@extends('layouts.app')

@section('content')
    <div class="min-vh-100 bg-light py-5">
        <div class="container" style="max-width: 56rem;">
            
            <!-- Step Indicator -->
            <div class="mb-5">
                <div class="d-flex align-items-center justify-content-between mb-4">
                    <div class="d-flex align-items-center gap-3">
                        <div class="rounded-circle bg-success text-white d-flex align-items-center justify-content-center fw-bold shadow" style="width: 3rem; height: 3rem; font-size: 1.25rem;">
                            1
                        </div>
                        <div>
                            <p class="small text-secondary fw-medium mb-0">STEP 1 OF 4</p>
                            <h1 class="fs-4 fw-bold text-dark mb-0">Request Type</h1>
                        </div>
                    </div>
                </div>

                <!-- Progress Bar -->
                <div class="progress" style="height: 0.5rem;">
                    <div class="progress-bar bg-success" role="progressbar" style="width: 16.66%" aria-valuenow="16.66" aria-valuemin="0" aria-valuemax="100"></div>
                </div>
            </div>

            <!-- Main Content -->
            <div class="card border rounded-4 shadow-sm">
                <div class="card-body p-5">
                    
                    <div class="mb-5">
                        <h2 class="fs-1 fw-bold text-dark mb-2">Request Type</h2>
                        <p class="fs-5 text-secondary">Please select the type of prescription request</p>
                    </div>

                    <form action="{{ route('intake.step1.store') }}" method="POST" class="vstack gap-4">
                        @csrf

                        <!-- Refill Request -->
                        <label class="d-block cursor-pointer">
                            <div class="card border-2 border-secondary-subtle rounded-3 transition-all hover-shadow position-relative">
                                <input type="radio" name="request_type" value="refill" class="form-check-input position-absolute" style="top: 2rem; left: 2rem; width: 1.25rem; height: 1.25rem;" checked>
                                <div class="card-body p-4 ps-5 ms-4">
                                    <div class="d-flex align-items-start gap-3 mb-3">
                                        <div class="d-flex align-items-center justify-content-center rounded-3 bg-primary bg-opacity-10" style="width: 3rem; height: 3rem;">
                                            <svg xmlns="http://www.w3.org/2000/svg" fill="none" viewBox="0 0 24 24" stroke-width="2" stroke="currentColor" class="text-primary" width="24" height="24">
                                                <path stroke-linecap="round" stroke-linejoin="round" d="M16.023 9.348h4.992v-.001M2.985 19.644v-4.992m0 0h4.992m-4.993 0l3.181 3.183a8.25 8.25 0 0013.803-3.7M4.031 9.865a8.25 8.25 0 0113.803-3.7l3.181 3.182m0-4.991v4.99" />
                                            </svg>
                                        </div>
                                        <h3 class="fs-4 fw-bold text-dark mb-0">Refill Request</h3>
                                    </div>
                                    <p class="text-secondary mb-3">Request a refill for an existing prescription. This is the faster option if you're already taking this medication.</p>
                                    <div class="d-flex gap-2">
                                        <span class="badge bg-primary bg-opacity-25 text-primary">Faster Process</span>
                                        <span class="badge bg-primary bg-opacity-25 text-primary">Existing Medication</span>
                                    </div>
                                </div>
                            </div>
                        </label>

                        <!-- New Prescription -->
                        <label class="d-block cursor-pointer">
                            <div class="card border-2 border-secondary-subtle rounded-3 transition-all hover-shadow position-relative">
                                <input type="radio" name="request_type" value="new" class="form-check-input position-absolute" style="top: 2rem; left: 2rem; width: 1.25rem; height: 1.25rem;">
                                <div class="card-body p-4 ps-5 ms-4">
                                    <div class="d-flex align-items-start gap-3 mb-3">
                                        <div class="d-flex align-items-center justify-content-center rounded-3 bg-success bg-opacity-10" style="width: 3rem; height: 3rem;">
                                            <svg xmlns="http://www.w3.org/2000/svg" fill="none" viewBox="0 0 24 24" stroke-width="2" stroke="currentColor" class="text-success" width="24" height="24">
                                                <path stroke-linecap="round" stroke-linejoin="round" d="M12 9v6m3-3H9m12 0a9 9 0 11-18 0 9 9 0 0118 0z" />
                                            </svg>
                                        </div>
                                        <h3 class="fs-4 fw-bold text-dark mb-0">New Prescription</h3>
                                    </div>
                                    <p class="text-secondary mb-3">Request a new prescription for a different medication. You'll need to complete a full medical assessment.</p>
                                    <div class="d-flex gap-2">
                                        <span class="badge bg-success bg-opacity-25 text-success">New Medication</span>
                                        <span class="badge bg-success bg-opacity-25 text-success">Full Assessment</span>
                                    </div>
                                </div>
                            </div>
                        </label>

                        <!-- Info Box -->
                        <div class="mt-3 p-4 bg-light rounded-3 border">
                            <div class="d-flex gap-3">
                                <svg xmlns="http://www.w3.org/2000/svg" fill="none" viewBox="0 0 24 24" stroke-width="2" stroke="currentColor" class="text-success flex-shrink-0 mt-1" width="20" height="20">
                                    <path stroke-linecap="round" stroke-linejoin="round" d="M11.25 11.25l.041-.02a.75.75 0 011.063.852l-.708 2.836a.75.75 0 001.063.853l.041-.021M21 12a9 9 0 11-18 0 9 9 0 0118 0zm-9-3.75h.008v.008H12V8.25z" />
                                </svg>
                                <div>
                                    <h4 class="fw-semibold text-dark mb-2">What's the difference?</h4>
                                    <p class="small text-secondary mb-0">
                                        <strong>Refill:</strong> For existing prescriptions you need refilled<br>
                                        <strong>New:</strong> For new medications requiring a prescription
                                    </p>
                                </div>
                            </div>
                        </div>

                        <!-- Continue Button -->
                        <div class="pt-4">
                            <button type="submit" class="btn btn-success btn-lg w-100 py-3 fs-5 fw-semibold rounded-3 shadow">
                                Continue to Personal Information →
                            </button>
                        </div>
                    </form>
                </div>
            </div>

            <!-- Help Link -->
            <div class="mt-4 text-center">
                <p class="text-secondary mb-0">
                    Need help? <a href="#" class="text-success fw-medium text-decoration-underline">Contact Support</a>
                </p>
            </div>
        </div>
    </div>
@endsection