

<?php $__env->startSection('content'); ?>
<div class="container py-4">
    <!-- Main Header with Right-Aligned Button -->
    <div class="main-header mb-4 d-flex justify-content-between align-items-center">
        <h1 class="h2">Adult ADHD Self-Report Scale (ASRS-v1.1)</h1>
        <button type="button" class="btn btn-sm btn-outline-secondary show-view" data-view="dashboard">
            <i class="bi bi-arrow-left"></i> Back to Dashboard
        </button>
    </div>

    <!-- Instructions Section -->
    <h2 class="h5">Instructions</h2>
    <p>
        Please answer the questions below, rating yourself on each of the criteria shown using the scale on the right
        side of the page.
        As you answer each question, select the box that best describes how you have felt and conducted yourself over
        the past 6 months.
    </p>
</div>
<form id="questionForm" onsubmit="submitForm(event)" class="ajax-form forms-sample" method="post" action="<?php echo e(route('mentalHealth.asrsStore')); ?>" data-redirect="<?php echo e(route('mentalHealth.dashboard')); ?>">     
<!-- Centered Content with Card and Progress Bar --> 
<div class="d-flex justify-content-center min-vh-75 align-items-center">
    <div class="col-sm-12 col-xl-6">

        <!-- Progress Bar -->
        <div class="progress mb-4">
  <div class="progress-bar bg-primary" id="progress-bar" role="progressbar" style="width: 0%;" 
       aria-valuenow="0" aria-valuemin="0" aria-valuemax="100">0%</div>
</div>

<h2>Part A</h2>
        <!-- Question 1 -->
        <div class="bg-secondary border border-white rounded h-100 p-4 question" data-question="1">
       
            <h6 class="mb-4 text-white">How often do you have trouble wrapping up the final details of a project, once
                the challenging parts have been done?</h6>
            <input type="hidden" name="question" value="How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?">
            <?php for($i = 0; $i <= 4; $i++): ?> <div class="form-check form-check-inline">
                <input class="form-check-input" type="radio" name="question1" id="question1_<?php echo e($i); ?>" value="<?php echo e($i); ?>">
                <label class="form-check-label text-white"
                    for="question1_<?php echo e($i); ?>"><?php echo e(['Never', 'Rarely', 'Sometimes', 'Often', 'Very Often'][$i]); ?></label>
        </div>
        <hr> 
        <?php endfor; ?>

        <!-- Buttons -->
        <div class="d-flex justify-content-between mt-4">
            <button class="btn btn-outline-light" onclick="navigateQuestion(-1, event)" id="prevBtn">Previous</button>
            <button class="btn btn-primary" id="nextBtn" onclick="navigateQuestion(1, event)">Next</button>

        </div>
    </div>
  
    <!-- Question 2 -->
    <div class="bg-secondary border border-white rounded h-100 p-4 question d-none" data-question="2">
        <h6 class="mb-4 text-white">How often do you have difficulty getting things in order when you have to do a task
            that requires organization?</h6>
            <input type="hidden" name="question" value="How often do you have difficulty getting things in order when you have to do a task
            that requires organization?">
          

        <?php for($i = 0; $i <= 4; $i++): ?> <div class="form-check form-check-inline">
            <input class="form-check-input" type="radio" name="question2" id="question2_<?php echo e($i); ?>" value="<?php echo e($i); ?>">
            <label class="form-check-label text-white"
                for="question2_<?php echo e($i); ?>"><?php echo e(['Never', 'Rarely', 'Sometimes', 'Often', 'Very Often'][$i]); ?></label>
    </div>
    <hr>
    <?php endfor; ?>

    <!-- Buttons -->
    <div class="d-flex justify-content-between mt-4">
        <button class="btn btn-outline-light" onclick="navigateQuestion(-1, event)" id="prevBtn">Previous</button>
        <button class="btn btn-primary" id="nextBtn" onclick="navigateQuestion(1, event)">Next</button>

    </div>
</div>

<!-- Question 3 -->
<div class="bg-secondary border border-white rounded h-100 p-4 question d-none" data-question="3">
    <h6 class="mb-4 text-white">How often do you have problems remembering appointments or obligations?</h6>
    <input type="hidden" name="question" value="How often do you have problems remembering appointments or obligations?">

    <?php for($i = 0; $i <= 4; $i++): ?> <div class="form-check form-check-inline">
        <input class="form-check-input" type="radio" name="question3" id="question3_<?php echo e($i); ?>" value="<?php echo e($i); ?>">
        <label class="form-check-label text-white"
            for="question3_<?php echo e($i); ?>"><?php echo e(['Never', 'Rarely', 'Sometimes', 'Often', 'Very Often'][$i]); ?></label>
</div>
<hr>
<?php endfor; ?>

