tellcorecar.com Open in urlscan Pro
18.155.145.17  Public Scan

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1 forms found in the DOM

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<form method="POST" enctype="multipart/form-data" id="feedback-submission-form">
  <input type="hidden" name="_token" value="Q68bKWWYWxAm0nEbrvwJvxsG24r3GomBc7tYZ9RW" autocomplete="off"> <input type="hidden" name="g-recaptcha-response" id="g-recaptcha-response" value="">
  <div class="form-group feedback-form-group mt-20" style="color:#1C75BC;">
    <div id="feedback_textarea_wrapper">
      <textarea name="description" id="feedback" cols="30" rows="4" class="form-control feedback_textarea" placeholder=" " style="overflow: hidden; overflow-wrap: break-word; resize: none; height: 130px;">
                            </textarea>
      <label class="input-place-label">Enter Feedback here</label>
    </div>
  </div>
  <div class=" text-center" id="feedback_attachment_div">
    <div id="feedback_attachments_preview">
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    <label for="feedback_attachment_1" id="feedback_attachment_label" class=" col-12">
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      </svg><!-- <i class="fas fa-camera"></i> Font Awesome fontawesome.com --> Attach photo/video(s) to your Feedback </label><br>
    <input type="file" class="feedback_attachment" name="feedback_attachment[]" id="feedback_attachment_1" accept="image/png, image/jpeg, image/*, video/mp4, video/webm, application/pdf, video/quicktime, video/x-msvideo, video/x-ms-wmv, video/MP2T">
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  <div class="col-md-12 pl-0 pr-0 mt-3" id="anonymous-toggle-container" style="align-items: center;text-align:left; ">
    <div style="text-align: left; width:100%;">
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        </svg><!-- <i class="fal fa-toggle-on fa-2x" id="anonymous-toggle" data-fa-transform="rotate-180" data-icon="toggle-on" data-prefix="fal"></i> Font Awesome fontawesome.com -->
        <input type="checkbox" style="visibility: hidden; position:absolute;" name="anonymous" value="off">
        <input type="checkbox" style="visibility: hidden; position:absolute;" id="anonymous" name="anonymous" value="on">
      </span>
      <label class="anonymous-label ml-2" for="anonymous" style="line-height: 1.4em;">Submit anonymously</label>
    </div>
  </div>
  <div class="row">
    <div class="col-12 pl-0 pr-0">
      <hr>
    </div>
  </div>
  <div id="isanonymous" class="text-center hidden">
    <label class="" for="like-reply"><strong>Your feedback will be sent anonymously</strong></label>
  </div>
  <div class="text-center" id="feedback-reply-choices" style="">
    <label class="like-reply" for="like-reply"><strong>I would like a reply via</strong></label>
    <div class="form-group row text-center" style="display:flex;justify-content:center;">
      <button type="button" class="btn btn-light reply-method-toggle justify-content-center active" id="feedback-reply-text" data-toggle="button" aria-pressed="true" autocomplete="off">
        <svg width="20" height="19" viewBox="0 0 20 19" fill="none" xmlns="http://www.w3.org/2000/svg">
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            stroke="white" stroke-width="1.5" stroke-linecap="round" stroke-linejoin="round"></path>
        </svg>
        <br>
        <span>Text</span>
      </button>
      <button type="button" class="btn btn-light reply-method-toggle justify-content-center" id="feedback-reply-call" data-toggle="button" aria-pressed="false" autocomplete="off">
        <svg width="27" height="27" viewBox="0 0 27 27" fill="none" xmlns="http://www.w3.org/2000/svg">
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            fill="black"></path>
        </svg>
        <br>
        <span>Call</span>
      </button>
      <button type="button" class="btn btn-light reply-method-toggle justify-content-center" id="feedback-reply-email" data-toggle="button" aria-pressed="false" autocomplete="off">
        <svg width="30" height="24" viewBox="0 0 30 24" fill="none" xmlns="http://www.w3.org/2000/svg">
          <path
            d="M3.45638 23.7936C2.66432 23.7936 1.98651 23.5118 1.42295 22.9483C0.858432 22.3838 0.576172 21.7055 0.576172 20.9134V3.63216C0.576172 2.8401 0.858432 2.16229 1.42295 1.59873C1.98651 1.03421 2.66432 0.751953 3.45638 0.751953H26.498C27.2901 0.751953 27.9684 1.03421 28.5329 1.59873C29.0965 2.16229 29.3783 2.8401 29.3783 3.63216V20.9134C29.3783 21.7055 29.0965 22.3838 28.5329 22.9483C27.9684 23.5118 27.2901 23.7936 26.498 23.7936H3.45638ZM26.498 6.51237L15.7333 13.2449C15.6133 13.3169 15.487 13.3706 15.3545 13.4061C15.223 13.4426 15.0972 13.4609 14.9772 13.4609C14.8572 13.4609 14.7314 13.4426 14.5999 13.4061C14.4674 13.3706 14.3412 13.3169 14.2212 13.2449L3.45638 6.51237V20.9134H26.498V6.51237ZM14.9772 10.8327L26.498 3.63216H3.45638L14.9772 10.8327ZM3.45638 6.8724V4.74824V4.78425V4.76552V6.8724Z"
            fill="black"></path>
        </svg>
        <br>
        <span>Email</span>
      </button>
      <input type="hidden" name="reply-email" id="feedback-reply-email-input" value="">
      <input type="hidden" name="reply-call" id="feedback-reply-call-input" value="">
      <input type="hidden" name="reply-text" id="feedback-reply-text-input" value="1">
    </div>
    <div id="pre_input_hidden_pii_fields" style="display:none;">
      <div class="form-group feedback-form-group phone-entry" style="">
        <input type="tel" id="call_number" class="form-control" name="call_number" placeholder=" " value="" autocomplete="mobile tel">
        <label class="input-place-label">Phone number</label>
      </div>
      <div class="form-group feedback-form-group name-entry" style="">
        <input type="text" id="first_name" class="form-control" name="first_name" placeholder=" " value="">
        <label class="input-place-label">First name</label>
      </div>
      <div class="form-group feedback-form-group name-entry" id="last_name_div" style="">
        <input type="text" id="last_name" class="form-control" name="last_name" placeholder=" " value="">
        <label class="input-place-label">Last name (Optional)</label>
      </div>
      <div class="form-group feedback-form-group email-entry" id="email_address_div" style="">
        <input type="email" id="email_address" class="form-control" name="email" placeholder=" " value="">
        <label class="input-place-label">Email (Optional)</label>
      </div>
      <div class="form-group feedback-form-group hidden">
        <input type="text" id="username" class="form-control" name="username" placeholder=" " value="">
        <label class="input-place-label">Username</label>
      </div>
    </div>
  </div>
  <div class="form-group text-center">
    <button type="submit" id="submits_feedback" class="btn btn-primary btn-submit-feedback mt-4" value="Submit Feedback"> Send Feedback </button>
  </div>
  <div class="form-group text-center">
    <p style="font-size:12px;" class="mt-4"> By sending Feedback you are agreeing to these <a href="https://www.realtimefeedback.com/terms-conditions/" target="_blank">Terms and Conditions</a>. </p>
  </div>
  <input type="hidden" name="from_domain" id="from_domain" value="">
</form>

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