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Form analysis
1 forms found in the DOM

POST

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  data-honeypot-name="important_message_1b7d5a" data-honeypot-value="f66e05f2d" data-scripts-datepicker="">
  <input type="hidden" name="action" value="freeform/api/form"><input type="hidden" name="formHash" value="lw70Q85mz_2lDaGWaoN_fa720d0104b269e7d9f8a4b06e99df90d2462a1f657134b4bf75b"><input type="hidden" name="CRAFT_CSRF_TOKEN"
    value="VbVh-Q6helMfaRAe_noUBKhGAXwS_TUKl_nnmdjqcm88nAOqbCeva2OBJpZpziUAfSchZJZNV2HcB1Q0WqtZSNmggNy7uAsLeNJZ0ipR6j4=">
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  <div class="important_message_1b7d5a" style="position: absolute !important; width: 0 !important; height: 0 !important; overflow: hidden !important;" aria-hidden="true" tabindex="-1"><label aria-hidden="true" tabindex="-1"
      for="important_message_1b7d5a">Leave this field blank</label><input type="text" value="6da47e" name="important_message_1b7d5a" id="important_message_1b7d5a" aria-hidden="true" tabindex="-1"></div>
  <script type="text/javascript" async="" src="https://www.gstatic.com/recaptcha/releases/cwQvQhsy4_nYdnSDY4u7O5_B/recaptcha__de.js" crossorigin="anonymous" integrity="sha384-NkkVgE9OBmtoDPMiiUNgVslcMH/olECiCBW/2Sa0fUgijBu0p5s6mABiWxCFtaqZ"></script>
  <script>
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    if (form) {
      form.addEventListener("freeform-stripe-styling", function(event) {
        event.detail.base = {
          fontSize: "16px",
          fontFamily: "-apple-system,BlinkMacSystemFont,\"Segoe UI\",Roboto,\"Helvetica Neue\",Arial,sans-serif,\"Apple Color Emoji\",\"Segoe UI Emoji\",\"Segoe UI Symbol\",\"Noto Color Emoji\"",
        }
      })
    }
  </script>
  <div class="freeform-row ">
    <div class="freeform-column ">
      <h1>Please fill out the following:<span style="display: block">(Veuillez remplir le formulaire suivant:)</span></h1>
      <p class="required-field"><span>*</span> Required Field (Champ obligatoire)</p>
    </div>
  </div>
  <div class="freeform-row ">
    <div class="freeform-column ">
      <label for="form-input-topic" class="freeform-label freeform-required">Topic (Sujet)</label>
      <select class="freeform-input" name="topic" id="form-input-topic" data-required="">
        <option value="Compliment (Compliment)" selected="">Compliment (Compliment)</option>
        <option value="Concern (Préoccupation)">Concern (Préoccupation)</option>
        <option value="Credit Card/Debit Card Questions and Comments (Carte de Crédit ou Débit)">Credit Card/Debit Card Questions and Comments (Carte de Crédit ou Débit)</option>
      </select>
    </div>
  </div>
  <div class="freeform-row ">
    <div class="freeform-column ">
      <label for="form-input-message" class="freeform-label freeform-required">Message</label>
      <textarea class="freeform-input" name="message" id="form-input-message" rows="5" data-required=""></textarea>
    </div>
  </div>
  <div class="freeform-row ">
    <div class="freeform-column ">
      <label for="form-input-areYouWritingAboutASpecificRestaurantExperience" class="freeform-label freeform-required">Are you writing about a specific restaurant experience?</label>
      <div class="freeform-instructions">Votre commentaire porte-t-il sur une expérience vécue à un restaurant?</div>
      <div class="input-group-one-line"><label><input class="freeform-input" name="areYouWritingAboutASpecificRestaurantExperience" type="radio" id="form-input-areYouWritingAboutASpecificRestaurantExperience-0" value="Yes"
            data-required="">Yes</label><label><input class="freeform-input" name="areYouWritingAboutASpecificRestaurantExperience" type="radio" id="form-input-areYouWritingAboutASpecificRestaurantExperience-1" value="No" data-required="">No</label>
      </div>
    </div>
  </div>
  <div class="freeform-row ">
    <div class="freeform-column "
      data-ff-rule="{&quot;show&quot;:true,&quot;type&quot;:&quot;any&quot;,&quot;criteria&quot;:[{&quot;tgt&quot;:&quot;areYouWritingAboutASpecificRestaurantExperience&quot;,&quot;o&quot;:&quot;=&quot;,&quot;val&quot;:&quot;Yes&quot;}]}"
      data-hidden-by-rules="true" style="display: none;">
