{% extends "social_services/base.html" %} {% load i18n %} {% load styled_forms %} {% block title %}{{ block.super }}Relief Assessment Form{% endblock %} {% block extra_head %} {{ block.super }} {% endblock %} {% block body %} {% include "social_services/nav.html" %}

{% 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 }} {% endblock %}