<!-- Buttons -->
<div class="d-flex justify-content-between mt-4">
    <button class="btn btn-outline-light" onclick="navigateQuestion(-1, event)" id="prevBtn">Previous</button>
    <button class="btn btn-primary" id="nextBtn" onclick="navigateQuestion(1, event)">Next</button>

</div>
</div>

  <!-- Question 4 -->
  <div class="bg-secondary border border-white rounded h-100 p-4 question d-none" data-question="4">
            <h6 class="mb-4 text-white">When you have a task that requires a lot of thought, how often do you avoid or delay getting started?</h6>
            <input type="hidden" name="question" value="When you have a task that requires a lot of thought, how often do you avoid or delay getting started?">
            <?php for($i = 0; $i <= 4; $i++): ?>
            <div class="form-check form-check-inline">
                <input class="form-check-input" type="radio" name="question4" id="question4_<?php echo e($i); ?>" value="<?php echo e($i); ?>">
                <label class="form-check-label text-white" for="question4_<?php echo e($i); ?>"><?php echo e(['Never', 'Rarely', 'Sometimes', 'Often', 'Very Often'][$i]); ?>

                </label>
            </div>
            <hr>
            <?php endfor; ?>

   
            <!-- Buttons -->
            <div class="d-flex justify-content-between mt-4">
                <button class="btn btn-outline-light" onclick="navigateQuestion(-1, event)">Previous</button>
                <button class="btn btn-primary" id="nextBtn" onclick="navigateQuestion(1, event)">Next</button>

            </div>
        </div>

        <!-- Question 5 -->
        <div class="bg-secondary border border-white rounded h-100 p-4 question d-none" data-question="5">
            <h6 class="mb-4 text-white">How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?</h6>
            <input type="hidden" name="question" value="How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?">
            <?php for($i = 0; $i <= 4; $i++): ?>
            <div class="form-check form-check-inline">
                <input class="form-check-input" type="radio" name="question5" id="question5_<?php echo e($i); ?>" value="<?php echo e($i); ?>">
                <label class="form-check-label text-white" for="question5_<?php echo e($i); ?>"><?php echo e(['Never', 'Rarely', 'Sometimes', 'Often', 'Very Often'][$i]); ?>

                </label>
            </div>
            <hr>
            <?php endfor; ?>

      
            <!-- Buttons -->
            <div class="d-flex justify-content-between mt-4">
                <button class="btn btn-outline-light" onclick="navigateQuestion(-1, event)">Previous</button>
                <button class="btn btn-primary" id="nextBtn" onclick="navigateQuestion(1, event)">Next</button>

            </div>
        </div>

        <!-- Question 6 -->
        <div class="bg-secondary border border-white rounded h-100 p-4 question d-none" data-question="6">
            <h6 class="mb-4 text-white">How often do you feel overly active and compelled to do things, like you were driven by a motor?</h6>
            <input type="hidden" name="question" value="How often do you feel overly active and compelled to do things, like you were driven by a motor?">
            <?php for($i = 0; $i <= 4; $i++): ?>
            <div class="form-check form-check-inline">
                <input class="form-check-input" type="radio" name="question6" id="question6_<?php echo e($i); ?>" value="<?php echo e($i); ?>">
                <label class="form-check-label text-white" for="question6_<?php echo e($i); ?>"><?php echo e(['Never', 'Rarely', 'Sometimes', 'Often', 'Very Often'][$i]); ?>

                </label>
            </div>
            <hr>
            <?php endfor; ?>

              <!-- Buttons -->
              <div class="d-flex justify-content-between mt-4">
                <button class="btn btn-outline-light" onclick="navigateQuestion(-1, event)">Previous</button>
                <button class="btn btn-primary" id="nextBtn" onclick="navigateQuestion(1, event)">Next</button>

            </div>
        </div>



                   <!-- Question 7 -->
        <div class="bg-secondary border border-white rounded h-100 p-4 question d-none" data-question="7">
            <h6 class="mb-4 text-white">How often do you make careless mistakes when you have to work on a boring or difficult project?</h6>
            <input type="hidden" name="question" value="How often do you make careless mistakes when you have to work on a boring or difficult project?">
            <?php for($i = 0; $i <= 4; $i++): ?>
            <div class="form-check form-check-inline">
                <input class="form-check-input" type="radio" name="question7" id="question7_<?php echo e($i); ?>" value="<?php echo e($i); ?>">
                <label class="form-check-label text-white" for="question7_<?php echo e($i); ?>"><?php echo e(['Never', 'Rarely', 'Sometimes', 'Often', 'Very Often'][$i]); ?>

