${ parent.decodeEntities(`Telephone`) } * parent.activateValidation({"message":"This field is required.","minLength":9,"maxLength":"","type":"by_character_length","required":true,"expression":"null"}, el)} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-telephone" as=${html``} />

${ parent.decodeEntities(`Date`) } * <${props.Flatpickr} name="mf-date" className="mf-input mf-date-input mf-left-parent " placeholder="${ parent.decodeEntities(`Date`) } " options=${{"minDate":"","maxDate":"","dateFormat":"m-d-Y","enableTime":"","disable":[],"mode":"single","static":true,"disableMobile":true,"time_24hr":false}} value=${parent.getValue('mf-date')} onInput=${parent.handleDateTime} aria-invalid=${validation.errors['mf-date'] ? 'true' : 'false'} ref=${el => props.DateWidget( el, '', {"message":"This field is required.","required":true}, register, parent )} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-date" as=${html``} />

${ parent.decodeEntities(`Select Services`) } <${props.Select} className=${"mf-input mf-input-select " + ( validation.errors['mf-select'] ? 'mf-invalid' : '' )} classNamePrefix="mf_select" name="mf-select" placeholder="${ parent.decodeEntities(`Services`) } " isSearchable=${false} options=${[{"label":"Companionship Service","value":"value-1","isDisabled":false},{"label":"Hospice care with DR.","value":"value-2","isDisabled":false},{"label":"24\/7 Live-in care","value":"value-3","isDisabled":false},{"label":"Hospice Care","value":"value-4","isDisabled":false},{"label":"Home Helper","value":"value-6","isDisabled":false},{"label":"Two clients ","value":"Input Value","isDisabled":false},{"label":"Personal care ","value":"Input Value","isDisabled":false}]} value=${parent.getValue("mf-select") ? [{"label":"Companionship Service","value":"value-1","isDisabled":false},{"label":"Hospice care with DR.","value":"value-2","isDisabled":false},{"label":"24\/7 Live-in care","value":"value-3","isDisabled":false},{"label":"Hospice Care","value":"value-4","isDisabled":false},{"label":"Home Helper","value":"value-6","isDisabled":false},{"label":"Two clients ","value":"Input Value","isDisabled":false},{"label":"Personal care ","value":"Input Value","isDisabled":false}].filter(item => item.value === parent.getValue("mf-select"))[0] : []} onChange=${(e)=> parent.handleSelect(e, "mf-select")} ref=${() => { register({ name: "mf-select" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false})); if ( parent.getValue("mf-select") === '' && false ) { parent.setValue( 'mf-select', '', true ); parent.handleChange({ target: { name: 'mf-select', value: '' } }); } }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-select" as=${html``} />

${ parent.decodeEntities(`Message`) } parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)} > <${validation.ErrorMessage} errors=${validation.errors} name="mf-comment" as=${html``} />

${ parent.decodeEntities(`Make Appointment`) }