app.smartsheet.com
Open in
urlscan Pro
34.199.253.153
Public Scan
URL:
https://app.smartsheet.com/b/form/f10c770be42a4306a2b3740ea3bac94b
Submission: On July 07 via api from QA — Scanned from DE
Submission: On July 07 via api from QA — Scanned from DE
Form analysis 1 forms found in the DOM
<form>
<div class="css-1o5h39n e1tmc1mx0">
<fieldset data-client-id="container_Type of Feedback" data-client-type="radio" data-client-align="horizontal" id="bloaJRK" class="css-1v3zkla etth7i50">
<legend data-client-id="label_Type of Feedback" class="css-1yfbzum etth7i52">Type of Feedback<span data-client-id="required_indicator" class="css-mfmuai etth7i53">*</span></legend>
<div class="css-la3s4b etth7i51">
<div class="css-1r7q5sr etth7i54"><label class="css-1fg467d etth7i56"><input aria-label="Feedback" tabindex="0" data-client-value="Feedback" data-client-id="radio_Type of Feedback" type="radio" title="Feedback" name="bloaJRK"
class="css-10i6ipn etth7i57"><span class="css-1pu7ejh etth7i58">Feedback</span></label></div>
<div class="css-1r7q5sr etth7i54"><label class="css-1fg467d etth7i56"><input aria-label="Complaint" tabindex="0" data-client-value="Complaint" data-client-id="radio_Type of Feedback" type="radio" title="Complaint" name="bloaJRK"
class="css-10i6ipn etth7i57"><span class="css-1pu7ejh etth7i58">Complaint</span></label></div>
<div class="css-1r7q5sr etth7i54"><label class="css-1fg467d etth7i56"><input aria-label="Suggestion" tabindex="0" data-client-value="Suggestion" data-client-id="radio_Type of Feedback" type="radio" title="Suggestion" name="bloaJRK"
class="css-10i6ipn etth7i57"><span class="css-1pu7ejh etth7i58">Suggestion</span></label></div>
</div>
</fieldset>
</div>
<div class="css-tkslta e1tmc1mx0">
<div role="application" title="" data-client-id="container_Branch Location" data-client-type="dropdown" id="ajoADRj" class="css-u3yn36 ef83ajd0"><label for="select_input_Branch Location" id="6cd9a725-b42c-41b1-8a49-31bcf995203d"
data-client-id="label_Branch Location" class="css-1xl1v40 ekxsfat0">Branch Location<span data-client-id="required_indicator" class="css-skcghl ekxsfat1">*</span></label>
<div class="css-t8xanh-container">
<div class="css-kf2egt-control react-select__control">
<div class="css-11ksah1 react-select__value-container">
<div class="css-1i5h0xy-placeholder react-select__placeholder">Select or enter value</div>
<div class="css-1g6gooi">
<div class="react-select__input" style="display: inline-block;"><input autocapitalize="none" autocomplete="off" autocorrect="off" id="select_input_Branch Location" spellcheck="false" tabindex="-1" type="text"
aria-label="Select or enter value" aria-labelledby="6cd9a725-b42c-41b1-8a49-31bcf995203d" value=""
style="box-sizing: content-box; width: 2px; background: 0px center; border: 0px; font-size: inherit; opacity: 1; outline: 0px; padding: 0px; color: inherit;">
<div
style="position: absolute; top: 0px; left: 0px; visibility: hidden; height: 0px; overflow: scroll; white-space: pre; font-size: 13px; font-family: Arial; font-weight: 400; font-style: normal; letter-spacing: normal; text-transform: none;">
</div>
</div>
</div>
</div>
<div class="css-1wy0on6 react-select__indicators"><span class="css-9lpq22-indicatorSeparator react-select__indicator-separator"></span><span style="margin-right: 6px;"><svg data-client-id="caret_icon" width="16px" height="16px"
