<html>
 <head>
   <title>Confirm Appointment</title>
   
   <link href="css/__account__.css" rel="stylesheet" type="text/css" />

   
   </head>
   <body>
   <div id="wrapper">
   
   <?php include('headers/__account_location_id__.html');  ?>
   
<div id="terms">
<h2>Terms and Conditions</h2>
<p>Sed ut perspiciatis unde omnis iste natus error sit voluptatem accusantium doloremque laudantium, totam rem aperiam, eaque ipsa quae ab illo inventore veritatis et quasi architecto beatae vitae dicta sunt explicabo. Nemo enim ipsam voluptatem quia voluptas sit aspernatur aut odit aut fugit, sed quia consequuntur magni dolores eos qui ratione voluptatem sequi nesciunt. Neque porro quisquam est, qui dolorem ipsum quia dolor sit amet, consectetur, adipisci velit, sed quia non numquam eius modi tempora incidunt ut labore et dolore magnam aliquam quaerat voluptatem. Ut enim ad minima veniam, quis nostrum exercitationem ullam corporis suscipit laboriosam, nisi ut aliquid ex ea commodi consequatur? Quis autem vel eum iure reprehenderit qui in ea voluptate velit esse quam nihil molestiae consequatur, vel illum qui dolorem eum fugiat quo voluptas nulla pariatur?</p>
</div>
   
   <div id="apptinfo">
   <h2>Appointment Info</h2>
   <p>__date__ __time__</p>
   <p>Services: __service__ </p>
   <p>Stylist: __stylist__</p>
   </div>
   
   <div id="contactinfo">
   <form action="verify.php" method="post">
   <h2>Contact Info</h2>
 
   <table width="500" border="0" cellspacing="0" cellpadding="0">
  <tr>
    <td><label for="firstname">First Name:</label></td>
    <td><input type="text" name="firstname" id="firstname" value="__firstname__" /></td>
    <td>&nbsp;</td>
    <td> <label for="email">Email:</label></td>
    <td> <input type="text" name="email" id="email" value="__email__" /></td>
  </tr>
  <tr>
    <td><label for="lastname">Last Name:</label></td>
    <td><input type="text" name="lastname" id="lastname" value="__lastname__" /></td>
    <td>&nbsp;</td>
    <td><label for="phone1">Phone:</label></td>
    <td><input type="text" name="phone1" id="phone1" value="__phone1__" /></td>
  </tr>
  <tr>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
  </tr>
  
</table>
   
   
   <table width="500" border="0" cellspacing="0" cellpadding="0">
 <tr>
    <td width="30"><input type="checkbox" name="verified" id="verified" value="verified" /></td>
    <td width="470" colspan="4"><label for="verified">I confirm that my appointment and contact info are correct, and that I have read the cancellation policy.</label></td>
    </tr>
</table>
  
 
   
   <input type="hidden" name="id" id="id" value="__id__" />
   <br/>
   <input type="submit" name="verify_submit" id="verify_submit" value="Confirm" />
   </form>
   </div>
   <div class="clear"></div>
   </div>
   </body>
   </html>