@extends('master')


@section('content')

<div class="row">
	<div class="small-12 medium-6 large-6 columns">
		<h1>Preferences</h1>
	</div>
</div>

<div class="row">
    <div class="small-12 medium-6 large-6 columns">
        <h4>Place Holder</h4>
    </div>
</div>

<form action="{{{ URL::to('provider/' . $providerID . '/preferences') }}}" method="post" data-abide>

	<div class="row">
		<div class="small-12 medium-4 large-4 columns">
			<label>
				Preferred Language
				@if(isset($language))
					(Actual - {{{$language}}})
				@endif
			</label>
			<select id="preferred_language" name="preferred_language">
				<option value="English">English</option>
				<option value="Spanish">Spanish</option>
			</select>
		</div>
	</div>

	<div class="row">
		<div class="small-12 medium-4 large-4 end columns">
	        <label>
	        	Preferred Lab
	        	@if(isset($laboratory))
					(Actual - {{{$laboratory}}})
				@endif
	        </label>
	        <select id="preferred_lab" name="preferred_lab">
				<option value="ARUP">ARUP</option>
				<option value="MEDTOX">MEDTOX</option>
				<option value="PACTOX">PACTOX</option>
				<option value="PALI">PALI</option>
				<option value="QDI-SAC">QDI-SAC</option>
				<option value="QDI-SJC">QDI-SJC</option>
				<option value="QDI-WH">QDI-WH</option>
			</select>
	    </div>
	</div>

	<div class="row">
		<div class="small-12 medium-6 large-6 columns">
			<button>Save</button>
		</div>

		<div class="small-12 medium-6 large-6 end columns">
			<a href="{{{URL::to('patients')}}}" class="button">Cancel</a>
		</div>
	</div>

</form>



@stop