New ID Card Setup:

(<%= @employer.name %>)

<%= form_with model: @setup, local: true, multipart: true do |f| %>

<%= f.text_field :print_name, label: { text: "Print Name" }, class: "w-full" %>

<%= f.text_field :rx_group_number, label: { text: "Rx Group Number" }, class: "w-full" %>

<%= f.select :network_provider, options_for_select(["Cigna", "Medcost", "Other"]), { label: { text: "Provider Network" }, include_blank: "Select", class: "w-full" } %>

<%= f.select :card_template, options_for_select([["FairosRx", "FairosRxIDCard"], ["Tandemloc", "TandemlocIDCard"], ["smART", "SmartIDCard"], ["QRCode (Healthbus)", "QRCodeIDCard"]]), { label: { text: "Card Template" }, include_blank: "Select", class: "w-full" } %>

Employer Logo

<%= icon "image-plus", library: "lucide" %>

<%= f.hidden_field :id_card_employer_logo_id, data: { logo_upload_target: "logofield", logo_upload_target: "employer" } %> <%= f.file_field :add_or_update_logo, class: "hidden", id: "employer_logo_file", data: { logo_upload_target: "previewContainer", parent_value: "network_logo", action: "change->logo-upload#uploadLogo" }, direct_upload: true %>

<%= f.submit "Create New Employer" %>

<% end %>