{"id":236,"date":"2026-03-30T19:27:09","date_gmt":"2026-03-30T19:27:09","guid":{"rendered":"https:\/\/zenec.client-demo-websites.com\/?page_id=236"},"modified":"2026-04-29T18:41:24","modified_gmt":"2026-04-29T18:41:24","slug":"feedback-form","status":"publish","type":"page","link":"https:\/\/zenec.client-demo-websites.com\/index.php\/feedback-form\/","title":{"rendered":"Feedback Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"236\" class=\"elementor elementor-236\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0246602 e-flex e-con-boxed e-con e-parent\" data-id=\"0246602\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-58aec5b e-con-full e-flex e-con e-child\" data-id=\"58aec5b\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3121867 elementor-widget elementor-widget-heading\" data-id=\"3121867\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Feedback Form<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-287372a elementor-icon-list--layout-inline elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"287372a\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items elementor-inline-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item elementor-inline-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"\/\">\n\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Home<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item elementor-inline-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-angle-right\" viewBox=\"0 0 256 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M224.3 273l-136 136c-9.4 9.4-24.6 9.4-33.9 0l-22.6-22.6c-9.4-9.4-9.4-24.6 0-33.9l96.4-96.4-96.4-96.4c-9.4-9.4-9.4-24.6 0-33.9L54.3 103c9.4-9.4 24.6-9.4 33.9 0l136 136c9.5 9.4 9.5 24.6.1 34z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\"><\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item elementor-inline-item\">\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Feedback Form<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-d8a5180 e-flex e-con-boxed e-con e-parent\" data-id=\"d8a5180\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-afd48db elementor-widget__width-initial elementor-widget-tablet__width-inherit elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"afd48db\" data-element_type=\"widget\" id=\"form-style\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"New Form\" aria-label=\"New Form\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"236\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"afd48db\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Feedback Form\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"236\"\/>\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-name\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNDIS Participant's Name (optional):\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_51965ec elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_51965ec\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPhone Number (optional):\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_51965ec]\" id=\"form-field-field_51965ec\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-field_59d721d elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_59d721d\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEmail Address (optional):\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[field_59d721d]\" id=\"form-field-field_59d721d\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_4b76549 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_4b76549\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHow satisfied are you?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Rate 1 out of 5\" id=\"form-field-field_4b76549-0\" name=\"form_fields[field_4b76549][]\"> <label for=\"form-field-field_4b76549-0\">Rate 1 out of 5<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Rate 2 out of 5\" id=\"form-field-field_4b76549-1\" name=\"form_fields[field_4b76549][]\"> <label for=\"form-field-field_4b76549-1\">Rate 2 out of 5<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Rate 3 out of 5\" id=\"form-field-field_4b76549-2\" name=\"form_fields[field_4b76549][]\"> <label for=\"form-field-field_4b76549-2\">Rate 3 out of 5<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Rate 4 out of 5\" id=\"form-field-field_4b76549-3\" name=\"form_fields[field_4b76549][]\"> <label for=\"form-field-field_4b76549-3\">Rate 4 out of 5<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Rate 5 out of 5\" id=\"form-field-field_4b76549-4\" name=\"form_fields[field_4b76549][]\"> <label for=\"form-field-field_4b76549-4\">Rate 5 out of 5<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_2923fde elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_2923fde\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHow likely is it that you would recommend Zenec Home Care & Community Services Community Service to a friend, family, or members of the community? \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_2923fde]\" id=\"form-field-field_2923fde\" rows=\"4\" required=\"required\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_1c6a8b8 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_1c6a8b8\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tImprovement\/Suggestions\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_1c6a8b8]\" id=\"form-field-field_1c6a8b8\" rows=\"4\" required=\"required\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_827b6ce elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_827b6ce\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAre the Zenec Home Care & Community Services Community Service respectful of your privacy and values?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_827b6ce]\" id=\"form-field-field_827b6ce\" rows=\"4\" required=\"required\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_13d16cb elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_13d16cb\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWhat would you rate the overall responsiveness of Zenec Home Care & Community Services Community Service to your needs and questions?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_13d16cb]\" id=\"form-field-field_13d16cb\" rows=\"4\" required=\"required\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_6e91304 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_6e91304\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tIs the information provided on our website easy to understand?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_6e91304]\" id=\"form-field-field_6e91304\" rows=\"4\" required=\"required\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_cc93fad elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_cc93fad\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWere you supported by Zenec Home Care & Community Services Community Service to have choice and control?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_cc93fad]\" id=\"form-field-field_cc93fad\" rows=\"4\" required=\"required\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_827741b elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_827741b\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDo you know how to provide feedback or make a complaint? (either verbal, email, website, or NDIS)?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_827741b]\" id=\"form-field-field_827741b\" rows=\"4\" required=\"required\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_a3b7d02 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a3b7d02\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDo you have any suggestions or comments on how or what we can do to improve our services?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_a3b7d02]\" id=\"form-field-field_a3b7d02\" rows=\"4\" required=\"required\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_272081f elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_272081f\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tConsent to Use Feedback *\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\" \" id=\"form-field-field_272081f-0\" name=\"form_fields[field_272081f]\"> <label for=\"form-field-field_272081f-0\"> <\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_7ab5039 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_7ab5039\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tI consent to my feedback being used for improvement purposes.\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"\" id=\"form-field-field_7ab5039-0\" name=\"form_fields[field_7ab5039]\"> <label for=\"form-field-field_7ab5039-0\"><\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Send<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Feedback Form Home Feedback Form<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-236","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/zenec.client-demo-websites.com\/index.php\/wp-json\/wp\/v2\/pages\/236","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zenec.client-demo-websites.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/zenec.client-demo-websites.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/zenec.client-demo-websites.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/zenec.client-demo-websites.com\/index.php\/wp-json\/wp\/v2\/comments?post=236"}],"version-history":[{"count":16,"href":"https:\/\/zenec.client-demo-websites.com\/index.php\/wp-json\/wp\/v2\/pages\/236\/revisions"}],"predecessor-version":[{"id":547,"href":"https:\/\/zenec.client-demo-websites.com\/index.php\/wp-json\/wp\/v2\/pages\/236\/revisions\/547"}],"wp:attachment":[{"href":"https:\/\/zenec.client-demo-websites.com\/index.php\/wp-json\/wp\/v2\/media?parent=236"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}