<form name="editemail" id="editemail">
<input type="hidden" name="formAction" id="formAction" class="formAction" value="" />
<input type="hidden" name="location" value="<?php echo $location; ?>" />
<fieldset id="contactPanel"><legend>Customer Info</legend>
<label for="customer_firstname">First Name</label><br />
<input type="text" id="customer_firstname" name="customer_firstname" value="" required /><br />
<label for="customer_lastname">Last Name</label><br />
<input type="text" id="customer_lastname" name="customer_lastname" value="" required /><br />
<label for="customer_email">Email</label><br />
<input type="email" id="customer_email" name="customer_email" value="" required /><br />
<label for="customer_phone">Phone</label><br />
<input type="text" id="customer_phone" name="customer_phone" value="" required /><br />
</fieldset>

<fieldset id="apptPanel"><legend>Appointment Info</legend>
<label for="apptDate">Date</label><br />
<input type="text" id="apptDate" name="apptDate" value="<?php
//echo $displayApptDate;
?>" required />
<br />
<label for="apptTime">Time</label><br />
<input type="text" id="apptTime" name="apptTime" value="<?php
//echo $displayApptTime;
?>" required />
<br />
<label for="service">Service</label><br />
    <input type="text" name="service" id="service" />
<br />
<label for="staff">Provider</label>
<br />
<input type="text" name="staff" id="staff" />
<br />
<label for="notes">Notes</label>
    <br />
    <textarea name="notes" id="notes"></textarea>
    <br />
    <label for="promotion">Promotion</label>
    <br />
    <select name="promotion" id="promotion">
        <?php echo getPromotions($_SESSION['account'], $optionEl); ?>
    </select>

<input type="hidden" name="appt_id" id="appt_id" value="<?php if ($appt_id) { echo $appt_id; } ?>" />

</fieldset>
<input type="submit" name="setAppt" id="setAppt" value="<?php echo $setApptText; ?>" />
</form>