viewBox="0 0 16 16" version="1.1" role="img" xmlns="http://www.w3.org/2000/svg">
<title>Caret Icon</title>
<desc>Caret symbol</desc>
<g stroke="none" stroke-width="1" fill="none" fill-rule="evenodd">
<g fill="#161616">
<path
d="M8.38951287,9.81740951 C8.3743818,9.83527284 8.35811596,9.85207547 8.34082332,9.86770589 C8.12569934,10.0621513 7.79871352,10.0396329 7.61048004,9.81740951 L5.12806062,6.88673235 C5.04550447,6.78926879 5,6.66416424 5,6.53465776 C5,6.23937443 5.23172713,6 5.51757703,6 L10.4824159,6 C10.607785,6 10.7288928,6.04700617 10.8232427,6.13228679 C11.0383667,6.32673222 11.0601658,6.664509 10.8719323,6.88673235 L8.38951287,9.81740951 Z">
</path>
</g>
</g>
</svg></span></div>
</div>
</div>
</div>
</div>
<div class="css-tkslta e1tmc1mx0">
<div data-client-id="container_Your Name" data-client-type="text" id="3n09aA5" class="css-1e3khfm ef83ajd0"><label for="text_box_Your Name" data-client-id="label_Your Name" class="css-1xl1v40 ekxsfat0">Your Name</label>
<div style="display: flex;"><input title="" aria-invalid="false" tabindex="-1" id="text_box_Your Name" data-testid="text_box_Your Name" data-client-id="text_box_Your Name" data-client-type="" name="3n09aA5" maxlength="4000"
class="css-1p0590h e1407lhe0" value=""></div>
</div>
</div>
<div class="css-tkslta e1tmc1mx0">
<div data-client-id="container_Company" data-client-type="text" id="PqdnKXQ" class="css-1e3khfm ef83ajd0"><label for="text_box_Company" data-client-id="label_Company" class="css-1xl1v40 ekxsfat0">Company</label>
<div style="display: flex;"><input title="" aria-invalid="false" tabindex="-1" id="text_box_Company" data-testid="text_box_Company" data-client-id="text_box_Company" data-client-type="" name="PqdnKXQ" maxlength="4000"
class="css-1p0590h e1407lhe0" value=""></div>
</div>
</div>
<div class="css-tkslta e1tmc1mx0">
<div data-client-id="container_Contact Phone Number" data-client-type="text" id="5dQva9L" class="css-1e3khfm ef83ajd0"><label for="text_box_Contact Phone Number" data-client-id="label_Contact Phone Number" class="css-1xl1v40 ekxsfat0">Contact
Phone Number</label>
<div style="display: flex;"><input title="" aria-invalid="false" tabindex="-1" id="text_box_Contact Phone Number" data-testid="text_box_Contact Phone Number" data-client-id="text_box_Contact Phone Number" data-client-type="" name="5dQva9L"
maxlength="4000" class="css-1p0590h e1407lhe0" value=""></div>
</div>
</div>
<div class="css-tkslta e1tmc1mx0">
<div data-client-id="container_Details" data-client-type="text" id="JDawgym" class="css-1e3khfm ef83ajd0"><label for="textarea_Details" data-client-id="label_Details" class="css-1xl1v40 ekxsfat0">Details<span data-client-id="required_indicator"
class="css-skcghl ekxsfat1">*</span></label>
<p id="description_Details" class="css-1jo9ly9 e5k3c9p0">Please give a detailed account of the nature of the complaint/feedback, including times, dates, names and places where the incident or event occurred</p><textarea aria-invalid="false"
aria-describedby="description_Details" tabindex="-1" name="JDawgym" id="textarea_Details" data-client-id="textarea_Details" maxlength="4000" rows="6" class="css-1lh64kx e1407lhe1"></textarea>
</div>
</div>
<div class="css-tkslta e1tmc1mx0">
<div role="application" title="" data-client-id="container_Do you want us to contact you?" data-client-type="dropdown" id="0aENaQ0" class="css-u3yn36 ef83ajd0"><label for="select_input_Do you want us to contact you?"
