A support ticket form with priority levels and troubleshooting context.
Exactly what visitors will see on your site
Every field in this template, ready to use out of the box.
Name
text · required
email · required
Subject
text · required
Priority
select · required
Description
textarea · required
Steps Already Tried
textarea · optional
Choose HTML for static sites or React for component-based apps. Replace YOUR_FORM_ID with your Flowqen endpoint ID.
<formaction="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>
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.
Common questions about request form templates.
Other free templates in the same category.
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