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<!-- Formtruck Generated HTML5 Form -->
<form 
  action="https://formtruck.com/s/your-form-id" 
  method="POST"
  enctype="multipart/form-data"
  class="formtruck-form"
>
  <div class="form-group">
    <label for="account_email">Account Email *</label>
    <input type="email" id="account_email" name="account_email" placeholder="user@domain.com" required />
  </div>
 
  <div class="form-group">
    <label for="problem_summary">Problem Summary *</label>
    <input type="text" id="problem_summary" name="problem_summary" placeholder="Cannot connect webhook endpoint" required />
  </div>
 
  <div class="form-group">
    <label for="severity_level">Severity Level *</label>
    <select id="severity_level" name="severity_level" required>
      <option value="">Select severity</option>
      <option value="Low - General Question">Low - General Question</option>
      <option value="Medium - Feature Glitch">Medium - Feature Glitch</option>
      <option value="High - System Blocker">High - System Blocker</option>
      <option value="Critical - Data Loss">Critical - Data Loss</option>
    </select>
  </div>
 
  <div class="form-group">
    <label for="steps_to_reproduce">Steps to Reproduce *</label>
    <textarea id="steps_to_reproduce" name="steps_to_reproduce" placeholder="1. Click submit
2. See error..." rows="4" required></textarea>
  </div>
 
  <div class="form-group">
    <label for="screenshot___error_log">Screenshot / Error Log</label>
    <input type="file" id="screenshot___error_log" name="screenshot___error_log" />
  </div>
 
  <!-- Anti-spam Honeypot -->
  <input type="text" name="_gotcha" style="display:none" tabindex="-1" autocomplete="off" />
 
  <button type="submit">Submit Form</button>
</form>