Name* {!! Form::text('name', old('name') , array('id' => 'name', 'class' => 'form-control ac-input','onpaste'=>"return false;",'onCopy'=>"return false;",'onCut'=>"return false;",'onDrag'=>"return false;",'onDrop'=>"return false;", 'placeholder'=>'Name*')) !!} @if (isset($errors) && $errors->has('name')) {{ $errors->first('name') }} @endif

Phone {!! Form::tel('phone', old('phone') , array('id' => 'phone', 'class' => 'form-control ac-input','onpaste'=>"return false;",'onCopy'=>"return false;",'onCut'=>"return false;",'onDrag'=>"return false;",'onDrop'=>"return false;", 'placeholder'=>'Phone','maxlength'=>"12")) !!} @if (isset($errors) && $errors->has('phone')) {{ $errors->first('phone') }} @endif

Email* {!! Form::email('email', old('email') , array('id' => 'email', 'class' => 'form-control ac-input','maxlength'=>"50", 'onpaste'=>"return false;",'onCopy'=>"return false;",'onCut'=>"return false;",'onDrag'=>"return false;",'onDrop'=>"return false;",'placeholder'=>'Email*')) !!} @if (isset($errors) && $errors->has('email')) {{ $errors->first('email') }} @endif

Reason for visit?* {!! Form::text('reason', old('reason') , array('id' => 'reason', 'class' => 'form-control ac-input','maxlength'=>"100",'onpaste'=>"return false;",'onCopy'=>"return false;",'onCut'=>"return false;",'onDrag'=>"return false;",'onDrop'=>"return false;", 'placeholder'=>'Reason for visit?*')) !!} @if (isset($errors) && $errors->has('reason')) {{ $errors->first('reason') }} @endif

Please leave your feedback below: {!! Form::text('feedback', old('feedback') , array( 'class' => 'form-control ac-input', 'id' => 'feedback','maxlength'=>"250", 'spellcheck' => 'true','onpaste'=>"return false;",'onCopy'=>"return false;",'onCut'=>"return false;",'onDrag'=>"return false;",'onDrop'=>"return false;" )) !!} @if (isset($errors) && $errors->has('feedback')) {{ $errors->first('feedback') }} @endif