biomedjs/public/partials/clients/add.html

<ul class="breadcrumb">
	<li><a href="/clients"><i class="icon-briefcase"></i> Clients</a><span class="divider"></span><li>
	<li class="active">New Client<li>
</ul>
<header>
	<h1>New Client</h1>
</header>

<form name="form" class="form">
	<div class="form-section">
		<div class="section-label">Client Name</div>
		<div class="section-container">
			<div class="form-editor">
				<div class="control-group">
					<label class="control-label">Name</label>
					<div class="controls">
						<input ng-model="model.name" type="text" name="name" class="input-xlarge">
					</div>
				</div>
				<div
					ng-class="{ 'error': form.identifier.$invalid && !form.identifier.$pristine }"
					class="control-group">

					<label class="control-label">Identifier</label>
					<div class="controls">
						<input
							ng-model="model.identifier"
							required
							ab-unique="{field: 'identifier'}"
							type="text"
							name="identifier"
							class="input-xlarge">
						<span ng-show="form.identifier.$error.unique" class="help-inline">Identifier must be unique</span>
					</div>
				</div>
			</div>
		</div>
	</div>
	<div class="form-section">
		<div class="section-label">Address</div>
		<div class="section-container">
			<div class="form-editor">
				<div class="control-group">
					<label class="control-label">Street</label>
					<div class="controls">
						<input ng-model="model.address.street1" type="text" name="street1" requiredclass="input-xlarge">
					</div>
				</div>
				<div class="control-group">
					<label class="control-label">Suite/Unit</label>
					<div class="controls">
						<input ng-model="model.address.street2" type="text" name="street2" class="input-xlarge">
					</div>
				</div>
				<div class="control-group">
					<label class="control-label">City</label>
					<div class="controls">
						<input ng-model="model.address.city" type="text" name="city" class="input-xlarge">
					</div>
				</div>
				<div class="control-group">
					<label class="control-label">State</label>
					<div class="controls">
						<select ng-model="model.address.state" name="state" class="input-xlarge">
							<option value="AL">Alabama</option>
							<option value="AK">Alaska</option>
							<option value="AZ">Arizona</option>
							<option value="AR">Arkansas</option>
							<option value="CA">California</option>
							<option value="CO">Colorado</option>
							<option value="CT">Connecticut</option>
							<option value="DC">District of Columbia</option>
							<option value="DE">Delaware</option>
							<option value="FL">Florida</option>
							<option value="GA">Georgia</option>
							<option value="HI">Hawaii</option>
							<option value="ID">Idaho</option>
							<option value="IL">Illinois</option>
							<option value="ID">Indiana</option>
							<option value="IA">Iowa</option>
							<option value="KS">Kansas</option>
							<option value="KY">Kentucky</option>
							<option value="LA">Louisiana</option>
							<option value="ME">Maine</option>
							<option value="MD">Maryland</option>
							<option value="MA">Massachusetts</option>
							<option value="MI">Michigan</option>
							<option value="MN">Minnesota</option>
							<option value="MS">Mississippi</option>
							<option value="MO">Missouri</option>
							<option value="MT">Montana</option>
							<option value="NE">Nebraska</option>
							<option value="NV">Nevada</option>
							<option value="NH">New Hampshire</option>
							<option value="NJ">New Jersey</option>
							<option value="NM">New Mexico</option>
							<option value="NY">New York</option>
							<option value="NC">North Carolina</option>
							<option value="ND">North Dakota</option>
							<option value="OH">Ohio</option>
							<option value="OK">Oklahoma</option>
							<option value="OR">Oregon</option>
							<option value="PA">Pennsylvania</option>
							<option value="RI">Rhode Island</option>
							<option value="SA">South Carolina</option>
							<option value="SD">South Dakota</option>
							<option value="TN">Tennessee</option>
							<option value="TX">Texas</option>
							<option value="UT">Utah</option>
							<option value="VT">Vermont</option>
							<option value="VA">Virginia</option>
							<option value="WA">Washington</option>
							<option value="WV">West Virginia</option>
							<option value="WI">Wisconsin</option>
							<option value="WY">Wyoming</option>
						</select>
					</div>
				</div>
				<div class="control-group">
					<label class="control-label">Zipcode</label>
					<div class="controls">
						<input ng-model="model.address.zip" type="text" name="zip" class="input-small">
					</div>
				</div>
			</div>
		</div>
	</div>
	<div class="form-section">
		<div class="section-label">Primary Contact</div>
		<div class="section-container">
			<div class="form-editor">
				<div class="control-group">
					<label class="control-label">Name</label>
					<div class="controls">
						<input ng-model="primaryContact.name" type="text" class="input-xlarge">
					</div>
				</div>
				<div class="control-group">
					<label class="control-label">Phone</label>
					<div class="controls">
						<input ng-model="primaryContact.phone" type="text" class="input-xlarge">
					</div>
				</div>
				<div class="control-group">
					<label class="control-label">E-Mail</label>
					<div class="controls">
						<input ng-model="primaryContact.email" type="text" class="input-xlarge">
					</div>
				</div>
			</div>
		</div>
	</div>
	<div class="form-section">
		<div class="section-label">Secondary Contact</div>
		<div class="section-container">
			<div class="form-editor">
				<div class="control-group">
					<label class="control-label">Name</label>
					<div class="controls">
						<input ng-model="secondaryContact.name" type="text" class="input-xlarge">
					</div>
				</div>
				<div class="control-group">
					<label class="control-label">Phone</label>
					<div class="controls">
						<input ng-model="secondaryContact.phone" type="text" class="input-xlarge">
					</div>
				</div>
				<div class="control-group">
					<label class="control-label">E-Mail</label>
					<div class="controls">
						<input ng-model="secondaryContact.email" type="text" class="input-xlarge">
					</div>
				</div>
			</div>
		</div>
	</div>
	
	<div class="form-section">
		<div class="section-label">Notes</div>
		<div class="section-container">
			<div class="form-editor">
				<div class="control-group">
					<label class="control-label">Internal</label>
					<div class="controls">
						<textarea ng-model="model.notes.internal" type="text" class="input-xlarge"></textarea>
					</div>
				</div>
				<div class="control-group">
					<label class="control-label">Tech</label>
					<div class="controls">
						<textarea ng-model="model.notes.tech" type="text" class="input-xlarge"></textarea>
					</div>
				</div>
			</div>
		</div>
	</div>


	<div class="form-section">
		<div class="section-label">&nbsp;</div>
		<div class="section-container">
			<button ng-click="save()" ng-disabled="form.$invalid" type="button" class="btn btn-primary">Save</button>
		</div>
	</div>
</form>