<commit_before> {% extends 'templates/nhs_transaction_layout.html' %}
{% import 'includes/form_macros.html' as form_macros %}

{% block afterHeader %}
  {% include "includes/service-headers/health-costs-checker.html" %}
{% endblock %}

{% block content %}

<main id="content" role="main">

  <div class="grid-row">
    <div class="column-two-thirds">

       <!--3- Are you named on a Medical Exemption certificate-->
    <h2 class="heading-large">Do you have glaucoma? //(over 40) or have a parent, sibling or child with glaucoma?//</h2>

      <form action="eligibility-handler" method="get" class="form">

          <div class="form-item-wrapper">
        <fieldset>
          <div class="inline-form-groups">
            <div class="form-group">
              <input id="medexYes" name="medex" type="radio" value="medexYes">
              <label class="form-control-radio" for="medexYes">
                Yes
              </label>
            </div>
            <div class="form-group">
              <input id="medexNo" name="medex" type="radio" value="medexNo">
              <label class="form-control-radio" for="medexNo">
                No
              </label>
            </div>
          </div>
        </fieldset>
      </div>


    {{
      form_macros.button({
        label: 'Next',
        href:""
      })
    }}

  </form>
      </div>
 <div class="column-third " id="lists">

      <div class="right-col-details">



          <h3 class="heading-medium">What you get free </h3>

<ul class="form-hint-list">
    <li class="form-hint-list-item  form-hint-list-item--valid">
        <span class="form-hint-list-item__primary">
            <span class="form-hint-list-item__indicator"></span>
        </span>
        Prescriptions
    </li>

    <li class="form-hint-list-item form-hint-list-item--valid">
        <span class="form-hint-list-item__primary">
            <span class="form-hint-list-item__indicator"></span>
        </span>
         NHS Sight test
    </li>

    <li class="form-hint-list-item form-hint-list-item--valid hidden" id="all">
        <span class="form-hint-list-item__primary">
            <span class="form-hint-list-item__indicator"></span>
        </span>
        Glasses or contact lenses
    </li>

            <li class="form-hint-list-item form-hint-list-item--valid hidden" id="all1">
        <span class="form-hint-list-item__primary">
            <span class="form-hint-list-item__indicator"></span>
        </span>
        NHS wigs
    </li>

    <li class="form-hint-list-item form-hint-list-item--valid hidden" id="all2">
        <span class="form-hint-list-item__primary">
            <span class="form-hint-list-item__indicator"></span>
        </span>
        Travel for treatment
    </li>

    <li class="form-hint-list-item form-hint-list-item--valid hidden" id="all3" >
        <span class="form-hint-list-item__primary">
            <span class="form-hint-list-item__indicator"></span>
        </span>
        NHS dental exam
    </li>

    <li class="form-hint-list-item form-hint-list-item--valid hidden" id="all4">
        <span class="form-hint-list-item__primary">
            <span class="form-hint-list-item__indicator"></span>
        </span>
         NHS dental treatment
    </li>
</ul>



      </div>

    </div>
    </div>

</main>

<!--<script>
$("#medexYes").click(function(){
    $("#all").removeClass("hidden");
    $("#all1").removeClass("hidden");
    $("#all2").removeClass("hidden");
    $("#all3").removeClass("hidden");
    $("#all4").removeClass("hidden");
}); </script>
<script>
$("#medexNo").click(function(){
    $("#all").addClass("hidden");
    $("#all1").addClass("hidden");
    $("#all2").addClass("hidden");
    $("#all3").addClass("hidden");
    $("#all4").addClass("hidden");
}); </script>
<script>-->

{% endblock %}






<commit_msg>glaucoma question<commit_after> {% extends 'templates/nhs_transaction_layout.html' %}
{% import 'includes/form_macros.html' as form_macros %}

{% block afterHeader %}
  {% include "includes/service-headers/health-costs-checker.html" %}
{% endblock %}

{% block content %}

<main id="content" role="main">

  <div class="grid-row">
    <div class="column-two-thirds">

       <!--3- Are you named on a Medical Exemption certificate-->
    <h2 class="heading-large">Do you have glaucoma? //(over 40) or have a parent, sibling or child with glaucoma?//</h2>

      <form action="eligibility-handler" method="get" class="form">

          <div class="form-item-wrapper">
        <fieldset>
          <div class="inline-form-groups">
            <div class="form-group">
              <input id="medexYes" name="medex" type="radio" value="medexYes">
              <label class="form-control-radio" for="medexYes">
                Yes
              </label>
            </div>
            <div class="form-group">
              <input id="medexNo" name="medex" type="radio" value="medexNo">
              <label class="form-control-radio" for="medexNo">
                No
              </label>
            </div>
          </div>
        </fieldset>
      </div>


    {{
      form_macros.button({
        label: 'Next',
        href:"care-home"
      })
    }}

  </form>
      </div>
 <div class="column-third " id="lists">

      <div class="right-col-details">



          <h3 class="heading-medium">What you get free </h3>

<ul class="form-hint-list">
    <li class="form-hint-list-item  form-hint-list-item--valid">
        <span class="form-hint-list-item__primary">
            <span class="form-hint-list-item__indicator"></span>
        </span>
        Prescriptions
    </li>

    <li class="form-hint-list-item form-hint-list-item--valid">
        <span class="form-hint-list-item__primary">
            <span class="form-hint-list-item__indicator"></span>
        </span>
         NHS Sight test
    </li>

    <li class="form-hint-list-item form-hint-list-item--valid hidden" id="all">
        <span class="form-hint-list-item__primary">
            <span class="form-hint-list-item__indicator"></span>
        </span>
        Glasses or contact lenses
    </li>

            <li class="form-hint-list-item form-hint-list-item--valid hidden" id="all1">
        <span class="form-hint-list-item__primary">
            <span class="form-hint-list-item__indicator"></span>
        </span>
        NHS wigs
    </li>

    <li class="form-hint-list-item form-hint-list-item--valid hidden" id="all2">
        <span class="form-hint-list-item__primary">
            <span class="form-hint-list-item__indicator"></span>
        </span>
        Travel for treatment
    </li>

    <li class="form-hint-list-item form-hint-list-item--valid hidden" id="all3" >
        <span class="form-hint-list-item__primary">
            <span class="form-hint-list-item__indicator"></span>
        </span>
        NHS dental exam
    </li>

    <li class="form-hint-list-item form-hint-list-item--valid hidden" id="all4">
        <span class="form-hint-list-item__primary">
            <span class="form-hint-list-item__indicator"></span>
        </span>
         NHS dental treatment
    </li>
</ul>



      </div>

    </div>
    </div>

</main>

<!--<script>
$("#medexYes").click(function(){
    $("#all").removeClass("hidden");
    $("#all1").removeClass("hidden");
    $("#all2").removeClass("hidden");
    $("#all3").removeClass("hidden");
    $("#all4").removeClass("hidden");
}); </script>
<script>
$("#medexNo").click(function(){
    $("#all").addClass("hidden");
    $("#all1").addClass("hidden");
    $("#all2").addClass("hidden");
    $("#all3").addClass("hidden");
    $("#all4").addClass("hidden");
}); </script>
<script>-->

{% endblock %}







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