{"html":" <form class=\"help-us-form\" method=\"post\" id=\"help-us-form\"> <div class=\"question\"><span class=\"silver\">1.<\/span> Are satisfied with product selection offered on our website?:<ul><li class=\"left\"><label><input type=\"radio\" name=\"q1\" value=\"Yes\">Yes<\/label><\/li><li class=\"left\"><label><input type=\"radio\" name=\"q1\" value=\"No\">No<\/label><\/li><li class=\"left\"><label><input type=\"radio\" name=\"q1\" value=\"Not sure\">Not sure<\/label><\/li><div class=\"clear\">&nbsp;<\/div><\/ul><\/div><div class=\"question\"><span class=\"silver\">2.<\/span> What product you were looking for?:<ul><li><input type=\"text\" name=\"q2\" value=\"\"><\/li><div class=\"clear\">&nbsp;<\/div><\/ul><\/div><div class=\"question\"><span class=\"silver\">3.<\/span> What product you think we might have to add to our product line?:<ul><li><input type=\"text\" name=\"q3\" value=\"\"><\/li><div class=\"clear\">&nbsp;<\/div><\/ul><\/div><div class=\"question\"><span class=\"silver\">4.<\/span> Was navigation easy and intuitive for you?:<ul><li class=\"left\"><label><input type=\"radio\" name=\"q4\" value=\"Yes\">Yes<\/label><\/li><li class=\"left\"><label><input type=\"radio\" name=\"q4\" value=\"No\">No<\/label><\/li><li class=\"left\"><label><input type=\"radio\" name=\"q4\" value=\"Not sure\">Not sure<\/label><\/li><div class=\"clear\">&nbsp;<\/div><\/ul><\/div><div class=\"question\"><span class=\"silver\">5.<\/span> Was purchase process easy and quick for you?:<ul><li class=\"left\"><label><input type=\"radio\" name=\"q5\" value=\"Yes\">Yes<\/label><\/li><li class=\"left\"><label><input type=\"radio\" name=\"q5\" value=\"No\">No<\/label><\/li><li class=\"left\"><label><input type=\"radio\" name=\"q5\" value=\"Not sure\">Not sure<\/label><\/li><div class=\"clear\">&nbsp;<\/div><\/ul><\/div><div class=\"question\"><span class=\"silver\">6.<\/span> What you did not like on our website?:<ul><li><input type=\"text\" name=\"q6\" value=\"\"><\/li><div class=\"clear\">&nbsp;<\/div><\/ul><\/div><div class=\"question\"><span class=\"silver\">7.<\/span> Have you bought from us previously:<ul><li class=\"left\"><label><input type=\"radio\" name=\"q7\" value=\"Yes\">Yes<\/label><\/li><li class=\"left\"><label><input type=\"radio\" name=\"q7\" value=\"No\">No<\/label><\/li><div class=\"clear\">&nbsp;<\/div><\/ul><\/div><div class=\"question\"><span class=\"silver\">8.<\/span> Would you buy from us again?:<ul><li class=\"left\"><label><input type=\"radio\" name=\"q8\" value=\"Yes\">Yes<\/label><\/li><li class=\"left\"><label><input type=\"radio\" name=\"q8\" value=\"No\">No<\/label><\/li><li class=\"left\"><label><input type=\"radio\" name=\"q8\" value=\"Not sure\">Not sure<\/label><\/li><div class=\"clear\">&nbsp;<\/div><\/ul><\/div><div class=\"question\"><span class=\"silver\">9.<\/span> How did you find about our company?:<ul><li>Search engine<ul><li class=\"left\"><label><input type=\"checkbox\" name=\"google\">Google<\/label><\/li><li class=\"left\"><label><input type=\"checkbox\" name=\"bing\">Bing<\/label><\/li><li class=\"left\"><label><input type=\"checkbox\" name=\"yahoo\">Yahoo<\/label><\/li><li><input type=\"text\" name=\"q9i1\" value=\"\" placeholder=\"other\"><\/li><div class=\"clear\">&nbsp;<\/div><\/ul><\/li><li>Social media<ul><li class=\"left\"><label><input type=\"checkbox\" name=\"facebook\">Facebook<\/label><\/li><li class=\"left\"><label><input type=\"checkbox\" name=\"pinterest\">Pinterest<\/label><\/li><li class=\"left\"><label><input type=\"checkbox\" name=\"twitter\">Twitter<\/label><\/li><li class=\"left\"><label><input type=\"checkbox\" name=\"linkedin\">LinkedIn<\/label><\/li><li class=\"left\"><label><input type=\"checkbox\" name=\"etsy\">Etsy<\/label><\/li><li class=\"left\"><label><input type=\"checkbox\" name=\"instagram\">Instagram<\/label><\/li><li><input type=\"text\" name=\"q9i2\" value=\"\" placeholder=\"other\"><\/li><div class=\"clear\">&nbsp;<\/div><\/ul><\/li><div class=\"clear\">&nbsp;<\/div><\/ul><\/div><div class=\"question\"><span class=\"silver\">10.<\/span> What primary keyword have you used to find us?:<ul><li><input type=\"text\" name=\"q10\" value=\"\"><\/li><div class=\"clear\">&nbsp;<\/div><\/ul><\/div><div class=\"question\"><span class=\"silver\">11.<\/span> What we have to do to improve?:<ul><li><input type=\"text\" name=\"q11\" value=\"\"><\/li><div class=\"clear\">&nbsp;<\/div><\/ul><\/div> <div class=\"center\"> <input type=\"hidden\" name=\"helpUsForm\" value=\"1\"> <a class=\"sBtn sBtnPrimary\" id=\"help-us-send\"> Send<\/a> <\/div> <\/form> "}