+ <%= form_for @form, url: claim_path(current_journey_routing_name), builder: GOVUKDesignSystemFormBuilder::FormBuilder do |f| %>
+ <%= f.govuk_error_summary %>
+
+
+ <%= t("questions.personal_details") %>
+
+
+ <% if @form.show_name_section? %>
+
+ <%= f.govuk_fieldset legend: {
+ text: "What is your full name?",
+ tag: "h2",
+ size: subheading_size
+ } do %>
+ <%= f.govuk_text_field :first_name,
+ label: { text: "First name" },
+ autocomplete: "given-name"
+ %>
+
+ <%= f.govuk_text_field :middle_name,
+ label: { text: "Middle names" },
+ autocomplete: "additional-name"
+ %>
+
+ <%= f.govuk_text_field :surname,
+ label: { text: "Last name" },
+ autocomplete: "family-name"
+ %>
+ <% end %>
+
+ <% end %>
+
+ <% if @form.show_date_of_birth_section? %>
+
+ <%= f.govuk_date_field :date_of_birth,
+ date_of_birth: true,
+ legend: {
+ text: "What is your date of birth?",
+ tag: "h2",
+ size: subheading_size
+ },
+ hint: { text: "For example, 31 03 1980. We need this information to verify your identity." } %>
+
+ <% end %>
+
+ <% if @form.show_nino_section? %>
+
+ <%= f.govuk_text_field :national_insurance_number,
+ width: 10,
+ spellcheck: false,
+ autocomplete: "off",
+ label: {
+ text: t("questions.national_insurance_number"),
+ size: subheading_size,
+ tag: "h2"
+ },
+ hint: -> do %>
+ It’s on your National Insurance card, benefit letter, payslip or P60. For example ‘QQ123456C’.
+ <% end %>
+
+ <% end %>
+
+ <%= f.govuk_submit "Continue" %>
+ <% end %>
+