{"id":8624,"date":"2026-02-14T16:03:26","date_gmt":"2026-02-14T16:03:26","guid":{"rendered":"https:\/\/essentyal.store\/?post_type=sureforms_form&#038;p=8624"},"modified":"2026-02-16T21:37:40","modified_gmt":"2026-02-16T21:37:40","slug":"customer-feedback-form","status":"publish","type":"sureforms_form","link":"https:\/\/essentyal.store\/?sureforms_form=customer-feedback-form","title":{"rendered":"Customer Feedback Form"},"content":{"rendered":"\t\t\t<div data-block-id=\"07668135\" class=\"srfm-block-single srfm-block srfm-input-block srf-input-07668135-block  srfm-block-width-100 srfm-slug-customer-name 8624\" >\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-07668135-lbl-Q3VzdG9tZXIgTmFtZQ\" for=\"srfm-input-07668135-lbl-Q3VzdG9tZXIgTmFtZQ\" class=\"srfm-block-label\">\n\t\t\t\t\t\tCustomer Name\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"srfm-required\" aria-hidden=\"true\"> *<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-description\" id=\"srfm-description-07668135\">\n\t\t\t\t\t\tPlease enter your full name.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<input class=\"srfm-input-common srfm-input-input\" type=\"text\" name=\"srfm-input-07668135-lbl-Q3VzdG9tZXIgTmFtZQ-customer-name\" id=\"srfm-input-07668135-lbl-Q3VzdG9tZXIgTmFtZQ\"\n\t\t\t\t\taria-describedby='srfm-error-07668135 srfm-description-07668135'\t\t\t\t\tdata-required=\"true\" aria-required=\"true\" data-unique=\"false\" maxlength=\"100\" value=\"\"  data-srfm-mask=\"none\"   \/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-07668135\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"4cfd00a9\" class=\"srfm-block-single srfm-block srfm-email-block srf-email-4cfd00a9-block  srfm-block-width-100 srfm-slug-email-address 8624 srfm-email-block-wrap\">\n\t\t\t\t<div class=\"srfm-email-block srf-email-4cfd00a9-block\">\n\t\t\t\t\t\t\t\t\t\t<label id=\"srfm-label-4cfd00a9-lbl-RW1haWwgQWRkcmVzcw\" for=\"srfm-email-4cfd00a9-lbl-RW1haWwgQWRkcmVzcw\" class=\"srfm-block-label\">\n\t\t\t\t\t\tEmail Address\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"srfm-required\" aria-hidden=\"true\"> *<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-description\" id=\"srfm-description-4cfd00a9\">\n\t\t\t\t\t\tWe&#8217;ll use this to contact you if needed.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t\t\t<input class=\"srfm-input-common srfm-input-email\" type=\"email\" name=\"srfm-email-4cfd00a9-lbl-RW1haWwgQWRkcmVzcw-email-address\" id=\"srfm-email-4cfd00a9-lbl-RW1haWwgQWRkcmVzcw\"\n\t\t\t\t\t\taria-describedby='srfm-error-4cfd00a9 srfm-description-4cfd00a9'\t\t\t\t\t\tdata-required=\"true\" aria-required=\"true\" data-unique=\"false\" value=\"\"   \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-4cfd00a9\" data-error-msg=\"This field is required.\" data-unique-msg=\"Value needs to be unique.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\n\n\t\t\t<div data-block-id=\"dcef8c29\" class=\"srfm-block-single srfm-block srfm-dropdown-block srf-dropdown-dcef8c29-block  srfm-block-width-100 srfm-slug-product-service-used 8624\">\n\t\t\t\t<fieldset>\n\t\t\t\t\t<input class=\"srfm-input-dropdown-hidden\" data-required=\"true\" aria-required=\"true\"  name=\"srfm-dropdown-1-dcef8c29-lbl-UHJvZHVjdC9TZXJ2aWNlIFVzZWQ-product-service-used\" type=\"hidden\" value=\"\"\/>\n\t\t\t\t\t<legend class=\"srfm-block-legend\">\n\t\t\t\t\t\t\t\t\t\t\tProduct\/Service Used\t\t\t\t\t\t\t\t\t\t\t<span class=\"srfm-required\" aria-hidden=\"true\"> *<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-description\" id=\"srfm-description-dcef8c29\">\n\t\t\t\t\t\tSelect the product or service you used.