forked from itchy/Dialyse-Webseite
86 lines
4.9 KiB
PHP
86 lines
4.9 KiB
PHP
<?php
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/* @var Session $session */
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$form = $session->get('form');
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?>
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<div class="form-card">
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<?php if($session->has('alert')): ?>
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<div class="alert <?=$session->get('alert-class')?>">
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<?php if($session->get('alert-class') === 'alert-success'): ?>
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<svg style="width: 22px; height: 22px; fill: currentColor; flex-shrink: 0;" viewBox="0 0 24 24"><path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm-2 15l-5-5 1.41-1.41L10 14.17l7.59-7.59L19 8l-9 9z"/></svg>
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<?php else: ?>
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<svg style="width: 22px; height: 22px; fill: currentColor; flex-shrink: 0;" viewBox="0 0 24 24"><path d="M12 2C6.48 2 2 6.48 2 12s4.48 10 10 10 10-4.48 10-10S17.52 2 12 2zm1 15h-2v-2h2v2zm0-4h-2V7h2v6z"/></svg>
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<?php endif; ?>
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<div><?=$session->get('alert')?></div>
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</div>
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<?php $session->remove('alert'); ?>
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<?php endif; ?>
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<h1>Ihre Kontaktanfrage</h1>
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<p style="color: var(--text-muted); margin-bottom: 2rem;">
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Hier können Sie, unter Angabe Ihrer Kontaktdaten, eine persönliche Anfrage stellen.
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Die mit einem (<span style="color: var(--danger); font-weight: bold;">*</span>) gekennzeichneten Felder sind Pflichtfelder.
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Bitte geben Sie entweder eine E-Mailadresse oder Ihre Telefonnummer an, damit wir Sie erreichen können.
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</p>
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<form action="/contact.php" method="post" id="contactForm">
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<input type="hidden" name="timestamp" value="<?=time()?>">
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<input type="hidden" name="check" id="formCheck" value="<?=(isset($form) && !empty($form['check']) ? 'send' : '0')?>">
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<!-- Honeypot Bot Field (hidden from real users) -->
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<div style="display: none;" aria-hidden="true">
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<label for="company">Firma (Bitte freilassen)</label>
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<input type="text" name="company" id="company" tabindex="-1" autocomplete="off" value="">
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</div>
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<div class="form-row">
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<div class="form-group">
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<label class="form-label" for="surname">Vorname</label>
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<input type="text" class="form-control" name="surname" id="surname" placeholder="Ihr Vorname" value="<?=isset($form) ? htmlspecialchars($form['surname']) : ''?>">
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</div>
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<div class="form-group">
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<label class="form-label" for="name">Nachname <span class="required">*</span></label>
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<input type="text" class="form-control" name="name" id="name" required placeholder="Ihr Nachname" value="<?=isset($form) ? htmlspecialchars($form['name']) : ''?>">
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</div>
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</div>
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<div class="form-row">
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<div class="form-group">
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<label class="form-label" for="email">E-Mail-Adresse <span class="required">*</span></label>
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<input type="email" class="form-control" name="email" id="email" required placeholder="ihre.adresse@example.de" value="<?=isset($form) ? htmlspecialchars($form['email']) : ''?>">
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</div>
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<div class="form-group">
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<label class="form-label" for="phone">Telefonnummer <span class="required">*</span></label>
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<input type="tel" class="form-control" name="phone" id="phone" required placeholder="030 12345678" value="<?=isset($form) ? htmlspecialchars($form['phone']) : ''?>">
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</div>
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</div>
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<div class="form-group">
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<label class="form-label" for="message">Ihre Mitteilung <span class="required">*</span></label>
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<textarea class="form-control" name="message" id="message" required rows="6" placeholder="Wie können wir Ihnen weiterhelfen?"><?=isset($form) ? htmlspecialchars($form['message']) : ''?></textarea>
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</div>
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<div class="form-note">
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<svg style="width: 16px; height: 16px; fill: currentColor; vertical-align: middle; margin-right: 4px;" viewBox="0 0 24 24"><path d="M12 1L3 5v6c0 5.55 3.84 10.74 9 12 5.16-1.26 9-6.45 9-12V5l-9-4zm0 10.99h7c-.53 4.12-3.28 7.79-7 8.94V12H5V6.3l7-3.11v8.8z"/></svg>
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Ihre persönlichen Daten werden von uns nicht gespeichert und ausschließlich zur Kontaktaufnahme verwendet. Wir werden Ihre Angaben niemals an Dritte weitergeben.
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</div>
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<div class="form-actions">
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<button type="button" class="btn btn-outline-primary" onclick="history.back();">Abbrechen</button>
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<button type="submit" class="btn btn-primary" name="send">
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<svg style="width: 18px; height: 18px; fill: currentColor;" viewBox="0 0 24 24"><path d="M2.01 21L23 12 2.01 3 2 10l15 2-15 2z"/></svg>
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Anfrage absenden
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</button>
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</div>
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</form>
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</div>
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<script type="text/javascript">
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$(document).ready(function() {
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// Human interaction verification for bot protection
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$('#contactForm input, #contactForm textarea').one('focus', function() {
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$('#formCheck').val('send');
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});
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});
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</script>
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