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Request6 fields

Support Request

A support ticket form with priority levels and troubleshooting context.

Spam protectionEmail notificationsAI sales agentSubmission dashboardNo backend needed

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Exactly what visitors will see on your site

Support Request

What you'll collect

Every field in this template, ready to use out of the box.

Name

text · required

Email

email · required

Subject

text · required

Priority

select · required

Description

textarea · required

Steps Already Tried

textarea · optional

Copy the Code

Choose HTML for static sites or React for component-based apps. Replace YOUR_FORM_ID with your Flowqen endpoint ID.

<form
action="https://flowqen.com/api/f/YOUR_FORM_ID"
method="POST"
class="max-w-xl mx-auto rounded-[32px] border border-white/10 bg-[#1f1a17] px-6 py-7 shadow-[0_28px_90px_rgba(23,16,12,0.28)] sm:px-8"
>
<h2 class="text-2xl font-semibold tracking-tight text-white mb-6">Support Request</h2>
<div class="space-y-4">
<div>
<label class="mb-1.5 block text-sm font-medium text-stone-200">Name</label>
<input type="text" name="name" class="w-full rounded-[20px] border border-white/10 bg-white/5 px-4 py-3 text-sm text-white outline-none transition placeholder:text-stone-400 focus:border-[#ff8a6c] focus:ring-4 focus:ring-[#E14E3A]/18" placeholder="Jane Doe" required />
</div>
<div>
<label class="mb-1.5 block text-sm font-medium text-stone-200">Email</label>
<input type="email" name="email" class="w-full rounded-[20px] border border-white/10 bg-white/5 px-4 py-3 text-sm text-white outline-none transition placeholder:text-stone-400 focus:border-[#ff8a6c] focus:ring-4 focus:ring-[#E14E3A]/18" placeholder="jane@example.com" required />
</div>
<div>
<label class="mb-1.5 block text-sm font-medium text-stone-200">Subject</label>
<input type="text" name="subject" class="w-full rounded-[20px] border border-white/10 bg-white/5 px-4 py-3 text-sm text-white outline-none transition placeholder:text-stone-400 focus:border-[#ff8a6c] focus:ring-4 focus:ring-[#E14E3A]/18" placeholder="Brief description of your issue" required />
</div>
<div>
<label class="mb-1.5 block text-sm font-medium text-stone-200">Priority</label>
<select name="priority" class="w-full rounded-[20px] border border-white/10 bg-white/5 px-4 py-3 text-sm text-white outline-none transition focus:border-[#ff8a6c] focus:ring-4 focus:ring-[#E14E3A]/18" required>
<option value="">Select...</option>
<option value="Low">Low</option>
<option value="Medium">Medium</option>
<option value="High">High</option>
<option value="Urgent">Urgent</option>
</select>
</div>
<div>
<label class="mb-1.5 block text-sm font-medium text-stone-200">Description</label>
<textarea name="description" rows="4" class="w-full rounded-[20px] border border-white/10 bg-white/5 px-4 py-3 text-sm text-white outline-none transition placeholder:text-stone-400 focus:border-[#ff8a6c] focus:ring-4 focus:ring-[#E14E3A]/18 resize-none" placeholder="Describe the issue in detail..." required></textarea>
</div>
<div>
<label class="mb-1.5 block text-sm font-medium text-stone-200">Steps Already Tried</label>
<textarea name="steps_tried" rows="4" class="w-full rounded-[20px] border border-white/10 bg-white/5 px-4 py-3 text-sm text-white outline-none transition placeholder:text-stone-400 focus:border-[#ff8a6c] focus:ring-4 focus:ring-[#E14E3A]/18 resize-none" placeholder="What have you tried so far?"></textarea>
</div>
</div>
<!-- Honeypot (spam protection) -->
<div style="display:none">
<input type="text" name="_gotcha" style="display:none" />
</div>
<button type="submit" class="mt-6 w-full rounded-[20px] bg-white py-3 text-sm font-semibold text-[#201814] transition hover:bg-stone-100">
Submit Request
</button>
</form>

What is a Support Request?

A support request form template gives your customers a structured way to submit help tickets. With priority levels, detailed descriptions, and a field for steps already tried, this HTML form helps your support team respond faster and with better context. Essential for any product or service with customer support.

Frequently Asked Questions

Common questions about request form templates.

Start with this Support Request

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