{!! Form::open(
	[
		'data-toggle' => 'validator',
		'action' => action('Payment/OrdersController@edit', [$order->id])
	]
) !!}
	<div class="form-group">
		{!! Form::label('data[request_change]', t('Request Order Change')) !!}
		{!! Form::textarea(
		    'data[request_change]',
		    null,
		    [
		        'placeholder' => t('Type why you need to change your order'),
		        'class' => 'form-control'
		    ]
		) !!}
	</div>
	<div class="text-right">
		<button class="btn btn-pink btn-lg submit">@t('Send')</button>
	</div>
{!! Form::close() !!}