{{ trans('payments.modal.instruction.new', array( 'name' => $policy->client->first_name )) }}

@foreach ($policy->customFields->all() as $custom_field) @if ($custom_field->type === 'checkbox')

value) ? ' checked' : '' }} name="custom_fields[C{{ $policy->client->company->id }}F{{ $custom_field->id }}][value]"{{ isset($custom_field->required) ? ' required' : '' }}> {{ $custom_field->label }}

@elseif ($custom_field->type === 'date')

{{ $custom_field->label }} required) ? ' required' : '' }} value="{{ $custom_field->value }}">

@elseif ($custom_field->type === 'email')

{{ $custom_field->label }} required) ? ' required' : '' }} value="{{ $custom_field->value }}">

@elseif ($custom_field->type === 'hidden') @elseif ($custom_field->type === 'number')

{{ $custom_field->label }} required) ? ' required' : '' }} value="{{ $custom_field->value }}">

@elseif ($custom_field->type === 'select') @foreach ($custom_field->value->choices as $option) @endforeach @if (count($custom_field->value->choices) > 2)

@else

{{ $custom_field->label }} @foreach ($custom_field->value->choices as $option)

value->choice ? ' checked' : '' }} name="custom_fields[C{{ $company->id }}F{{ $custom_field->id }}][value][choice]"{{ isset($custom_field->required) ? ' required' : '' }} value="{{ trim($option) }}"> {{ trim($option) }}

@endforeach

@endif @elseif ($custom_field->type === 'tel')

{{ $custom_field->label }} required) ? ' required' : '' }} value="{{ $custom_field->default }}">

@elseif ($custom_field->type === 'text')

{{ $custom_field->label }} required) ? ' required' : '' }} value="{{ $custom_field->value }}">

@else

@endif @endforeach