Customer Feedback Form

{“id”:137,”field_id”:9,”fields”:{“1”:{“id”:”1″,”type”:”name”,”label”:”Name”,”format”:”first-last”,”description”:””,”required”:”1″,”size”:”medium”,”simple_placeholder”:””,”simple_default”:””,”first_placeholder”:””,”first_default”:””,”middle_placeholder”:””,”middle_default”:””,”last_placeholder”:””,”last_default”:””,”css”:””},”2″:{“id”:”2″,”type”:”email”,”label”:”Email”,”description”:””,”required”:”1″,”size”:”medium”,”placeholder”:””,”confirmation_placeholder”:””,”default_value”:””,”css”:””},”3″:{“id”:”3″,”type”:”radio”,”label”:”On a scale of 1 to 5, how would you rate your experience with our product / service?”,”choices”:{“1”:{“label”:”1 (poor)”,”value”:”1″},”2″:{“label”:”2 (mediocre)”,”value”:”2″},”3″:{“label”:”3 (average)”,”value”:”3″},”4″:{“label”:”4 (fair)”,”value”:”4″},”5″:{“label”:”5 (excellent)”,”value”:”5″}},”description”:””,”show_values”:”1″,”input_columns”:””,”css”:””,”dynamic_choices”:””},”4″:{“id”:”4″,”type”:”radio”,”label”:”How likely are you to recommend our product / service to people you know?”,”choices”:{“1”:{“label”:”Likely”,”value”:”Likely”},”2″:{“label”:”Somewhat Likely”,”value”:”Somewhat Likely”},”3″:{“label”:”Somewhat Unlikely”,”value”:”Somewhat Unlikely”},”4″:{“label”:”Unlikely”,”value”:”Unlikely”}},”description”:””,”show_values”:”1″,”input_columns”:””,”css”:””,”dynamic_choices”:””},”5″:{“id”:”5″,”type”:”radio”,”label”:”Would you use our product / service in the future?”,”choices”:{“1”:{“label”:”Yes”,”value”:”Yes”},”2″:{“label”:”No”,”value”:”No”}},”description”:””,”show_values”:”1″,”input_columns”:””,”css”:””,”dynamic_choices”:””},”6″:{“id”:”6″,”type”:”select”,”label”:”How long have you used our product / service?”,”choices”:{“1”:{“label”:”Select…”,”value”:””},”6″:{“label”:”Less than a month”,”value”:”Less than a month”},”2″:{“label”:”1 Month – 11 Months”,”value”:”1 Month – 11 Months”},”3″:{“label”:”1 Year – 2 Years”,”value”:”1 Year – 2 Years”},”5″:{“label”:”3 Years – 5 Years”,”value”:”3 Years – 5 Years”},”4″:{“label”:”Over 5 Years”,”value”:”Over 5 Years”}},”description”:””,”show_values”:”1″,”size”:”medium”,”placeholder”:””,”css”:””,”dynamic_choices”:””},”7″:{“id”:”7″,”type”:”textarea”,”label”:”Please tell us what you liked or disliked about our product / service”,”description”:””,”size”:”medium”,”placeholder”:””,”css”:””},”8″:{“id”:”8″,”type”:”textarea”,”label”:”Additional Comments”,”description”:””,”size”:”medium”,”placeholder”:””,”css”:””}},”settings”:{“form_title”:”Customer Feedback Form”,”form_desc”:””,”form_class”:””,”submit_text”:”Submit”,”submit_text_processing”:”Sending…”,”submit_class”:””,”honeypot”:”1″,”notification_enable”:”1″,”notifications”:{“1”:{“email”:”{admin_email}”,”subject”:”Customer Feedback Form submission”,”sender_name”:””,”sender_address”:”{admin_email}”,”replyto”:””,”message”:”{all_fields}”}},”confirmation_type”:”message”,”confirmation_message”:”Thank you for getting in touch with us! We will try our best to respond back to you within 24 hours.“,”confirmation_message_scroll”:”1″,”confirmation_page”:”72532″,”confirmation_redirect”:””},”meta”:{“template”:”blank”}}