      <label for="form-input-creditCardNum" class="freeform-label">Check/Order number</label>
      <input oninput="this.value = this.value.replace(/[^0-9]/g, '').replace(/(\..*?)\..*/g, '$1');" class="freeform-input " name="creditCardNum" type="text" id="form-input-creditCardNum" maxlength="8">
    </div>
  </div>
  <div class="freeform-row ">
    <div class="freeform-column ">
      <label for="form-input-phoneNumber" class="freeform-label">Phone Number</label>
      <div class="freeform-instructions">Votre numéro de téléphone</div>
      <input class="freeform-input " name="phoneNumber" type="text" id="form-input-phoneNumber">
    </div>
    <div class="freeform-column ">
      <label for="form-input-email" class="freeform-label freeform-required">Email</label>
      <div class="freeform-instructions">Courriel</div>
      <input class="freeform-input" name="email" type="email" id="form-input-email" data-required="">
    </div>
  </div>
  <div class="freeform-row ">
    <div class="freeform-column ">
      <label for="form-input-dateOfVisit" class="freeform-label">Date of Visit (Date de la visite)</label>
      <input class="freeform-input form-date-time-field form-datepicker flatpickr-input" name="dateOfVisit" type="text" id="form-input-dateOfVisit" data-datepicker="1" data-datepicker-enabled="1" data-datepicker-format="m/d/Y h:i K"
        data-datepicker-enabletime="1" data-datepicker-enabledate="1" data-datepicker-locale="default" data-datepicker-min-date="" data-datepicker-max-date="" placeholder="MM/DD/YYYY H:MM TT" autocomplete="off">
    </div>
    <div class="freeform-column "
      data-ff-rule="{&quot;show&quot;:true,&quot;type&quot;:&quot;any&quot;,&quot;criteria&quot;:[{&quot;tgt&quot;:&quot;areYouWritingAboutASpecificRestaurantExperience&quot;,&quot;o&quot;:&quot;=&quot;,&quot;val&quot;:&quot;Yes&quot;}]}"
      data-hidden-by-rules="true" style="display: none;">
      <label for="form-input-location" class="freeform-label freeform-required">Location (Lieu)</label>
      <input class="freeform-input " name="location" type="text" id="form-input-location" data-required="">
    </div>
  </div>
  <div class="freeform-row ">
    <div class="freeform-column "
      data-ff-rule="{&quot;show&quot;:true,&quot;type&quot;:&quot;any&quot;,&quot;criteria&quot;:[{&quot;tgt&quot;:&quot;areYouWritingAboutASpecificRestaurantExperience&quot;,&quot;o&quot;:&quot;=&quot;,&quot;val&quot;:&quot;Yes&quot;}]}"
      data-hidden-by-rules="true" style="display: none;">
      <label for="form-input-restaurantNameAndStoreID" class="freeform-label freeform-required">Restaurant Name and Store ID</label>
      <div class="freeform-instructions">(found at the bottom of the receipt) Nom du restaurant et numéro d’identification de l’établissement (au bas du reçu)(au bas du reçu)</div>
      <input class="freeform-input " name="restaurantNameAndStoreID" type="text" id="form-input-restaurantNameAndStoreID" data-required="">
    </div>
  </div>
  <div class="freeform-row ">
    <div class="freeform-column  freeform-column-content-align-left">
      <button class="" data-submit-button="1" type="submit" name="form_page_submit" data-original-text="SEND MESSAGE (ENVOYER LE MESSAGE)" data-loading-text="null">Send message (Envoyer le message)</button>
    </div>
  </div>
</form>

Text Content

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CONTACT US


 * Guest Feedback
 * Guest Receipt Request
 * News Media
 * Vendor Inquiries
 * Verify Employment
 * CPRA Request

Leave this field blank


PLEASE FILL OUT THE FOLLOWING:(VEUILLEZ REMPLIR LE FORMULAIRE SUIVANT:)

* Required Field (Champ obligatoire)

Topic (Sujet) Compliment (Compliment)Concern (Préoccupation)Credit Card/Debit
Card Questions and Comments (Carte de Crédit ou Débit)
Message
Are you writing about a specific restaurant experience?
Votre commentaire porte-t-il sur une expérience vécue à un restaurant?
YesNo
Check/Order number
Phone Number
Votre numéro de téléphone
Email
Courriel
Date of Visit (Date de la visite)
Location (Lieu)
Restaurant Name and Store ID
(found at the bottom of the receipt) Nom du restaurant et numéro
d’identification de l’établissement (au bas du reçu)(au bas du reçu)
Send message (Envoyer le message)

We want to hear your feedback!

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