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<\/legend>\n\t\t\t\t\t<div class=\"srfm-block-wrap srfm-dropdown-common-wrap\">\n\t\t\t\t\t\t\t\t\t\t<select\n\t\t\t\t\t\tclass=\"srfm-dropdown-common srfm-dropdown-input\"\n\t\t\t\t\t\taria-describedby='srfm-error-dcef8c29 srfm-description-dcef8c29'\t\t\t\tdata-required=\"true\" aria-required=\"true\"  name=\"srfm-dropdown-1-dcef8c29-lbl-UHJvZHVjdC9TZXJ2aWNlIFVzZWQ-product-service-used\" data-multiple=\"false\" data-searchable=\"true\"\n\t\t\t\t\t\t\t\t\t\t\t\ttabindex=\"0\" aria-hidden=\"true\">\n\t\t\t\t\t<option class=\"srfm-dropdown-placeholder\" value=\"\" disabled selected>Select an option<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"Product A\" data-icon=\"\"  >Product A<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"Product B\" data-icon=\"\"  >Product B<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"Service A\" data-icon=\"\"  >Service A<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"Service B\" data-icon=\"\"  >Service B<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/select>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-dcef8c29\" data-error-msg=\"This field is required.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/fieldset>\n\t\t\t<\/div>\n\t\t\n\n\t\t<div data-block-id=\"afd745cd\" class=\"srfm-block-single srfm-block srfm-textarea-block srf-textarea-afd745cd-block  srfm-block-width-100 8624\">\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-afd745cd-lbl-Q29tbWVudHM-7515\" for=\"srfm-textarea-afd745cd-lbl-Q29tbWVudHM-7515\" class=\"srfm-block-label\">\n\t\t\t\t\t\tComments\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"srfm-required\" aria-hidden=\"true\"> *<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-description\" id=\"srfm-description-afd745cd\">\n\t\t\t\t\t\tYour feedback is valuable to us. Share your thoughts!\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<textarea\n\t\t\t\t\tclass=\"srfm-input-common srfm-input-textarea\"\n\t\t\t\t\tname=\"srfm-textarea-afd745cd-lbl-Q29tbWVudHM-comments\"\n\t\t\t\t\tid=\"srfm-textarea-afd745cd-lbl-Q29tbWVudHM-7515\"\n\t\t\t\t\taria-describedby='srfm-error-afd745cd srfm-description-afd745cd'\t\t\t\t\tdata-required=\"true\" aria-required=\"true\"  rows=\"4\"  \t\t\t\t\t\t\t\t\t\t\t\t\t\t\t><\/textarea>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-afd745cd\" data-error-msg=\"This field is required.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t\n\n\t\t<div data-block-id=\"ab38691d\" class=\"srfm-block-single srfm-block srfm-multi-choice-block srf-multi-choice-ab38691d-block  srfm-block-width-100 srfm-slug-would-you-recommend-us 8624 srfm-radio-mode\">\n\t\t\t<fieldset>\n\t\t\t\t<input class=\"srfm-input-multi-choice-hidden\" data-required=\"true\" aria-required=\"true\"  name=\"srfm-input-multi-choice-ab38691d-lbl-V291bGQgeW91IHJlY29tbWVuZCB1cz8-would-you-recommend-us\" type=\"hidden\" value=\"\"\/>\n\t\t\t\t<legend class=\"srfm-block-legend\">\n\t\t\t\t\t\t\t\t\t\tWould you recommend us?