        </div>
        <form id="frmBasic" name="frmBasic">
            <div class="wrap">
                <div class="form_field">
                    <input class="checkbox" type="checkbox" name="setHealthIssues[]" id="tiredness" value="Tiredness"
                        @checked(in_array('Tiredness', $setHealthIssues))>
                    <label class="checkbox_btn" for="tiredness">
                        Tiredness
                    </label>
                </div>

                <div class="form_field">
                    <input class="checkbox" type="checkbox" name="setHealthIssues[]" id="shortnessofbreath"
                        value="Shortness of breath" @checked(in_array('Shortness of breath', $setHealthIssues))>
                    <label class="checkbox_btn" for="shortnessofbreath">
                        Shortness of breath
                    </label>
                </div>

                <div class="form_field">
                    <input class="checkbox" type="checkbox" name="setHealthIssues[]" id="frequentcough"
                        value="Frequent cough/cold/flu" @checked(in_array('Frequent cough/cold/flu', $setHealthIssues))>
                    <label class="checkbox_btn" for="frequentcough">
                        Frequent cough/cold/flu
                    </label>
                </div>

                <div class="form_field">
                    <input class="checkbox" type="checkbox" name="setHealthIssues[]" id="dentalissues" value="Dental issues"
                        @checked(in_array('Dental issues', $setHealthIssues))>
                    <label class="checkbox_btn" for="dentalissues">
                        Dental issues
                    </label>
                </div>

                <div class="form_field">
                    <input class="checkbox" type="checkbox" name="setHealthIssues[]" id="moodissues" value="Mood issues"
                        @checked(in_array('Mood issues', $setHealthIssues))>
                    <label class="checkbox_btn" for="moodissues">
                        Mood issues
                    </label>
                </div>

                <div class="form_field">
                    <input class="checkbox" type="checkbox" name="setHealthIssues[]" id="bloodpressure"
                        value="High blood pressure" @checked(in_array('High blood pressure', $setHealthIssues))>
                    <label class="checkbox_btn" for="bloodpressure">
                        High blood pressure
                    </label>
                </div>

                <div class="form_field">
                    <input class="checkbox" type="checkbox" name="setHealthIssues[]" id="asthma" value="Asthma/COPD"
                        @checked(in_array('Asthma/COPD', $setHealthIssues))>
                    <label class="checkbox_btn" for="asthma">
                        Asthma/COPD
                    </label>
                </div>

                <div class="form_field">
                    <input class="checkbox" type="checkbox" name="setHealthIssues[]" id="sexualhealth"
                        value="Sexual health/impotence/fertility" @checked(in_array('Sexual health/impotence/fertility', $setHealthIssues))>
                    <label class="checkbox_btn" for="sexualhealth">
                        Sexual health/impotence/fertility
                    </label>
                </div>

                <div class="form_field">
                    <input class="checkbox" type="checkbox" name="setHealthIssues[]" id="heartdisease" value="Heart disease"
                        @checked(in_array('Heart disease', $setHealthIssues))>
                    <label class="checkbox_btn" for="heartdisease">
                        Heart disease
                    </label>
                </div>

                <div class="form_field">
                    <input class="checkbox" type="checkbox" name="setHealthIssues[]" id="cancer" value="Cancer"
                        @checked(in_array('Cancer', $setHealthIssues))>
                    <label class="checkbox_btn" for="cancer">
                        Cancer
                    </label>
                </div>

                <div class="form_field">
                    <input class="checkbox" type="checkbox" name="setHealthIssues[]" id="other" value="Other"
                        @checked(in_array('Other', $setHealthIssues))>
                    <label class="checkbox_btn" for="other">
                        Other
                    </label>
                </div>

                <div class="form_field">
                    <input class="checkbox" type="checkbox" name="setHealthIssues[]" id="nohealthissue"
                        value="No health issues" @checked(in_array('No health issues', $setHealthIssues))>
                    <label class="checkbox_btn" for="nohealthissue">
                        No health issues
                    </label>
                </div>
            </div>
            <div class="form_field button_wrap">
                <button type="button" class="button" name="btnSubmit" id="btnSubmit">SUBMIT</button>
            </div>
        </form>
    </div>
@endsection