                </label>
            </div> 
            <hr>
            <?php endfor; ?>

      
            <!-- Buttons -->
            <div class="d-flex justify-content-between mt-4">
                <button class="btn btn-outline-light" onclick="navigateQuestion(-1, event)">Previous</button>
                <button class="btn btn-primary" id="nextBtn" onclick="navigateQuestion(1, event)">Next</button>

            </div>
        </div>



                         <!-- Question 8 -->
                         <div class="bg-secondary border border-white rounded h-100 p-4 question d-none" data-question="8">
            <h6 class="mb-4 text-white">How often do you have difficulty keeping your attention when you are doing boring or repetitive work?</h6>
            <input type="hidden" name="question" value="How often do you have difficulty keeping your attention when you are doing boring or repetitive work?">
            <?php for($i = 0; $i <= 4; $i++): ?>
            <div class="form-check form-check-inline">
                <input class="form-check-input" type="radio" name="question8" id="question8_<?php echo e($i); ?>" value="<?php echo e($i); ?>">
                <label class="form-check-label text-white" for="question8_<?php echo e($i); ?>"><?php echo e(['Never', 'Rarely', 'Sometimes', 'Often', 'Very Often'][$i]); ?>

                </label>
            </div> 
            <hr>
            <?php endfor; ?>

      
            <!-- Buttons -->
            <div class="d-flex justify-content-between mt-4">
                <button class="btn btn-outline-light" onclick="navigateQuestion(-1, event)">Previous</button>
                <button class="btn btn-primary" id="nextBtn" onclick="navigateQuestion(1, event)">Next</button>

            </div>
        </div>


                                <!-- Question 9 -->
                                <div class="bg-secondary border border-white rounded h-100 p-4 question d-none" data-question="9">
            <h6 class="mb-4 text-white">How often do you have difficulty concentrating on what people say to you, even when they are speaking to you directly?</h6>
            <input type="hidden" name="question" value="How often do you have difficulty concentrating on what people say to you, even when they are speaking to you directly?">
            <?php for($i = 0; $i <= 4; $i++): ?>
            <div class="form-check form-check-inline">
                <input class="form-check-input" type="radio" name="question9" id="question9_<?php echo e($i); ?>" value="<?php echo e($i); ?>">
                <label class="form-check-label text-white" for="question9_<?php echo e($i); ?>"><?php echo e(['Never', 'Rarely', 'Sometimes', 'Often', 'Very Often'][$i]); ?>

                </label>
            </div> 
            <hr>
            <?php endfor; ?>

      
            <!-- Buttons -->
            <div class="d-flex justify-content-between mt-4">
                <button class="btn btn-outline-light" onclick="navigateQuestion(-1, event)">Previous</button>
                <button class="btn btn-primary" id="nextBtn" onclick="navigateQuestion(1, event)">Next</button>

            </div>
        </div>



                             <!-- Question 10 -->
                             <div class="bg-secondary border border-white rounded h-100 p-4 question d-none" data-question="10">
            <h6 class="mb-4 text-white">How often do you misplace or have difficulty finding things at home or at work?</h6>
            <input type="hidden" name="question" value="How often do you misplace or have difficulty finding things at home or at work?">

            <?php for($i = 0; $i <= 4; $i++): ?>
            <div class="form-check form-check-inline">
                <input class="form-check-input" type="radio" name="question10" id="question10_<?php echo e($i); ?>" value="<?php echo e($i); ?>">
                <label class="form-check-label text-white" for="question10_<?php echo e($i); ?>"><?php echo e(['Never', 'Rarely', 'Sometimes', 'Often', 'Very Often'][$i]); ?>

                </label>
            </div> 
            <hr>
            <?php endfor; ?>

      
            <!-- Buttons -->
            <div class="d-flex justify-content-between mt-4">
                <button class="btn btn-outline-light" onclick="navigateQuestion(-1, event)">Previous</button>
                <button class="btn btn-primary" id="nextBtn" onclick="navigateQuestion(1, event)">Next</button>

            </div>
        </div>


                           <!-- Question 11 -->
                           <div class="bg-secondary border border-white rounded h-100 p-4 question d-none" data-question="11">
            <h6 class="mb-4 text-white">How often are you distracted by activity or noise around you?</h6>
            <input type="hidden" name="question" value="How often are you distracted by activity or noise around you?">
            <?php for($i = 0; $i <= 4; $i++): ?>
            <div class="form-check form-check-inline">
                <input class="form-check-input" type="radio" name="question11" id="question11_<?php echo e($i); ?>" value="<?php echo e($i); ?>">
                <label class="form-check-label text-white" for="question11_<?php echo e($i); ?>"><?php echo e(['Never', 'Rarely', 'Sometimes', 'Often', 'Very Often'][$i]); ?>

