@extends('layout.layout') @section('title') Subject Details @endsection @section('backurl') / @endsection @section('content')
@csrf @method('POST') @if (isset($user->id)) id }}> @endif

Create a Subject Profile

Please provide Subject Details for creating profile

Basic Information

{{ $errors->first('erxId') }}

0050

{{ $errors->first('subjectId') }}

{{ $errors->first('first_name') }}

{{ $errors->first('last_name') }}

{{ $errors->first('dateOfBirth') }}

Contact Information

*

{{ $errors->first('email') }}

{{ $errors->first('phoneNo') }}

{{ $errors->first('address') }}

{{ $errors->first('country') }}

{{ $errors->first('state') }}

{{ $errors->first('city') }}

{{ $errors->first('zip') }}

Compensation Method *

Please select preferred compensation method from the available options below

id) && $user->compensationType == "GiftCard" ) ? 'checked' : '' ) ) }}>
id) && $user->compensationType == "PaperCheck" ) ? 'checked' : '' ) ) }}>
id) && $user->compensationType == "ACH") onclick="show_ach()" @else onclick="enable_ach()" @endif value="ACH" {{ (old('compensationType') == "ACH" ? 'checked' : ( (isset($user->id) && $user->compensationType == "ACH" ) ? 'checked' : '' ) ) }}>

{{ $errors->first('compensationType') }}

id) && $user->compensationType == "ACH" ) ? 'block' : 'none' ) ) }}">

Bank Account Information

Please provide bank account details.
@if (isset($user->id) && $user->compensationType == "ACH") Edit ACH Details @endif

{{ $errors->first('bank') }}

{{ $errors->first('branchName') }}

{{ $errors->first('bankCountry') }}

{{ $errors->first('bankState') }}

{{ $errors->first('bankCity') }}

{{ $errors->first('bankPostalCode') }}

{{ $errors->first('bankAddress') }}

id) && $user->compensationType == "ACH" ) ? 'block' : 'none' ) ) }}">

Account Information

*

{{ $errors->first('accountType') }}

{{ $errors->first('accountNumber') }}

{{ $errors->first('confirm_accountNumber') }}

{{ $errors->first('routingNumber') }}

@if (isset($user->id))
{{ Str::length(old('justification')) ?? '0' }} characters reached

{{ $errors->first('justification') }}

@endif
@endsection