{% extends "base.html" %}
{% set active_nav = "admin" %}

{% block title %}{{ 'Edit' if site else 'Create' }} Site - Admin - LSMC Hub{% endblock %}

{% block content %}
<div class="page-header">
    <div>
        <a href="/admin/sites" class="text-sm text-muted">&larr; Back to Sites</a>
        <h1>{{ 'Edit' if site else 'Create' }} Site</h1>
    </div>
</div>

<div class="card" style="max-width: 600px;">
    <form method="POST" action="{{ '/admin/sites/' + site.euid|string + '/edit' if site else '/admin/sites/create' }}">
        <input type="hidden" name="csrf_token" value="{{ csrf_token }}">

        <div class="form-group">
            <label for="name">Site Name *</label>
            <input type="text" id="name" name="name" class="form-input" required
                   value="{{ revision.name if revision else '' }}"
                   placeholder="e.g., Main Clinic, Lab A">
        </div>

        <div class="form-group">
            <label for="site_code">Site Code</label>
            <input type="text" id="site_code" name="site_code" class="form-input"
                   value="{{ revision.site_code if revision else '' }}"
                   placeholder="e.g., MC01, LABA">
            <small class="text-muted">Short identifier for the site</small>
        </div>

        <h4 class="mt-lg mb-md">Address</h4>

        <div class="form-group">
            <label for="address_line1">Address Line 1</label>
            <input type="text" id="address_line1" name="address_line1" class="form-input"
                   value="{{ revision.address.get('line1', '') if revision and revision.address else '' }}">
        </div>

        <div class="form-group">
            <label for="address_line2">Address Line 2</label>
            <input type="text" id="address_line2" name="address_line2" class="form-input"
                   value="{{ revision.address.get('line2', '') if revision and revision.address else '' }}">
        </div>

        <div class="grid grid-3 gap-md">
            <div class="form-group">
                <label for="city">City</label>
                <input type="text" id="city" name="city" class="form-input"
                       value="{{ revision.address.get('city', '') if revision and revision.address else '' }}">
            </div>
            <div class="form-group">
                <label for="state">State</label>
                <input type="text" id="state" name="state" class="form-input"
                       value="{{ revision.address.get('state', '') if revision and revision.address else '' }}">
            </div>
            <div class="form-group">
                <label for="postal_code">Postal Code</label>
                <input type="text" id="postal_code" name="postal_code" class="form-input"
                       value="{{ revision.address.get('postal_code', '') if revision and revision.address else '' }}">
            </div>
        </div>

        <h4 class="mt-lg mb-md">Contact</h4>

        <div class="form-group">
            <label for="contact_email">Contact Email</label>
            <input type="email" id="contact_email" name="contact_email" class="form-input"
                   value="{{ revision.contact_email if revision else '' }}">
        </div>

        <div class="form-group">
            <label for="contact_phone">Contact Phone</label>
            <input type="tel" id="contact_phone" name="contact_phone" class="form-input"
                   value="{{ revision.contact_phone if revision else '' }}">
        </div>

        {% if site %}
        <div class="form-group">
            <label class="checkbox-label">
                <input type="checkbox" name="is_active" value="true"
                       {{ 'checked' if revision and revision.is_active else '' }}>
                Active
            </label>
        </div>
        {% endif %}

        <div class="form-actions mt-lg">
            <button type="submit" class="btn btn-primary">{{ 'Update' if site else 'Create' }} Site</button>
            <a href="/admin/sites" class="btn btn-secondary">Cancel</a>
        </div>
    </form>
</div>
{% endblock %}