Elep

<div class="empty-wrapper">
        <div class="add-food-wrapper">
            <form action="/api/food/{{ $slug }}" class="edit-form" method="POST">
                <h5>{{ $place }} </h5>
                <h5><small>Add and/or review new food</small></h5>
                <input type="hidden" name="slug" value="{{ $slug }}">
                <div class="input-group new-food">
                    <input type="text" data-type="food" name="name" class="form-control food-name" id="name" autocomplete="off" placeholder="Food">
                    <div class="input-group-append">
                        <input type="text" data-type="food" name="price" class="form-control food-price" id="price" autocomplete="off" placeholder="How much is it?">
                    </div>
                </div>
                <input type="hidden" name="type" value="add">
                <div class="review-food">
                    <h6>Review (optional)</h6>
                    <div class="rating-stars rate">
                        <input type="radio" id="star5" name="rate" value="5" />
                        <label for="star5" title="text">5 stars</label>
                        <input type="radio" id="star4" name="rate" value="4" />
                        <label for="star4" title="text">4 stars</label>
                        <input type="radio" id="star3" name="rate" value="3" />
                        <label for="star3" title="text">3 stars</label>
                        <input type="radio" id="star2" name="rate" value="2" />
                        <label for="star2" title="text">2 stars</label>
                        <input type="radio" id="star1" name="rate" value="1" />
                        <label for="star1" title="text">1 star</label>
                    </div>
                    <div class="rating-comment">
                        <textarea name="comment" rows="3" placeholder="Have you tried it? How was the it?"></textarea>
                    </div>
                    
                    <span class="uploader-button">
                      <input 
                        type="hidden"
                        role="uploadcare-uploader"
                        name="image" 
                        data-crop="500x500"
                        data-tabs="file camera instagram" />
                    </span>
                    <div class="submit-rating">
                        <button class="button button-primary">SUBMIT</button>
                        <button type="button" class="button button-secondary close-modal">CANCEL</button>
                    </div>
                </div>
            </form>
        </div>
    </div>