<div class="{{ kvcoreidx.wrapper_class }}">
    <div id="modal--ask-a-question" class="modal kv-modal kv-modal-question fade in">
    
    
        <div class="modal-dialog kv-modal-dialog">
            <div class="kv-modal-content">
                <div class="kv-modal-header">
                    <h4 class="kv-modal-title">Ask A Question</h4>
                    <button type="button" class="kv-modal-close" data-dismiss="kv-modal">&times;</button>
                </div>
                <div class="kv-modal-body">
                    <form class="ask-a-question-form kv-form"
                          action="public/leads/question"
                          method="put"
                          data-callback="{{ callback|json_encode|url_encode }}"
                    >
                        <input type="hidden" id="modal--question-mlsid" name="mls_id" value="">
                        <input type="hidden" id="modal--question-mls" name="mls" value="">
                        <input type="hidden" id="modal--question-lead_id" name="lead_id" value="{{ user.lead_id }}">
                        <input type="hidden" id="modal--question-website" name="website" value="{{ kvcoreidx.siteUrl }}">
                        <div id="kv-modal-intro-txt"></div>
                        <label for="modal--question-name">Name</label>
                        <input class="kv-form-control" name="name" id="modal--question-name"
                               placeholder="John Doe" type="text"
                        >

                        <label for="modal--question-email">Email</label>
                        <input class="kv-form-control" name="email" id="modal--question-email"
                               placeholder="Email Address" type="text"
                        >

                        <label for="modal--question-phone">Phone</label>
                        <input class="kv-form-control" name="phone"
                               id="modal--question-phone" placeholder="Phone" type="text"
                        >

                        <div class="modal-date-field">
                            <label for="modal--question-date">Date & Time</label>
                            <div class="kv-form-group">
                                <input type="date"
                                       id="modal--question-date"
                                       class="kv-form-control"
                                       name="date"
                                       placeholder="Date"
                                >

                                <input type="time"
                                       id="modal--question-time"
                                       class="kv-form-control" name="time"
                                       placeholder="Time"
                                >
                            </div>
                        </div>
                        <label for="modal--question-question">Comments</label>
                        <label for="modal--question-question"></label>
                        <textarea name="question" id="modal--question-question" class="kv-form-control"></textarea>
                        
                        {% if kvcoreidx.options.optimize_for_canada == "1" %}
                            <p class="kv-my-3">
                                <small>By submitting your message and personal details you are permitting us to contact you by these means in response to your inquiry.</small>
                            </p>
                            <div class="kv-form-group">
                                <div class="kv-form-group-field kv-w-100">
                                    <input id="terms-agreement-canada" type="checkbox"
                                            name="preferred-contact-method"
                                            class="kv-form-control form-check-input" required="required" style="margin-bottom:0">
                                    <label for="terms-agreement-canada" class="form-check-label" style="display:inline">
                                        <small>I would also like to receive email newsletters and periodic updates about real estate in my area and other related communications from <span class="kv-modal-terms-canada-name"></span>. I understand I can withdraw my consent at any time. <span class="kv-modal-terms-canada-name"></span>, <span class="kv-modal-terms-canada-address"></span></small>
                                    </label>
                                </div>
                            </div>
                            <div class="kv-form-group">
                                <div class="kv-form-group-field kv-w-100">
                                    <p class="kv-disclaimer kv-my-3">
                                        <small>
                                            {% if kvcoreidx.pages.privacy_policy and kvcoreidx.pages.terms_of_use %}
                                                In addition, you also agree to our <a href="{{ kvcoreidx.pages.privacy_policy }}" target="_blank">Privacy Policy</a> and <a href="{{ kvcoreidx.pages.terms_of_use }}" target="_blank">Terms & Conditions</a>.
                                            {% elseif kvcoreidx.pages.privacy_policy %}
                                                In addition, you also agree to our <a href="{{ kvcoreidx.pages.privacy_policy }}" target="_blank">Privacy Policy</a>.
                                            {% elseif kvcoreidx.pages.terms_of_use %}
                                                In addition, you also agree to our <a href="{{ kvcoreidx.pages.terms_of_use }}" target="_blank">Terms & Conditions</a>.
                                            {% endif %}
                                        </small>
                                    </p>
                                </div>
                            </div>
                        {% endif %}

                        <button type="submit" class="kv-button">SUBMIT</button>
                    </form>

                    <div class="kv-modal-login-agreement">
                        {% if kvcoreidx.options.optimize_for_canada != "1" %}
                            <small>
                                By clicking on login buttons you are agreeing to our <a href="{{ pages.terms_of_use }}">
                                    terms of use</a> and giving us expressed written consent to contact you
                            </small>
                        {% endif %}
                        
                    </div>

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