{% extends "social_services/base.html" %} {% load styled_forms %} {% block title %}{{ block.super }}{% trans 'Relief Assessment Form' %}{% endblock %} {% block extra_head %} {{ block.super }} {% endblock %} {% block content %}

{% trans "relief assessment form" %}

{% trans "date of visit" %}: {{ now|date:"j-F-Y P" }}

{% csrf_token %}
{{ form|styled_form }}
{% endblock %} {% block extra_body %} {{ block.super }} {{ form.media }} {% endblock %}