\t\t\t\t\t\t\t\t\t\t\t<span class=\"srfm-required\" aria-hidden=\"true\"> *<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/legend>\n\t\t\t\t\t\t\t\t\t<div class=\"srfm-description\" id=\"srfm-description-ab38691d\">\n\t\t\t\t\t\tLet us know your recommendation status.\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap srfm-choice-width-50 \">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-multi-choice-single\">\n\t\t\t\t\t\t\t\t\t<input type=\"radio\"\n\t\t\t\t\t\t\t\t\t\tid=\"srfm-multi-choice-ab38691d-0\"\n\t\t\t\t\t\t\t\t\t\tclass=\"srfm-input-multi-choice-single\" name=\"srfm-input-multi-choice-ab38691d\"\t\t\t\t\t\t\t\t\t\taria-describedby=\"srfm-error-ab38691d srfm-description-ab38691d\"\t\t\t\t\t\t\t\t\t\taria-required=\"true\"\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-content-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-option-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<!-- This label content is used in conditional logic and for storing values in a hidden input field as comma-separated values.\n\t\t\t\t\t\t\t\t\t\t\tThe markup should remain unchanged.\n\t\t\t\t\t\t\t\t\t\t\tIf you make any changes here, ensure the corresponding JavaScript value functionality and conditional logic are also updated. -->\n\t\t\t\t\t\t\t\t\t\t\t<label for=\"srfm-multi-choice-ab38691d-0\" data-option-text=\"Yes\">Yes<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-icon-container\">\t\t<span class=\"srfm-icon srfm-multi-choice-icon\" aria-hidden=\"true\">\n\t\t\t<svg width='17' height='16' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'><path d='M15.1663 7.38674V8.00007C15.1655 9.43769 14.7 10.8365 13.8392 11.988C12.9785 13.1394 11.7685 13.9817 10.3899 14.3893C9.0113 14.797 7.53785 14.748 6.18932 14.2498C4.8408 13.7516 3.68944 12.8308 2.90698 11.6248C2.12452 10.4188 1.75287 8.99211 1.84746 7.55761C1.94205 6.12312 2.49781 4.75762 3.43186 3.66479C4.36591 2.57195 5.6282 1.81033 7.03047 1.4935C8.43274 1.17668 9.89985 1.32163 11.213 1.90674' stroke='#111C44' stroke-width='1.25' stroke-linecap='round' stroke-linejoin='round' \/><path d='M15.1667 2.6665L8.5 9.33984L6.5 7.33984' stroke='#111C44' stroke-width='1.25' stroke-linecap='round' stroke-linejoin='round' \/><\/svg>\t\t<\/span>\n\t\t\t\t<span class=\"srfm-icon srfm-multi-choice-icon-unchecked\" aria-hidden=\"true\">\n\t\t\t<svg width='16' height='16' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'><path d='M7.99967 14.6668C11.6816 14.6668 14.6663 11.6821 14.6663 8.00016C14.6663 4.31826 11.6816 1.3335 7.99967 1.3335C4.31778 1.3335 1.33301 4.31826 1.33301 8.00016C1.33301 11.6821 4.31778 14.6668 7.99967 14.6668Z' stroke='#1E1E1E' stroke-opacity='0.7' stroke-width='1.25' stroke-linecap='round' stroke-linejoin='round' \/><\/svg>\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-multi-choice-single\">\n\t\t\t\t\t\t\t\t\t<input type=\"radio\"\n\t\t\t\t\t\t\t\t\t\tid=\"srfm-multi-choice-ab38691d-1\"\n\t\t\t\t\t\t\t\t\t\tclass=\"srfm-input-multi-choice-single\" name=\"srfm-input-multi-choice-ab38691d\"\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t\t<div class=\"srfm-block-content-wrap\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-option-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<!-- This label content is used in conditional logic and for storing values in a hidden input field as comma-separated values.