<?php $this->extend('layouts/master') ?>
<?php $this->section('content') ?>
<div id="breadcrumbs">
    <a title="Home" href="#">Home »</a>  Contacts
</div><!--/ breadcrumbs-->
<div class="contacts-wrapper">
    <div class="content-wrapper"><h3>Contacts</h3></div>



    <div class="content-wrapper">

        <h3>Send Us Mail -  Email: icarementalhealth@gmail.com</h3>

        <div id="contact">
            <div id="message"></div>
            <form method="post" action="/contacts" id="contactform">
                <fieldset>
                    <div class="alignleft">
                        <div class="row">
                            <label for="name"><span class="required">*</span>Your Name:</label>
                            <input type="text" name="name" id="name" />
                        </div><!--/ row-->
                        <div class="row">
                            <label for="email"><span class="required">*</span>E-mail:</label>
                            <input type="text" name="email" id="email" />
                        </div><!--/ row-->
                        <div class="row">
                            <label for="phone">Phone:</label>
                            <input type="text" name="phone" id="phone" />
                        </div><!--/ row-->
                        <div class="row">
                            <label for="subject">Subject</label>
                            <select name="subject" id="subject">
                                <option value="Support">Support</option>
                                <option value="a Sale">Sales</option>
                                <option value="a Bug fix">Report a bug</option>
                            </select>
                        </div><!--/ row-->
                        <div class="row">
                            <img src="image.php" alt="" style="vertical-align: middle;" /><input name="verify" type="text" id="verify" size="6" value="" style="width: 50px; margin: 0 0 0 8px; vertical-align: middle;" />
                        </div><!--/ row-->
                        <input type="submit" class="button green small" id="submit" value="Submit" />
                    </div><!--/ textfield-->
                    <div class="alignright">
                        <label for="comments">Message:</label>
                        <textarea name="comments" id="comments" cols="30" rows="10"></textarea>
                    </div><!--/ areafield-->
                </fieldset>
            </form>
        </div><!--/ contact-->

        <div class="clear"></div>

    </div><!--/ .content-wrapper-->
</div><!--/ contacts-wrapper-->
<?= $this->endSection() ?>