                </label>
            </div> 
            <hr>
            <?php endfor; ?>

      
            <!-- Buttons -->
            <div class="d-flex justify-content-between mt-4">
                <button class="btn btn-outline-light" onclick="navigateQuestion(-1, event)">Previous</button>
                <button class="btn btn-primary" id="nextBtn" onclick="navigateQuestion(1, event)">Next</button>

            </div>
        </div>



        
                           <!-- Question 12 -->
                           <div class="bg-secondary border border-white rounded h-100 p-4 question d-none" data-question="12">
            <h6 class="mb-4 text-white">How often do you leave your seat in meetings or other situations in which you are expected to remain seated</h6>
            <input type="hidden" name="question" value="How often do you leave your seat in meetings or other situations in which you are expected to remain seated">
            <?php for($i = 0; $i <= 4; $i++): ?>
            <div class="form-check form-check-inline">
                <input class="form-check-input" type="radio" name="question12" id="question12_<?php echo e($i); ?>" value="<?php echo e($i); ?>">
                <label class="form-check-label text-white" for="question12_<?php echo e($i); ?>"><?php echo e(['Never', 'Rarely', 'Sometimes', 'Often', 'Very Often'][$i]); ?>

                </label>
            </div> 
            <hr>
            <?php endfor; ?>

      
            <!-- Buttons -->
            <div class="d-flex justify-content-between mt-4">
                <button class="btn btn-outline-light" onclick="navigateQuestion(-1, event)">Previous</button>
                <button class="btn btn-primary" id="nextBtn" onclick="navigateQuestion(1, event)">Next</button>

            </div>
        </div>



                      <!-- Question 13 -->
                      <div class="bg-secondary border border-white rounded h-100 p-4 question d-none" data-question="13">
            <h6 class="mb-4 text-white">How often do you feel restless or fidgety?</h6>
            <input type="hidden" name="question" value="How often do you feel restless or fidgety?">
            <?php for($i = 0; $i <= 4; $i++): ?>
            <div class="form-check form-check-inline">
                <input class="form-check-input" type="radio" name="question13" id="question13_<?php echo e($i); ?>" value="<?php echo e($i); ?>">
                <label class="form-check-label text-white" for="question13_<?php echo e($i); ?>"><?php echo e(['Never', 'Rarely', 'Sometimes', 'Often', 'Very Often'][$i]); ?>

                </label>
            </div> 
            <hr>
            <?php endfor; ?>

      
            <!-- Buttons -->
            <div class="d-flex justify-content-between mt-4">
                <button class="btn btn-outline-light" onclick="navigateQuestion(-1, event)">Previous</button>
                <button class="btn btn-primary" id="nextBtn" onclick="navigateQuestion(1, event)">Next</button>

            </div>
        </div>





        
                      <!-- Question 14 -->
                      <div class="bg-secondary border border-white rounded h-100 p-4 question d-none" data-question="14">
            <h6 class="mb-4 text-white">How often do you have difficulty unwinding and relaxing when you have time to yourself?</h6>
            <input type="hidden" name="question" value="How often do you have difficulty unwinding and relaxing when you have time to yourself?">
            <?php for($i = 0; $i <= 4; $i++): ?>
            <div class="form-check form-check-inline">
                <input class="form-check-input" type="radio" name="question14" id="question14_<?php echo e($i); ?>" value="<?php echo e($i); ?>">
                <label class="form-check-label text-white" for="question14_<?php echo e($i); ?>"><?php echo e(['Never', 'Rarely', 'Sometimes', 'Often', 'Very Often'][$i]); ?>

                </label>
            </div> 
            <hr>
            <?php endfor; ?>

      
            <!-- Buttons -->
            <div class="d-flex justify-content-between mt-4">
                <button class="btn btn-outline-light" onclick="navigateQuestion(-1, event)">Previous</button>
                <button class="btn btn-primary" id="nextBtn" onclick="navigateQuestion(1, event)">Next</button>

            </div>
        </div>



                              <!-- Question 15 -->
                              <div class="bg-secondary border border-white rounded h-100 p-4 question d-none" data-question="15">
            <h6 class="mb-4 text-white">How often do you find yourself talking too much when you are in social situations?</h6>
            <input type="hidden" name="question" value="How often do you find yourself talking too much when you are in social situations?">

