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index.html
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>Survey Form</title>
<link rel="shortcut icon" href="favicon.ico" type="image/x-icon">
<link
href="https://cdn.jsdelivr.net/npm/bootstrap@5.1.3/dist/css/bootstrap.min.css"
rel="stylesheet"
integrity="sha384-1BmE4kWBq78iYhFldvKuhfTAU6auU8tT94WrHftjDbrCEXSU1oBoqyl2QvZ6jIW3"
crossorigin="anonymous">
<style>
.rating input {
display: none;
}
.rating label {
color: red
}
.rating input:checked+label~label {
color: lightslategrey
}
thead {
text-align: center;
}
td {
text-align: center;
}
</style>
</head>
<body>
<div class="container">
<div class="container-fluid mt-3">
<form>
<div class="row g-3 col-md-6 col-sm-12 ">
<div class="col">
<label for="First name"
class="form-label fs-5 fw-bold">First
Name<span style="color:red">*</span></label>
<input type="text" class="form-control "
aria-label="First name" id="First name"
placeholder="Enter First Name" required>
<span>first</span>
</div>
<div class="col">
<label for="Last name"
class="form-label fs-5 fw-bold">Last
Name<span style="color:red">*</span></label>
<input type="text" class="form-control"
aria-label="First name" id="Last name"
placeholder="Enter Last Name" required>
<span>last</span>
</div>
</div>
<div class="mb-3 mt-3 col-md-6 col-sm-12 ">
<label for="email"
class="form-label fs-5 fw-bold">Email<span
style="color:red">*</span></label>
<input type="email" class="form-control " id="email"
placeholder="Enter Email" name="email" required>
</div>
<div class=" mb-3 mt-3">
<span class="fs-5 fw-bold">Your Experience<span
style="color:red">*</span></span>
<div class="rating">
<input type="radio" name="rating1" id="rating1">
<label for="rating1">
<svg xmlns="http://www.w3.org/2000/svg"
width="20"
height="20" fill="currentColor"
class="bi bi-star-fill" viewBox="0 0 16 16">
<path
d="M3.612 15.443c-.386.198-.824-.149-.746-.592l.83-4.73L.173 6.765c-.329-.314-.158-.888.283-.95l4.898-.696L7.538.792c.197-.39.73-.39.927 0l2.184 4.327 4.898.696c.441.062.612.636.282.95l-3.522 3.356.83 4.73c.078.443-.36.79-.746.592L8 13.187l-4.389 2.256z" />
</svg>
</label>
<input type="radio" name="rating1" id="rating2">
<label for="rating2">
<svg xmlns="http://www.w3.org/2000/svg"
width="20"
height="20" fill="currentColor"
class="bi bi-star-fill" viewBox="0 0 16 16">
<path
d="M3.612 15.443c-.386.198-.824-.149-.746-.592l.83-4.73L.173 6.765c-.329-.314-.158-.888.283-.95l4.898-.696L7.538.792c.197-.39.73-.39.927 0l2.184 4.327 4.898.696c.441.062.612.636.282.95l-3.522 3.356.83 4.73c.078.443-.36.79-.746.592L8 13.187l-4.389 2.256z" />
</svg>
</label>
<input type="radio" name="rating1" id="rating3">
<label for="rating3">
<svg xmlns="http://www.w3.org/2000/svg"
width="20"
height="20" fill="currentColor"
class="bi bi-star-fill" viewBox="0 0 16 16">
<path
d="M3.612 15.443c-.386.198-.824-.149-.746-.592l.83-4.73L.173 6.765c-.329-.314-.158-.888.283-.95l4.898-.696L7.538.792c.197-.39.73-.39.927 0l2.184 4.327 4.898.696c.441.062.612.636.282.95l-3.522 3.356.83 4.73c.078.443-.36.79-.746.592L8 13.187l-4.389 2.256z" />
</svg>
</label>
<input type="radio" name="rating1" id="rating4">
<label for="rating4">
<svg xmlns="http://www.w3.org/2000/svg"
width="20"
height="20" fill="currentColor"
class="bi bi-star-fill" viewBox="0 0 16 16">
<path
