<div class="portal-order-address-form">
    <div class="grid grid-cols-1 gap-3">
        <InputGroup @name="Address Label">
            <Input @value={{this.name}} class="form-input w-full" placeholder="Warehouse, office, home..." {{on "input" (fn this.setInput "name")}} />
        </InputGroup>

        <InputGroup @name="Street Address" @required={{true}}>
            <Textarea @value={{this.street1}} class="form-input w-full" rows="3" placeholder="Enter the pickup or delivery address" {{on "input" (fn this.setInput "street1")}} />
        </InputGroup>

        <InputGroup @name="Contact Phone">
            <Input @value={{this.phone}} class="form-input w-full" placeholder="Optional phone number" {{on "input" (fn this.setInput "phone")}} />
        </InputGroup>

        <div class="grid grid-cols-1 md:grid-cols-2 gap-3">
            <InputGroup @name="Latitude">
                <Input @value={{this.latitude}} class="form-input w-full" placeholder="Optional" {{on "input" (fn this.setInput "latitude")}} />
            </InputGroup>
            <InputGroup @name="Longitude">
                <Input @value={{this.longitude}} class="form-input w-full" placeholder="Optional" {{on "input" (fn this.setInput "longitude")}} />
            </InputGroup>
        </div>
    </div>

    <div class="flex items-center justify-end space-x-2 mt-4">
        <Button @text="Cancel" @onClick={{@onCancel}} />
        <Button @type="primary" @text="Save Address" @icon="check" @onClick={{this.save}} @isLoading={{@isSaving}} @disabled={{not this.canSave}} />
    </div>
</div>