            <?php for($i = 0; $i <= 4; $i++): ?>
            <div class="form-check form-check-inline">
                <input class="form-check-input" type="radio" name="question15" id="question15_<?php echo e($i); ?>" value="<?php echo e($i); ?>">
                <label class="form-check-label text-white" for="question15_<?php echo e($i); ?>"><?php echo e(['Never', 'Rarely', 'Sometimes', 'Often', 'Very Often'][$i]); ?>

                </label>
            </div> 
            <hr>
            <?php endfor; ?>

      
            <!-- Buttons -->
            <div class="d-flex justify-content-between mt-4">
                <button class="btn btn-outline-light" onclick="navigateQuestion(-1, event)">Previous</button>
                <button class="btn btn-primary" id="nextBtn" onclick="navigateQuestion(1, event)">Next</button>

            </div>
        </div>




        
                              <!-- Question 16 -->
                              <div class="bg-secondary border border-white rounded h-100 p-4 question d-none" data-question="16">
            <h6 class="mb-4 text-white">When you're in a conversation, how often do you find yourself finishing the sentences of the people you are talking to, before they can finish them themselves?</h6>
            <input type="hidden" name="question" value="When you're in a conversation, how often do you find yourself finishing the sentences of the people you are talking to, before they can finish them themselves?">
                <?php for($i = 0; $i <= 4; $i++): ?>
            <div class="form-check form-check-inline">
                <input class="form-check-input" type="radio" name="question16" id="question16_<?php echo e($i); ?>" value="<?php echo e($i); ?>">
                <label class="form-check-label text-white" for="question16_<?php echo e($i); ?>"><?php echo e(['Never', 'Rarely', 'Sometimes', 'Often', 'Very Often'][$i]); ?>

                </label>
            </div> 
            <hr>
            <?php endfor; ?>

      
            <!-- Buttons -->
            <div class="d-flex justify-content-between mt-4">
                <button class="btn btn-outline-light" onclick="navigateQuestion(-1, event)">Previous</button>
                <button class="btn btn-primary" id="nextBtn" onclick="navigateQuestion(1, event)">Next</button>

            </div>
        </div>




                                 <!-- Question 17 -->
                                 <div class="bg-secondary border border-white rounded h-100 p-4 question d-none" data-question="17">
            <h6 class="mb-4 text-white">How often do you have difficulty waiting your turn in situations when turn taking is required?</h6>
            <input type="hidden" name="question" value="How often do you have difficulty waiting your turn in situations when turn taking is required?">
           
            <?php for($i = 0; $i <= 4; $i++): ?>
            <div class="form-check form-check-inline">
                <input class="form-check-input" type="radio" name="question17" id="question17_<?php echo e($i); ?>" value="<?php echo e($i); ?>">
                <label class="form-check-label text-white" for="question17_<?php echo e($i); ?>"><?php echo e(['Never', 'Rarely', 'Sometimes', 'Often', 'Very Often'][$i]); ?>

                </label>
            </div> 
            <hr>
            <?php endfor; ?>

      
            <!-- Buttons -->
            <div class="d-flex justify-content-between mt-4">
                <button class="btn btn-outline-light" onclick="navigateQuestion(-1, event)">Previous</button>
                <button class="btn btn-primary" id="nextBtn" onclick="navigateQuestion(1, event)">Next</button>

            </div>
        </div>



        
                                 <!-- Question 18 -->
                                 <div class="bg-secondary border border-white rounded h-100 p-4 question d-none" data-question="18">
            <h6 class="mb-4 text-white">How often do you interrupt others when they are busy?</h6>
            <input type="hidden" name="question" value="How often do you interrupt others when they are busy?">
            <?php for($i = 0; $i <= 4; $i++): ?>
            <div class="form-check form-check-inline">
                <input class="form-check-input" type="radio" name="question18" id="question18_<?php echo e($i); ?>" value="<?php echo e($i); ?>">
                <label class="form-check-label text-white" for="question18_<?php echo e($i); ?>"><?php echo e(['Never', 'Rarely', 'Sometimes', 'Often', 'Very Often'][$i]); ?>

                </label>
            </div> 
            <hr>
            <?php endfor; ?>
        
            <!-- Buttons -->
            <div class="d-flex justify-content-between mt-4">
                <button class="btn btn-outline-light" onclick="navigateQuestion(-1, event)">Previous</button>
                <button class="btn btn-primary" id="nextBtnfinel" onclick="navigateQuestion(1, event)">Next</button>

                <button type="submit" class="btn btn-success d-none" id="submitBtn">Submit</button>
            </div>

            </div> 
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