<?php echo $__env->make('frontend.include.header', \Illuminate\Support\Arr::except(get_defined_vars(), ['__data', '__path']))->render(); ?>

<!-- ==================== Start cursor ==================== -->

<div class="mouse-cursor cursor-outer"></div>
<div class="mouse-cursor cursor-inner"></div>

<!-- ==================== End cursor ==================== -->


<!-- ==================== Start Header ==================== -->

<header class="pages-header bg-img valign parallaxie" data-background="frontend/img/pg1.jpg" data-overlay-dark="6">
    <div class="container">
        <div class="row">
            <div class="col-lg-12">
                <div class="cont text-center">
                    <h1>Book Appointment</h1>
                    <div class="path">
                        <a href="/">Home</a><span>/</span><a href="#" class="active">Book Appointment</a>
                    </div>
                </div>
            </div>
        </div>
    </div>
</header>

<!-- ==================== End Header ==================== -->


<!-- ==================== Start Book Appointment ==================== -->

<section class="contact cont-map">
    <div class="container">
        <div class="row">
            <div class="col-lg-6 offset-lg-3 contact-form">
                <form action="<?php echo e(route('contactform')); ?>" method="POST" enctype="multipart/form-data" class="needs-validation" novalidate>
                    <?php echo csrf_field(); ?>
                        <?php if($message = Session::get('success')): ?>
                            <div class="alert alert-success">
                            <p><?php echo e($message); ?></p>
                            </div>
                        <?php endif; ?>

                    <div class="section-head">
                        <h6 class="custom-font">Want a Personal Session?</h6>
                        <h4 class="playfont">Book Appointment</h4>
                    </div>


                    <div class="controls">

                        <div class="row">

                            <div class="col-md-6">
                                <div class="form-group">
                                    <input id="form_name" type="text" name="name" placeholder="Name"
                                        required="required">
                                </div>
                            </div>

                            <div class="col-md-6">
                                <div class="form-group">
                                    <input id="form_email" type="number" name="number" placeholder="Phone Number"
                                        required="required">
                                </div>
                            </div>

                            <div class="col-md-6">
                                <div class="form-group">
                                    <input id="form_email" type="email" name="email" placeholder="Email"
                                        required="required">
                                </div>
                            </div>

                            <div class="col-md-6">
                                <div class="form-group">
                                    <input id="form_age" type="text" name="age" placeholder="Your Age"
                                        required="required">
                                </div>
                            </div>

                            <div class="col-md-6">
                                <div class="form-group">
                                    <input id="form_date" type="date" name="date" placeholder="Date"
                                        required="required">
                                </div>
                            </div>

                            <div class="col-md-6">
                                <div class="form-group">
                                    <select name="service" class="form-control" id="service" form="carform">
                                        <option value="#">Select Services</option>
                                        <option value="individual-counseling-session">Individual Counseling Session</option>
                                        <option value="couples-counseling-session">Couples’ Counseling Session</option>
                                        <option value="family-counseling-session">Family Counseling Session</option>
                                    </select>
                                </div>
                            </div>
                        </div>

                        <button type="submit" class="btn-curve btn-color"><span>Book Appointment</span></button>
                    </div>
                </form>
            </div>

        </div>
    </div>


</section>

<!-- ==================== End Book Appointment ==================== -->


<?php echo $__env->make('frontend.include.footer', \Illuminate\Support\Arr::except(get_defined_vars(), ['__data', '__path']))->render(); ?>
<?php /**PATH C:\xampp\htdocs\kanishka_laravel\resources\views/frontend/book-appointment.blade.php ENDPATH**/ ?>