Support Form<\/title>\r\n\r\n <style>\r\n body {\r\n font-family: Arial, sans-serif;\r\n }\r\n\r\n form {\r\n max-width: 500px;\r\n margin: 0 auto;\r\n }\r\n\r\n label {\r\n display: block;\r\n\r\n margin-top: 10px;\r\n }\r\n\r\n h1 {\r\n text-align: center;\r\n }\r\n\r\n input,\r\n select,\r\n textarea {\r\n width: 100%;\r\n margin-bottom: 15px;\r\n height: 45px;\r\n padding: 5px;\r\n box-sizing: border-box;\r\n border-radius: 15px;\r\n border-color: grey !important;\r\n }\r\n select[multiple=\"multiple\"] {\r\n height: 75px;\r\n }\r\n textarea {\r\n height: 150px;\r\n }\r\n input[type=\"submit\"] {\r\n background-color: #4caf50;\r\n\r\n color: white;\r\n cursor: pointer;\r\n }\r\n input[type=\"submit\"]:disabled {\r\n background-color: grey;\r\n cursor: not-allowed;\r\n }\r\n input[type=\"submit\"]:hover:disabled {\r\n background-color: grey;\r\n }\r\n input[type=\"submit\"]:hover {\r\n background-color: #45a049;\r\n }\r\n @media only screen and (max-width: 767px) {\r\n form {\r\n max-width: 350px;\r\n margin: 0 auto;\r\n }\r\n\r\n textarea {\r\n height: 150px;\r\n }\r\n\r\n input,\r\n select,\r\n textarea {\r\n height: 35px;\r\n margin-bottom: 15px;\r\n padding: 5px;\r\n }\r\n\r\n body {\r\n font-family: Arial, sans-serif;\r\n font-size: 14px;\r\n }\r\n }\r\n\r\n .required:after {\r\n content: \" *\";\r\n color: red;\r\n }\r\n\r\n .checkbox-container {\r\n margin-top: -20px;\r\n display: flex;\r\n align-items: center;\r\n margin-bottom: 15px;\r\n }\r\n\r\n .checkbox-container input[type=\"checkbox\"] {\r\n margin-top: 25px;\r\n margin-right: 10px;\r\n width: 25px;\r\n height: 25px;\r\n }\r\n\r\n .info-link {\r\n margin-top: -15px;\r\n font-size: 1em;\r\n }\r\n <\/style>\r\n <script>\r\n document.addEventListener(\"DOMContentLoaded\", function () {\r\n var checkbox = document.getElementById(\"consent\");\r\n var submitButton = document.getElementById(\"submit\");\r\n\r\n checkbox.addEventListener(\"change\", function () {\r\n submitButton.disabled = !checkbox.checked;\r\n });\r\n\r\n \/\/ Initially disable the submit button\r\n submitButton.disabled = true;\r\n });\r\n <\/script>\r\n <\/head>\r\n <body>\r\n <form\r\n action=\"https:\/\/webto.salesforce.com\/servlet\/servlet.WebToCase?encoding=UTF-8&orgId=00D3z000002uY18\"\r\n method=\"POST\"\r\n >\r\n <h1> <\/h1>\r\n <input type=\"hidden\" name=\"orgid\" value=\"00D3z000002uY18\" \/>\r\n <input\r\n type=\"hidden\"\r\n name=\"retURL\"\r\n value=\"https:\/\/temacons.com\/hakkimizda\/\"\r\n \/>\r\n\r\n <label for=\"name\" class=\"required\">Name<\/label\r\n ><input\r\n required\r\n id=\"name\"\r\n maxlength=\"80\"\r\n name=\"name\"\r\n size=\"20\"\r\n type=\"text\"\r\n \/><br \/>\r\n\r\n <label for=\"reason\">Case Reason<\/label>\r\n <select id=\"reason\" name=\"reason\" required>\r\n <option value=\"\">--Please Choose--<\/option>\r\n <option value=\"Medication Problem\">Medication Problem<\/option>\r\n <option value=\"Machine Problem\">Machine Problem<\/option>\r\n <option value=\"Support\">Support<\/option>\r\n <option value=\"New problem\">New problem<\/option>\r\n <\/select>\r\n <br \/>\r\n\r\n <label for=\"email\" class=\"required\">Email<\/label\r\n ><input\r\n required\r\n id=\"email\"\r\n maxlength=\"80\"\r\n name=\"email\"\r\n size=\"20\"\r\n type=\"text\"\r\n \/><br \/>\r\n\r\n <label aria-required=\"true\" for=\"phone\">Phone<\/label\r\n ><input\r\n id=\"phone\"\r\n maxlength=\"40\"\r\n name=\"phone\"\r\n size=\"20\"\r\n type=\"text\"\r\n \/><br \/>\r\n\r\n <label for=\"subject\" class=\"required\">Subject<\/label\r\n ><input\r\n id=\"subject\"\r\n maxlength=\"80\"\r\n name=\"subject\"\r\n size=\"20\"\r\n type=\"text\"\r\n \/><br \/>\r\n\r\n <label for=\"description\">Description<\/label\r\n ><textarea name=\"description\"><\/textarea><br \/>\r\n\r\n <div class=\"checkbox-container\">\r\n <input type=\"checkbox\" id=\"consent\" \/>\r\n <label for=\"consent\"\r\n >I have read and accept the personal data processing\r\n information.<\/label\r\n >\r\n <\/div>\r\n <p class=\"info-link\">\r\n <a target=\"_blank\" href=\"https:\/\/temacons.com\/aydinlatma-metni\"\r\n >Click here<\/a\r\n >\r\n for the personal data processing information page.\r\n <\/p>\r\n\r\n <input type=\"submit\" id=\"submit\" name=\"submit\" value=\"G\u00f6nder\" \/>\r\n <\/form>\r\n <\/body>\r\n<\/html>\r\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Support Form Support Form Name Case Reason –Please Choose–Medication ProblemMachine ProblemSupportNew problem Email Phone Subject Description I have read and accept the personal data processing information. Click here for the personal data processing information page.<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-7707","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/temacons.com\/en\/wp-json\/wp\/v2\/pages\/7707","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/temacons.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/temacons.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/temacons.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/temacons.com\/en\/wp-json\/wp\/v2\/comments?post=7707"}],"version-history":[{"count":0,"href":"https:\/\/temacons.com\/en\/wp-json\/wp\/v2\/pages\/7707\/revisions"}],"wp:attachment":[{"href":"https:\/\/temacons.com\/en\/wp-json\/wp\/v2\/media?parent=7707"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/temacons.com\/en\/wp-json\/wp\/v2\/categories?post=7707"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/temacons.com\/en\/wp-json\/wp\/v2\/tags?post=7707"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}