<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<meta name="description" content="">
<meta name="author" content="">
<title>Advanced Imaging</title>
<?php require("inc-css.php"); ?>
</head>
<!--/head-->

<body class="homepage">
<?php require("inc-header.php"); ?>

    <section id="contact-page">
        <div class="container">
            <div class="center">        
                <h2 style="margin-top: 20px;">This form is broken. Please email us at <a href="mailto:a.imaging@aigadsden.com">a.imaging@aigadsden.com</a></h2>
                <h4><a href="#map">or call us, get directions, or view hours below.</a></h4>
            </div> 
            <div class="row contact-wrap"> 
                <div class="status alert alert-success" style="display: none"></div>
                <form id="main-contact-form" class="contact-form" name="contact-form" method="post" action="sendemail.php">
                    <div class="col-sm-5 col-sm-offset-1">
                        <div class="form-group">
                            <label>Name *</label>
                            <input type="text" name="name" class="form-control" required="required">
                        </div>
                        <div class="form-group">
                            <label>Email *</label>
                            <input type="email" name="email" class="form-control" required="required">
                        </div>
                        <div class="form-group">
                            <label>Phone</label>
                            <input type="number" class="form-control">
                        </div>
                        <div class="form-group">
                            <label>Company Name</label>
                            <input type="text" class="form-control">
                        </div>                        
                    </div>
                    <div class="col-sm-5">
                        <div class="form-group">
                            <label>Subject *</label>
                            <input type="text" name="subject" class="form-control" required="required">
                        </div>
                        <div class="form-group">
                            <label>Message *</label>
                            <textarea name="message" id="message" required="required" class="form-control" rows="8"></textarea>
                        </div>                        
                        <div class="form-group">
                            <button type="submit" name="submit" class="btn btn-primary btn-lg" required="required">Submit Message</button>
                        </div>
                    </div>
                </form> 
            </div><!--/.row-->
        </div><!--/.container-->
    </section><!--/#contact-page-->
    
<?php require("inc-map.php"); ?>

<?php require("inc-footer.php"); ?>

<?php require("inc-footer-scripts.php"); ?>




</body>
</html>