<form name="search-form-two-form" id="search-form-two-form" class="clearfix" action="/results/view/list/search/all/<?php echo Config::get('app.default_search_distance'); ?>/none/distance/1" method="get">					
	<div id="search-input-two" class="clearfix">
		<input type="text" name="search" id="search-name-etc" class="required text" placeholder="Facility or Physician Name" value="<?php echo e(isset($search_terms) ? $search_terms : ''); ?>">
		<input id="search-button-two" type="submit" value="l" class="icon mag-lg" />
	</div>
	<ul id="messageBoxTwo"></ul>
</form>
