placeholder="Service Date" data-target="#date1" data-toggle="datetimepicker" style="height: 55px;">
                                    </div>
                                </div>
                                <div class="col-12">
                                    <textarea class="form-control border-0" placeholder="Special Request"></textarea>
                                </div>
                                <div class="col-12">
                                    <button class="btn btn-secondar