html-change-request-form.html

<div class="main-container">
    <!-- Author: FormBold Team -->
    <!-- Learn More: https://formbold.com -->
    <div class="form-wrapper">
        <img
            src="https://ucarecdn.com/8280195b-127b-4a46-9a6f-2910f9576521/changerequest.png"
            alt="Change Request Form Illustration"
            class="form-image"
        />

        <form
            action="https://formbold.com/s/FORM_ID"
            method="POST"
            enctype="multipart/form-data"
        >
            <!-- Title and Description -->
            <div class="form-header">
                <h2 class="form-title">Change Request Form</h2>
                <p class="form-description">
                    Please provide the details for your change request. All
                    required fields are marked with *.
                </p>
            </div>

            <!-- Requester Information -->
            <div class="form-group">
                <label for="fullname" class="form-label">Full Name*</label>
                <input
                    type="text"
                    name="fullname"
                    id="fullname"
                    class="form-input"
                    required
                />
            </div>

            <div class="form-group">
                <label for="email" class="form-label">Email Address*</label>
                <input
                    type="email"
                    name="email"
                    id="email"
                    class="form-input"
                    required
                />
            </div>

            <div class="form-group">
                <label for="department" class="form-label"
                    >Department / Team*</label
                >
                <input
                    type="text"
                    name="department"
                    id="department"
                    class="form-input"
                    required
                />
            </div>

            <!-- Request Type -->
            <div class="form-group">
                <label for="request-type" class="form-label"
                    >Request Type*</label
                >
                <select
                    name="request-type"
                    id="request-type"
                    class="form-select"
                    required
                >
                    <option value="sample-request">Sample Request</option>
                    <option value="change-request">Change Request</option>
                    <option value="data-update">Data Update</option>
                    <option value="document-access">Document Access</option>
                    <option value="technical-issue">Technical Issue</option>
                    <option value="other">Other</option>
                </select>
            </div>

            <!-- Request Details -->
            <div class="form-group">
                <label for="subject" class="form-label"
                    >Subject / Title of Request*</label
                >
                <input
                    type="text"
                    name="subject"
                    id="subject"
                    class="form-input"
                    required
                />
            </div>

            <div class="form-group">
                <label for="description" class="form-label">Description*</label>
                <textarea
                    name="description"
                    id="description"
                    rows="5"
                    class="form-textarea"
                    required
                ></textarea>
            </div>

            <div class="form-group">
                <label for="priority" class="form-label">Priority Level*</label>
                <select
                    name="priority"
                    id="priority"
                    class="form-select"
                    required
                >
                    <option value="low">Low</option>
                    <option value="medium">Medium</option>
                    <option value="high">High</option>
                </select>
            </div>

            <!-- Timeline -->
            <div class="form-group">
                <label for="completion-date" class="form-label"
                    >Preferred Completion Date (Optional)</label
                >
                <input
                    type="date"
                    name="completion-date"
                    id="completion-date"
                    class="form-input"
                />
            </div>

            <!-- Attachments -->
            <div class="form-group">
                <label for="attachments" class="form-label"
                    >Upload Supporting Files</label
                >
                <input
                    type="file"
                    name="attachments"
                    id="attachments"
                    accept=".pdf,.jpg,.jpeg,.png,.docx"
                    class="form-input"
                />
            </div>

            <!-- Acknowledgment / Consent -->
            <div class="consent-group">
                <input
                    type="checkbox"
                    id="acknowledgment"
                    class="form-checkbox"
                    required
                />
                <label for="acknowledgment" class="consent-label">
                    I confirm the above information is accurate and required for
                    official processing.
                </label>
            </div>

            <!-- Submit Button -->
            <button type="submit" class="submit-btn">Submit Request</button>
        </form>
    </div>
</div>
<style>
    /* General Body and Font Styles */
    body {
        font-family: "Inter", sans-serif;
        background-color: #f3f4f6;
        margin: 0;
    }

    /* Main container for centering the form */
    .main-container {
        display: flex;
        align-items: center;
        justify-content: center;
        padding: 3rem 1rem;
        min-height: 100vh;
        box-sizing: border-box;
    }

    /* Form wrapper/card */
    .form-wrapper {
        width: 100%;
        max-width: 42rem; /* max-w-2xl */
        border-radius: 0.5rem; /* rounded-lg */
        background-color: white;
        padding: 2.5rem; /* p-10 */
        box-shadow: 0 10px 15px -3px rgba(0, 0, 0, 0.1),
            0 4px 6px -4px rgba(0, 0, 0, 0.1);
        box-sizing: border-box;
    }

    /* Top image styling */
    .form-image {
        margin-bottom: 3rem; /* mb-12 */
        width: 100%;
        border-radius: 0.5rem;
    }

    /* Header section for title and description */
    .form-header {
        margin-bottom: 2rem; /* mb-8 */
        text-align: center;
    }

    .form-title {
        font-size: 1.875rem; /* text-2xl */
        font-weight: 600; /* font-semibold */
        color: #1f2937; /* text-gray-800 */
    }

    .form-description {
        margin-top: 0.5rem; /* mt-2 */
        font-size: 0.875rem; /* text-sm */
        color: #4b5563; /* text-gray-600 */
        line-height: 1.5;
    }

    /* Container for each form field group */
    .form-group {
        margin-bottom: 1.5rem; /* mb-6 */
    }

    /* Form labels */
    .form-label {
        display: block;
        margin-bottom: 0.5rem; /* mb-2 */
        font-size: 0.875rem; /* text-sm */
        font-weight: 500; /* font-medium */
        color: #4b5563; /* text-gray-600 */
    }

    /* Common styles for input, select, and textarea */
    .form-input,
    .form-select,
    .form-textarea {
        width: 100%;
        border-radius: 0.375rem; /* rounded-md */
        border: 1px solid #d1d5db; /* border-gray-300 */
        padding: 0.75rem; /* p-3 */
        font-size: 0.875rem; /* text-sm */
        color: #1f2937; /* text-gray-800 */
        box-sizing: border-box;
        transition: border-color 0.2s, box-shadow 0.2s;
    }

    .form-input:focus,
    .form-select:focus,
    .form-textarea:focus {
        border-color: #6366f1; /* focus:border-indigo-500 */
        box-shadow: 0 0 0 1px #6366f1; /* focus:ring-1 focus:ring-indigo-500 */
        outline: none;
    }

    /* Consent Checkbox Group */
    .consent-group {
        display: flex;
        align-items: center;
        margin-bottom: 1.5rem;
    }

    .form-checkbox {
        height: 1rem;
        width: 1rem;
        color: #4f46e5;
    }

    .consent-label {
        margin-left: 0.5rem;
        font-size: 0.875rem;
        color: #4b5563;
    }

    /* Submit Button */
    .submit-btn {
        width: 100%;
        border-radius: 0.375rem;
        background-color: #4f46e5;
        padding: 0.75rem 1.5rem;
        font-weight: 500;
        color: white;
        border: none;
        cursor: pointer;
        transition: background-color 0.3s, box-shadow 0.3s;
    }

    .submit-btn:hover {
        background-color: #4338ca;
    }

    .submit-btn:focus {
        outline: none;
        box-shadow: 0 0 0 3px rgba(99, 102, 241, 0.5);
    }

    /* Mobile Responsive Styles */
    @media (max-width: 640px) {
        .main-container {
            padding: 1rem;
        }
        .form-wrapper {
            padding: 1.5rem;
        }
        .form-title {
            font-size: 1.5rem;
        }
    }
</style>