\n\t\t\t\t\t\t\t\t\t\t\tThe markup should remain unchanged.\n\t\t\t\t\t\t\t\t\t\t\tIf you make any changes here, ensure the corresponding JavaScript value functionality and conditional logic are also updated. -->\n\t\t\t\t\t\t\t\t\t\t\t<label for=\"srfm-multi-choice-ab38691d-1\" data-option-text=\"No\">No<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-icon-container\">\t\t<span class=\"srfm-icon srfm-multi-choice-icon\" aria-hidden=\"true\">\n\t\t\t<svg width='17' height='16' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'><path d='M15.1663 7.38674V8.00007C15.1655 9.43769 14.7 10.8365 13.8392 11.988C12.9785 13.1394 11.7685 13.9817 10.3899 14.3893C9.0113 14.797 7.53785 14.748 6.18932 14.2498C4.8408 13.7516 3.68944 12.8308 2.90698 11.6248C2.12452 10.4188 1.75287 8.99211 1.84746 7.55761C1.94205 6.12312 2.49781 4.75762 3.43186 3.66479C4.36591 2.57195 5.6282 1.81033 7.03047 1.4935C8.43274 1.17668 9.89985 1.32163 11.213 1.90674' stroke='#111C44' stroke-width='1.25' stroke-linecap='round' stroke-linejoin='round' \/><path d='M15.1667 2.6665L8.5 9.33984L6.5 7.33984' stroke='#111C44' stroke-width='1.25' stroke-linecap='round' stroke-linejoin='round' \/><\/svg>\t\t<\/span>\n\t\t\t\t<span class=\"srfm-icon srfm-multi-choice-icon-unchecked\" aria-hidden=\"true\">\n\t\t\t<svg width='16' height='16' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'><path d='M7.99967 14.6668C11.6816 14.6668 14.6663 11.6821 14.6663 8.00016C14.6663 4.31826 11.6816 1.3335 7.99967 1.3335C4.31778 1.3335 1.33301 4.31826 1.33301 8.00016C1.33301 11.6821 4.31778 14.6668 7.99967 14.6668Z' stroke='#1E1E1E' stroke-opacity='0.7' stroke-width='1.25' stroke-linecap='round' stroke-linejoin='round' \/><\/svg>\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"srfm-error-wrap\">\t\t\t\t\t<div class=\"srfm-error-message\" data-srfm-id=\"srfm-error-ab38691d\" data-error-msg=\"This field is required.\">\n\t\t\t\t\t\tThis field is required.\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t<\/div>\n\t\t\n\n\t\t<div data-block-id=\"992257bc\" class=\"srfm-block-single srfm-block srfm-textarea-block srf-textarea-992257bc-block  srfm-block-width-100 8624\">\n\t\t\t\t\t\t\t\t<label id=\"srfm-label-992257bc-lbl-QWRkaXRpb25hbCBTdWdnZXN0aW9ucw-9937\" for=\"srfm-textarea-992257bc-lbl-QWRkaXRpb25hbCBTdWdnZXN0aW9ucw-9937\" class=\"srfm-block-label\">\n\t\t\t\t\t\tAdditional Suggestions\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"srfm-description\" id=\"srfm-description-992257bc\">\n\t\t\t\t\t\tAny suggestions for improvement?\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"srfm-block-wrap\">\n\t\t\t\t<textarea\n\t\t\t\t\tclass=\"srfm-input-common srfm-input-textarea\"\n\t\t\t\t\tname=\"srfm-textarea-992257bc-lbl-QWRkaXRpb25hbCBTdWdnZXN0aW9ucw-additional-suggestions\"\n\t\t\t\t\tid=\"srfm-textarea-992257bc-lbl-QWRkaXRpb25hbCBTdWdnZXN0aW9ucw-9937\"\n\t\t\t\t\taria-describedby='srfm-error-992257bc srfm-description-992257bc'\t\t\t\t\tdata-required=\"false\" aria-required=\"false\"  rows=\"4\"  \t\t\t\t\t\t\t\t\t\t\t\t\t\t\t><\/textarea>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t<div class=\"srfm-error-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t","protected":false},"author":1,"template":"","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center 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