d="M3.612 15.443c-.386.198-.824-.149-.746-.592l.83-4.73L.173 6.765c-.329-.314-.158-.888.283-.95l4.898-.696L7.538.792c.197-.39.73-.39.927 0l2.184 4.327 4.898.696c.441.062.612.636.282.95l-3.522 3.356.83 4.73c.078.443-.36.79-.746.592L8 13.187l-4.389 2.256z" />
</svg>
</label>
<input type="radio" name="rating1" id="rating5">
<label for="rating5">
<svg xmlns="http://www.w3.org/2000/svg"
width="20"
height="20" fill="currentColor"
class="bi bi-star-fill" viewBox="0 0 16 16">
<path
d="M3.612 15.443c-.386.198-.824-.149-.746-.592l.83-4.73L.173 6.765c-.329-.314-.158-.888.283-.95l4.898-.696L7.538.792c.197-.39.73-.39.927 0l2.184 4.327 4.898.696c.441.062.612.636.282.95l-3.522 3.356.83 4.73c.078.443-.36.79-.746.592L8 13.187l-4.389 2.256z" />
</svg>
</label>
</div>
</div>
<div class="mt-3">
<span> Overall,how would you rate your experience with
us?</span><br>
<span><b>How satisfied are you with<span
style="color:red">*</span></b></span>
<table class="table table-striped table-responsive-sm">
<thead>
<tr>
<th scope="col "> </th>
<th scope="col ">Very Unsatisfied</th>
<th scope="col ">Unsatisfied</th>
<th scope="col">Neutral</th>
<th scope="col">Satisfied</th>
<th scope="col">Very Satisfied</th>
</tr>
</thead>
<tbody>
<tr>
<th scope="row">Purchase</th>
<td><input type="radio" name="1" id></td>
<td><input type="radio" name="1" id></td>
<td><input type="radio" name="1" id></td>
<td><input type="radio" name="1" id></td>
<td><input type="radio" name="1" id></td>
</tr>
<tr>
<th scope="row">Service</th>
<td><input type="radio" name="2" id></td>
<td><input type="radio" name="2" id></td>
<td><input type="radio" name="2" id></td>
<td><input type="radio" name="2" id></td>
<td><input type="radio" name="2" id></td>
</tr>
<tr>
<th scope="row">Company Overall</th>
<td><input type="radio" name="3" id></td>
<td><input type="radio" name="3" id></td>
<td><input type="radio" name="3" id></td>
<td><input type="radio" name="3" id></td>
<td><input type="radio" name="3" id></td>
</tr>
</tbody>
</table>
</div>
<div class="mt-3">
<span><b>How likely are you to<span
style="color:red">*</span></b></span>
<table class="table table-striped table-responsive-sm">
<thead>
<tr>
<th scope="col "></th>
<th scope="col ">Very Unlikely</th>
<th scope="col ">Unlikely</th>
<th scope="col">Neutral</th>
<th scope="col">Likely</th>
<th scope="col">Very Likely</th>
</tr>
</thead>
<tbody>
<tr>
<th scope="row">Buy from us again</th>
<td><input type="radio" name="4" id></td>
<td><input type="radio" name="4" id></td>
<td><input type="radio" name="4" id></td>
<td><input type="radio" name="4" id></td>
<td><input type="radio" name="4" id></td>
</tr>
<tr>
<th scope="row">Recommend our products to
others</th>
<td><input type="radio" name="5" id></td>
<td><input type="radio" name="5" id></td>
<td><input type="radio" name="5" id></td>
<td><input type="radio" name="5" id></td>
<td><input type="radio" name="5" id></td>
</tr>
<tr>
<th scope="row">Recommend our company to
others</th>
<td><input type="radio" name="6" id></td>
<td><input type="radio" name="6" id></td>
<td><input type="radio" name="6" id></td>
<td><input type="radio" name="6" id></td>
<td><input type="radio" name="6" id></td>
</tr>
</tbody>
</table>
</div>
<div class="form-group mb-3 mt-3 fs-6 fw-bold">
<label for="comment">Additional comments or
Suggestions</label>
<textarea class="form-control" rows="6"
id="comment"></textarea>
</div>
<button type="submit"
class="btn btn-primary">Submit</button>
</form>
</div>
</div>
</body>
</html>