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Twitter Boostrap feedback Form
<style>
#feedback {
float: left;
position: fixed;
top: calc(50% - 47px);
right: 0;
}
#feedback a {
background: #FF4500;
border-radius: 5px 0 0 5px;
box-shadow: 0 0 3px rgba(0, 0, 0, .3);
border: 3px solid #fff;
border-right: 0;
display: block;
padding: 20px 12px;
transition: all .2s ease-in-out;
}
#feedback a:hover {
padding-right: 20px;
}
</style>
<div class="modal fade" id="feedback-modal" tabindex="-1" role="dialog" aria-labelledby="myModalLabel"
aria-hidden="true">
<div class="modal-dialog">
<div class="modal-content">
<form action="/feedback/send" id="feedback-form">
<div class="modal-header">
<button type="button" class="close" data-dismiss="modal" aria-label="Close"><span
aria-hidden="true">&times;</span></button>
<h4 class="modal-title">Submit your feedback to us</h4>
<small>Share your feedback with us! We're listening and ready to improve Testomato.</small>
</div>
<div class="modal-body">
<label for="feedback-email" class="label-control">Email</label>
<input type="email" class="form-control" name="feedback_email" id="feedback-email" value=""/>
<span class="help-block">If you don't want response from us leave email blank.</span>
<textarea name="feedback-message" id="feedback_message" cols="30" rows="10"
placeholder="Share your thoughts..." required="required" class="form-control"></textarea>
<script type="text/javascript">/* <![CDATA[ */
document.write('<input type="hidden" name="feedback_captcha" id="feedback-captcha" value="P' + 'r' + 'a' + 'g' + 'u' + 'e" />');
/* ]]> */
</script>
<noscript>
<label for="feedback-captcha" class="label-control">Are you human? Write "<em>Prague</em>"</label>
<input type="text" name="feedback_captcha" id="feedback-captcha" value="" class="form-control"/>
</noscript>
<div class="feedback-alerts"></div>
</div>
<div class="modal-footer">
<button type="reset" class="btn btn-default" data-dismiss="modal">Close</button>
<button type="submit" class="btn btn-primary">Submit!</button>
</div>
</form>
</div>
<!-- /.modal-content -->
</div>
<!-- /.modal-dialog -->
</div><!-- /.modal -->
<div id="feedback">
<a href="#" data-toggle="modal" data-target="#feedback-modal">
<img src="data:image/svg+xml;base64,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"
alt="Feedback" title="Feedback Button" height="70px"/>
</a>
</div>
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