consumerportal/views/help/contactus.html

mydna Custimised for you

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  ga('create', 'UA-69139205-6', 'auto');
  ga('set', {
  page: '/help/contactus.html',
  title: 'Contact Us'
	});
  ga('send', 'pageview');

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<div class="container">
	<div class="row">
		<div class="col-md-12">
			<div class='content_block content_blocks_padding'>
				
				<h1>Contact Us</h1>

				<div class="alert alert-danger"	ng-show="vm.showErrors && myForm.$invalid"	>
					<p>Please correct the highlighted fields.</p>
				</div>

				<div class="alert alert-info" ng-show="vm.showErrors && myForm.$valid"	>
					<p>All issues have been resolved.</p>
				</div>
				<div class="alert alert-success" ng-show="vm.sentSuccesfully"	>
					<p>Your request has been successfully sent. We will be in touch soon.</p>
				</div>
				
				<form name="myForm" class="form-horizontal" autocomplete="off" ng-submit="" novalidate="">
					<div class="form-group">
						<label class="control-label col-sm-2" for="FirstName">From</label>
						<div class="col-sm-10">
							<p class="form-control-static">{{vm.frm.FirstName}} {{vm.frm.LastName}}</p>
							<input						
								type="hidden" class="medium" 
								id="FirstName" name="FirstName"	
								ng-model="vm.frm.FirstName" ng-value="vm.frm.FirstName"
								ng-disabled="true" ng-required="true"
							/>
							<input						
								type="hidden" class="medium" 
								id="LastName" name="LastName"	
								ng-model="vm.frm.LastName" ng-value="vm.frm.LastName"
								ng-disabled="true" ng-required="true"
							/>
						</div>
					</div>			
				
					<div class="form-group">
						<label class="control-label col-sm-2" for="PhoneNumber">Phone/Mobile</label>
						<div class="col-sm-10">
							<input 							
								type="text" class="form-control"
								name="PhoneNumber" id="PhoneNumber" placeholder="Phone Number"
								ui-mask="(99) 9999 9999" ui-mask-placeholder ui-mask-placeholder-char="_"
								ng-model="vm.frm.PhoneNumber"	
								mydna-validator="phone"
								ng-required="true"
								ng-class="{'error-branch' : vm.showErrors && myForm.PhoneNumber.$invalid}"		
							/>							
							<div class="errorWrap">
								<div ng-messages="myForm.PhoneNumber.$error" ng-show="vm.showErrors&&myForm.PhoneNumber.$invalid">
									<div ng-message="mydnaValidator">Please enter a valid Phone Number</div>
									<div ng-message="required">Please enter a valid Phone Number</div>
								</div>
							</div>
						</div>
					</div>

					<div class="form-group">
						<label class="control-label col-sm-2" for="Email">Email</label>
						<div class="col-sm-10">
							<input 
								type="text" class="form-control"
								id="Email" name="Email" 						
								ng-required="true" placeholder="Email" 
								ng-model="vm.frm.Email"
								mydna-validator="email"
								ng-class="{'error-branch' : vm.showErrors && myForm.Email.$invalid}"	
							/>
							<div class="errorWrap">	
								<div ng-messages="myForm.Email.$error" ng-show="vm.showErrors&& myForm.Email.$invalid">
									<div ng-message="mydnaValidator">Please enter a valid Email</div>
								</div>	
							</div>
						</div>
					</div>

					<div class="form-group">
						<label class="control-label col-sm-2" for="Message">Message</label>
						<div class="col-sm-10">
							<textarea class="form-control" rows="5" id="Message" name="Message" 						
								ng-required="true" placeholder="Message"
								ng-model="vm.frm.Message"
								ng-required="true" 
								ng-minlegth="5" ng-maxlength="5000" 
								ng-class="{'error-branch' : vm.showErrors && myForm.Message.$invalid}" ></textarea>					
							<div class="errorWrap">	
								<div ng-messages="myForm.Message.$error" ng-show="vm.showErrors&& myForm.Message.$invalid">
									<div ng-message="required">Enter a Message</div>
									<div ng-message="minlength">Message is too short</div>
									<div ng-message="maxlength">Message is too long.Please enter below 5000 characters.</div>
								</div>				
							</div>
						</div>
					</div>

					<div class="form-group">
						<div class="col-sm-offset-2 col-sm-10">
							<p>&nbsp;</p>
							<button class="btn btn-primary" ng-click="vm.sendContactDetails()">Send</button>
						</div>
					</div>		
				</form>
				<div style="clear:both;"></div>
			</div>	
		</div>
	</div>	
</div>
<route-change-interrupt active="myForm.$dirty"></route-change-interrupt>