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<!DOCTYPE html>
<html lang="en">
<head>
    <meta charset="UTF-8">
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <title>Test Input Functionality</title>
    <link rel="stylesheet" href="https://cdn.jsdelivr.net/npm/bootstrap@4.6.2/dist/css/bootstrap.min.css">
    <style>
        body {
            background-color: #f8f9fa;
            padding: 20px;
        }
        .test-container {
            max-width: 800px;
            margin: 0 auto;
            background: white;
            padding: 20px;
            border-radius: 8px;
            box-shadow: 0 2px 4px rgba(0,0,0,0.1);
        }
        .form-control {
            background-color: #fff !important;
            color: #497060 !important;
            border: 1px solid #ced4da !important;
        }
        .form-control:focus {
            border-color: #7c3aed !important;
            box-shadow: 0 0 0 0.2rem rgba(124, 58, 237, 0.25) !important;
        }
    </style>
</head>
<body>
    <div class="test-container">
        <h2>Test Input Functionality</h2>
        <p>This page tests if the input fields are working properly. Try typing in each field below:</p>
        
        <form id="testForm">
            <div class="row">
                <div class="col-md-6">
                    <div class="form-group">
                        <label for="test_username">Username *</label>
                        <input type="text" class="form-control" id="test_username" name="username" required>
                    </div>
                </div>
                <div class="col-md-6">
                    <div class="form-group">
                        <label for="test_password">Password *</label>
                        <input type="password" class="form-control" id="test_password" name="password" required>
                    </div>
                </div>
            </div>
            
            <div class="row">
                <div class="col-md-6">
                    <div class="form-group">
                        <label for="test_first_name">First Name *</label>
                        <input type="text" class="form-control" id="test_first_name" name="first_name" required>
                    </div>
                </div>
                <div class="col-md-6">
                    <div class="form-group">
                        <label for="test_last_name">Last Name *</label>
                        <input type="text" class="form-control" id="test_last_name" name="last_name" required>
                    </div>
                </div>
            </div>
            
            <div class="row">
                <div class="col-md-6">
                    <div class="form-group">
                        <label for="test_email">Email *</label>
                        <input type="email" class="form-control" id="test_email" name="email" required>
                    </div>
                </div>
                <div class="col-md-6">
                    <div class="form-group">
                        <label for="test_phone">Phone</label>
                        <input type="tel" class="form-control" id="test_phone" name="phone">
                    </div>
                </div>
            </div>
            
            <div class="row">
                <div class="col-md-6">
                    <div class="form-group">
                        <label for="test_specialization">Specialization *</label>
                        <select class="form-control" id="test_specialization" name="specialization" required>
                            <option value="">Select Specialization</option>
                            <option value="psychiatrist">Psychiatrist</option>
                            <option value="psychologist">Psychologist</option>
                            <option value="counselor">Counselor</option>
                            <option value="social_worker">Social Worker</option>
                        </select>
                    </div>
                </div>
                <div class="col-md-6">
                    <div class="form-group">
                        <label for="test_experience">Experience (Years)</label>
                        <input type="number" class="form-control" id="test_experience" name="experience_years" min="0" value="0">
                    </div>
                </div>
            </div>
            
            <div class="form-group">
                <label for="test_bio">Bio</label>
                <textarea class="form-control" id="test_bio" name="bio" rows="3" placeholder="Brief professional background..."></textarea>
            </div>
            
            <div class="form-group">
                <label>Expertise Areas *</label>
                <div class="row">
                    <div class="col-md-6">
                        <div class="form-check">
                            <input class="form-check-input" type="checkbox" name="expertise" value="depression" id="test_expertise_depression">
                            <label class="form-check-label" for="test_expertise_depression">Depression</label>
                        </div>
                        <div class="form-check">
                            <input class="form-check-input" type="checkbox" name="expertise" value="anxiety" id="test_expertise_anxiety">
                            <label class="form-check-label" for="test_expertise_anxiety">Anxiety</label>
                        </div>
                    </div>
                    <div class="col-md-6">
                        <div class="form-check">
                            <input class="form-check-input" type="checkbox" name="expertise" value="ptsd" id="test_expertise_ptsd">
                            <label class="form-check-label" for="test_expertise_ptsd">PTSD</label>
                        </div>
                        <div class="form-check">
                            <input class="form-check-input" type="checkbox" name="expertise" value="trauma" id="test_expertise_trauma">
                            <label class="form-check-label" for="test_expertise_trauma">Trauma</label>
                        </div>
                    </div>
                </div>
            </div>
            
            <div class="form-group">
                <button type="submit" class="btn btn-primary">Test Submit</button>
                <button type="button" class="btn btn-secondary" onclick="clearForm()">Clear Form</button>
                <button type="button" class="btn btn-info" onclick="debugForm()">Debug Form</button>
            </div>
        </form>
        
        <div id="debugOutput" style="margin-top: 20px; padding: 10px; background-color: #f8f9fa; border-radius: 4px; display: none;">
            <h5>Debug Output:</h5>
            <pre id="debugContent"></pre>
        </div>
    </div>

    <script src="https://code.jquery.com/jquery-3.6.0.min.js"></script>
    <script src="https://cdn.jsdelivr.net/npm/bootstrap@4.6.2/dist/js/bootstrap.bundle.min.js"></script>
    <script>
        // Test form functionality
        document.getElementById('testForm').addEventListener('submit', function(e) {
            e.preventDefault();
            alert('Form submitted successfully! All inputs are working.');
        });
        
        function clearForm() {
            document.getElementById('testForm').reset();
            document.getElementById('debugOutput').style.display = 'none';
        }
        
        function debugForm() {
            const form = document.getElementById('testForm');
            const inputs = form.querySelectorAll('input, select, textarea');
            const debugInfo = [];
            
            inputs.forEach((input, index) => {
                debugInfo.push(`Input ${index}: ${input.type || 'select'} - ${input.name} - Value: "${input.value}" - Disabled: ${input.disabled} - ReadOnly: ${input.readOnly}`);
            });
            
            document.getElementById('debugContent').textContent = debugInfo.join('\n');
            document.getElementById('debugOutput').style.display = 'block';
        }
        
        // Test input functionality
        document.addEventListener('DOMContentLoaded', function() {
            const inputs = document.querySelectorAll('input, select, textarea');
            inputs.forEach(input => {
                input.addEventListener('input', function() {
                    console.log(`Input changed: ${this.name} = "${this.value}"`);
                });
                
                input.addEventListener('focus', function() {
                    console.log(`Input focused: ${this.name}`);
                });
            });
        });
    </script>
</body>
</html>