nginx-proxy-manager/frontend/js/app/nginx/access/form.ejs

<div class="modal-content">
    <div class="modal-header">
        <h5 class="modal-title"><%- i18n('access-lists', 'form-title', {id: id}) %></h5>
        <button type="button" class="close cancel" aria-label="Close" data-dismiss="modal">&nbsp;</button>
    </div>
    <div class="modal-body has-tabs">
        <form>
            <ul class="nav nav-tabs" role="tablist">
                <li role="presentation" class="nav-item"><a href="#details" aria-controls="tab1" role="tab" data-toggle="tab" class="nav-link active show" aria-selected="true"><i class="fe fe-zap"></i> <%- i18n('access-lists', 'details') %></a></li>
                <li role="presentation" class="nav-item"><a href="#auth" aria-controls="tab4" role="tab" data-toggle="tab" class="nav-link" aria-selected="false"><i class="fe fe-users"></i> <%- i18n('access-lists', 'authorization') %></a></li>
                <li role="presentation" class="nav-item"><a href="#access" aria-controls="tab2" role="tab" data-toggle="tab" class="nav-link" aria-selected="false"><i class="fe fe-radio"></i> <%- i18n('access-lists', 'access') %></a></li>
            </ul>

            <div class="tab-content">
                <!-- Details -->
                <div role="tabpanel" class="tab-pane active show" id="details">
                    <div class="row">
                        <div class="col-sm-12 col-md-12">
                            <div class="form-group">
                                <label class="form-label"><%- i18n('str', 'name') %> <span class="form-required">*</span></label>
                                <input type="text" name="name" class="form-control" value="<%- name %>" required>
                            </div>
                        </div>

                        <div class="col-sm-6 col-md-6">
                            <div class="form-group">
                                <label class="custom-switch">
                                    <input type="checkbox" class="custom-switch-input" name="satisfy_any" value="1"<%- typeof satisfy_any !== 'undefined' && satisfy_any ? ' checked' : '' %>>
                                    <span class="custom-switch-indicator"></span>
                                    <span class="custom-switch-description"><%- i18n('access-lists', 'satisfy-any') %></span>
                                </label>
                            </div>
                        </div>

                        <div class="col-sm-6 col-md-6">
                            <div class="form-group">
                                <label class="custom-switch">
                                    <input type="checkbox" class="custom-switch-input" name="pass_auth" value="1"<%- typeof pass_auth !== 'undefined' && pass_auth ? ' checked' : '' %>>
                                    <span class="custom-switch-indicator"></span>
                                    <span class="custom-switch-description"><%- i18n('access-lists', 'pass-auth') %></span>
                                </label>
                            </div>
                        </div>
                    </div>
                </div>

                <!-- Authorization -->
                <div class="tab-pane" id="auth">
                    <p>
                        Basic Authorization via
                        <a href="https://nginx.org/en/docs/http/ngx_http_auth_basic_module.html">
                            Nginx HTTP Basic Authentication
                        </a>
                    </p>
                    <div class="row">
                        <div class="col-sm-6 col-md-6">
                            <div class="form-group">
                                <label class="form-label"><%- i18n('str', 'username') %></label>
                            </div>
                        </div>
                        <div class="col-sm-6 col-md-6">
                            <div class="form-group">
                                <label class="form-label"><%- i18n('str', 'password') %></label>
                            </div>
                        </div>
                    </div>

                    <div class="items"><!-- items --></div>
                    <div class="btn-list justify-content-end">
                        <button type="button" class="btn btn-teal auth_add"><%- i18n('access-lists', 'auth-add') %></button>
                    </div>
                </div>

                <!-- Access -->
                <div class="tab-pane" id="access">
                    <p>
                        IP Address Whitelist/Blacklist via
                        <a href="https://nginx.org/en/docs/http/ngx_http_access_module.html">
                            Nginx HTTP Access
                        </a>
                    </p>
                    <div class="clients"><!-- clients --></div>
                    <div class="row">
                        <div class="col-sm-3 col-md-3">
                            <div class="form-group">
                                <input type="text" class="form-control disabled" value="deny" disabled>
                            </div>
                        </div>
                        <div class="col-sm-9 col-md-9">
                            <div class="form-group">
                                <input type="text" class="form-control disabled" value="all" disabled>
                            </div>
                        </div>
                    </div>
                    <div class="text-muted">Note that the <code>allow</code> and <code>deny</code> directives will be applied in the order they are defined.</div>
                    <div class="btn-list justify-content-end">
                        <button type="button" class="btn btn-teal access_add"><%- i18n('access-lists', 'access-add') %></button>
                    </div>
                </div>

            </div>
        </form>
    </div>
    <div class="modal-footer">
        <button type="button" class="btn btn-secondary cancel" data-dismiss="modal"><%- i18n('str', 'cancel') %></button>
        <button type="button" class="btn btn-teal save"><%- i18n('str', 'save') %></button>
    </div>
</div>