<div data-role="header" class="ui-header ui-bar-a ui-corner-top">
    <h1 class="ui-title" role="heading"><%- title %></h1>
</div>
<div data-role="content" class="ui-content ui-corner-bottom">
    <% if (typeof alertMessage !== "undefined" && alertMessage !== "") { %>
    <h3 class='popup-alert'>
        <span class="alert-icon"></span>
        <span>
            <p><%- alertMessage %></p>
            <% if (typeof alertMessageLine2 !== "undefined" && alertMessageLine2 !== "") { %>
            <p><%- alertMessageLine2 %></p>
            <% } %>
        </span>
    </h3>
    <% } %>
    <% if (typeof message !== "undefined" && message !== "") { %>
    <h3><%- message %></h3>
    <% } %>
    <form id="VAAC-form">
        <fieldset data-role="controlgroup">
            <legend><%- legend %></legend>
            <%
                _.each(checkboxRadios, function(checkboxRadio) {
            %>
                    <input type="<%- checkboxRadioType %>" name="VAAC-check-radio" id="<%- checkboxRadio.id %>" data-theme="c" value="<%- checkboxRadio.value %>">
                    <label for="<%- checkboxRadio.id %>"><%- checkboxRadio.label %></label>
            <%
                });
            %>
        </fieldset>
    </form>

    <div class="buttons-2">
        <button id="VAAC-close-btn" data-index="0">Return</button>
        <button id="VAAC-confirm-btn" data-index="1" disabled>Save</button>
    </div>
</div>