id="736a0b33-5655-4070-9597-52b227ef27f5" data-client-id="label_Do you want us to contact you?" class="css-1xl1v40 ekxsfat0">Do you want us to contact you?</label>
<div class="css-t8xanh-container">
<div class="css-kf2egt-control react-select__control">
<div class="css-11ksah1 react-select__value-container">
<div class="css-1i5h0xy-placeholder react-select__placeholder">Select or enter value</div>
<div class="css-1g6gooi">
<div class="react-select__input" style="display: inline-block;"><input autocapitalize="none" autocomplete="off" autocorrect="off" id="select_input_Do you want us to contact you?" spellcheck="false" tabindex="-1" type="text"
aria-label="Select or enter value" aria-labelledby="736a0b33-5655-4070-9597-52b227ef27f5" value=""
style="box-sizing: content-box; width: 2px; background: 0px center; border: 0px; font-size: inherit; opacity: 1; outline: 0px; padding: 0px; color: inherit;">
<div
style="position: absolute; top: 0px; left: 0px; visibility: hidden; height: 0px; overflow: scroll; white-space: pre; font-size: 13px; font-family: Arial; font-weight: 400; font-style: normal; letter-spacing: normal; text-transform: none;">
</div>
</div>
</div>
</div>
<div class="css-1wy0on6 react-select__indicators"><span class="css-9lpq22-indicatorSeparator react-select__indicator-separator"></span><span style="margin-right: 6px;"><svg data-client-id="caret_icon" width="16px" height="16px"
viewBox="0 0 16 16" version="1.1" role="img" xmlns="http://www.w3.org/2000/svg">
<title>Caret Icon</title>
<desc>Caret symbol</desc>
<g stroke="none" stroke-width="1" fill="none" fill-rule="evenodd">
<g fill="#161616">
<path
d="M8.38951287,9.81740951 C8.3743818,9.83527284 8.35811596,9.85207547 8.34082332,9.86770589 C8.12569934,10.0621513 7.79871352,10.0396329 7.61048004,9.81740951 L5.12806062,6.88673235 C5.04550447,6.78926879 5,6.66416424 5,6.53465776 C5,6.23937443 5.23172713,6 5.51757703,6 L10.4824159,6 C10.607785,6 10.7288928,6.04700617 10.8232427,6.13228679 C11.0383667,6.32673222 11.0601658,6.664509 10.8719323,6.88673235 L8.38951287,9.81740951 Z">
</path>
</g>
</g>
</svg></span></div>
</div>
</div>
</div>
</div>
<div class="css-1kpwj30">
<div>
<div>
<div class="grecaptcha-badge" data-style="bottomright"
style="width: 256px; height: 60px; display: block; transition: right 0.3s ease 0s; position: fixed; bottom: 14px; right: -186px; box-shadow: gray 0px 0px 5px; border-radius: 2px; overflow: hidden;">
<div class="grecaptcha-logo"><iframe title="reCAPTCHA" width="256" height="60" role="presentation" name="a-3beleyusa75w" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LfbDqAUAAAAAPc856qavjKSEVbYbOIj3lAb2x3l&co=aHR0cHM6Ly9hcHAuc21hcnRzaGVldC5jb206NDQz&hl=de&type=image&v=rKbTvxTxwcw5VqzrtN-ICwWt&theme=light&size=invisible&badge=bottomright&cb=bd8dwz86gfa3"></iframe>
</div>
<div class="grecaptcha-error"></div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div>
</div>
</div>
<div class="css-1ock8o4 e1xpzprc2"><button data-client-id="form_submit_btn" disabled="" type="submit" value="submit" class="css-oltpmt e1xpzprc0"><span>Submit</span></button></div>
<div data-client-id="footer" class="css-ybae4b e8i4qwl0">
<div class="css-1kw6mnl e8i4qwl1">
<div class="css-qoiejo e8i4qwl3"><span>Powered by
</span><a target="_blank" href="https://www.smartsheet.com/platform?s=154" rel="noopener noreferrer" data-client-id="footer_poweredBy" aria-label="logo" class="css-a7ff3e e8i4qwl2"><svg role="img" xmlns="http://www.w3.org/2000/svg" version="1.1" width="80" height="35" viewBox="0 -55 406 179" style="margin-top: 2px; margin-left: 5px;"><title id="smartsheet-modern-logo-light">Smartsheet Modern Logo On Light</title><path fill="#003059" d="M85.4,29.7c-0.8-0.9-1.7-1.7-2.8-2.3c-1.2-0.6-2.6-1-4-0.9c-1.4,0-2.7,0.3-3.9,0.9c-1,0.5-1.7,1.6-1.6,2.7 c0,0.9,0.3,1.7,1,2.3c0.6,0.6,1.4,1.1,2.2,1.4c0.9,0.4,1.8,0.7,2.8,0.8l2.5,0.5c1.3,0.3,2.6,0.7,3.8,1.2c1.1,0.4,2.2,1,3.1,1.8 c0.9,0.7,1.5,1.7,2,2.7c0.5,1.2,0.8,2.5,0.7,3.9c0,1.7-0.4,3.3-1.2,4.7c-0.8,1.3-1.8,2.4-3.1,3.2c-1.3,0.9-2.8,1.5-4.3,1.8 c-1.6,0.4-3.2,0.6-4.9,0.5c-2.5,0.1-4.9-0.4-7.2-1.2c-2.2-1-4.2-2.5-5.6-4.6l4.8-3.9c1,1,2.2,1.9,3.4,2.7c1.4,0.8,3,1.2,4.6,1.2 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