<div data-role="header" data-theme="c">
    <h3><%- title %></h3>
</div>
<div data-role="content" id="book-appt-content">

    <% if (typeof waitListId !== "undefined") { %>
    <div class="wait-list-item">

    </div>
    <% } %>

    <% if (typeof VAACRequestId !== "undefined") { %>
    <div class="VAAC-request-item">

    </div>
    <% } %>

    <h3>Please Complete the Following: </h3>
    <div class="book-input-fields">
        <div class="drop-down-menus">

        </div>
        <p class="counter" data-balance="<%- maxLength %>">Characters Remaining: </p>
        <div data-role="fieldcontain">
            <label for="booking-notes">Notes (Optional)</label>
            <textarea name="booking-notes" id="booking-notes" maxlength="<%- maxLength %>">
<% if (typeof VAACRequestId !== "undefined") {%>This appointment was booked from a Veteran Request.<% } %></textarea>
        </div>
        <p class="warning hidden">Error: ^ character is not allowed.</p>
    </div>
    <div class="buttons-2">
        <button id="cancel-btn"><%- cancelBtnTxt %></button>
        <button id="submit-btn" disabled><%- submitBtnTxt %></button>
    </div>
</div>
<div id="dialog-screen" class="hidden"></div>
