<turbo-stream action="replace" target="modal"><template>
  <turbo-stream action='set_modal_in_url' modal_url='/coordinator/west_oxfordshire/enquiries/reprocess_emis_referral/1024/enter_details'></turbo-stream>
  <turbo-frame id='modal'>
    <form data-turbo-frame="_top" action="/coordinator/west_oxfordshire/enquiries/reprocess_emis_referral/1024/enter_details" accept-charset="UTF-8" method="post"><input type="hidden" name="_method" value="put" autocomplete="off" /><input type="hidden" name="authenticity_token" value="QVQZ810JIoIkIcxe4ak3187YuCIdxI6HPsHGmmloBBIN6uLKHyNB9utKlgl0oPGNQRfUG2MDYqJxjrTsfUB3xw" autocomplete="off" />
      <div class="fixed inset-0 z-30 bg-gray-500/75 transition-opacity" aria-hidden="true"></div>
<div class="fixed inset-0 z-30 overflow-y-auto flex items-center justify-center" >
  <div class="max-h-screen w-full max-w-6xl relative">
    <div class="p-8 m-1 bg-white rounded shadow">
      
        <div class="flex justify-between gap-x-4 items-start">
          <h1 class="flex items-baseline gap-x-3">
            <div class="text-2xl font-bold text-gray-900">
              Reprocess EMIS referral
            </div>
          </h1>
          <div class='flex text-gray-500 rounded-full p-1 hover:bg-gray-100'>
            <button name="cancel" type="submit" value="cancel">
              <svg xmlns="http://www.w3.org/2000/svg" fill="none" viewbox="0 0 24 24" stroke="currentColor" data-icon-name="cross" class="h-5 w-5">
  <path stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M6 18L18 6M6 6l12 12"></path>
</svg>

</button>          </div>
        </div>

        <div class="mt-2">
          <div data-controller='better-conditional-fields'>
            

            <div class="pb-8 mb-8 border-b border-gray-200"><div><h3 class="text-md leading-6 font-medium text-gray-900"></h3></div><div class="mt-6 grid grid-cols-1 gap-y-6 gap-x-4 sm:grid-cols-6">
              <div class="sm:col-span-6">
                <div class="rounded-md p-4 shadow bg-blue-50">
  <div class="flex">
    <div class="flex-shrink-0">
        <svg xmlns="http://www.w3.org/2000/svg" viewbox="0 0 20 20" fill="currentColor" aria-hidden="true" data-icon-name="info-circle" class="h-5 w-5 text-blue-400">
  <path fill-rule="evenodd" d="M18 10a8 8 0 11-16 0 8 8 0 0116 0zm-7-4a1 1 0 11-2 0 1 1 0 012 0zM9 9a1 1 0 000 2v3a1 1 0 001 1h1a1 1 0 100-2v-3a1 1 0 00-1-1H9z" clip-rule="evenodd"></path>
</svg>

    </div>
    <div class="ml-3 flex-1">
      <h3 class="text-sm font-semibold text-blue-800">
        If your EMIS form failed to process then click on the button below to reprocess it.      </h3>

        <div class="mt-2 text-sm text-blue-700">
          
                  <div>Processing should take no longer than a couple of minutes. Please contact support@goodbase.co.uk if the referral continues to fail.</div>

        </div>
    </div>
  </div>
</div>
              </div>
</div></div>
            <div><div class="flex flex-col-reverse space-y-4 space-y-reverse sm:justify-end sm:flex-row sm:space-y-0 sm:space-x-3">
              <div class="flex-grow"></div>
              <div><button name="cancel" type="submit" value="cancel" class="py-2 px-4 inline-flex justify-start text-blue-500 hover:text-blue-700 text-sm font-medium underline">Cancel</button></div>
              <div><button name="button" type="submit" data-turbo-submits-with="Please wait..." class="inline-flex justify-center py-2 px-4 border shadow-sm text-sm font-medium rounded-md border-transparent text-white bg-primary-600 hover:bg-primary-700 focus:outline-none focus:ring-2 focus:ring-offset-2 focus:ring-indigo-500">Reprocess referral</button></div>
</div></div>          </div>
        </div>

    </div>
  </div>
</div>
</form>  </turbo-frame>
</template></turbo-stream>