1. System Generated Field Panel
2. Author Entered Field Panel
3. Form Title Panel
4. End-user Entered Field Panel
5. Thank You and Error Message Panel
6. Hidden Panel

• System Generated Field Panel
• Author Entered Field Panel
• Form Title Panel
• End-user Entered Field Panel
• Thank You and Error Message Panel
• Hidden Panel

System Generated Panel 

Market Region

Market Region ASIA APAC EMEA LATAM

*Nation / Country Bangladesh Australia Hongkong United Kingdom Turkey Kuwait Bahrain Egypt Jordan Greece Oman Lebanon Romania Bulgaria France Poland Portugal Spain UAE Italy Russia Portugal Argentina Columbia Brazil

User Date

Enable Captcha

SendUserEmail

Email Template for Recipient

Acknowledgement Email Template

Attachment Information

Glu Recaptcha Token

Locale

Secret Key

 Author Input Panel

Author Input Panel - Required fields

*Type of Form Integration siteComponent slider contactCardForm

Analytics form type

*Type Of Form Contactform Inquiry Grievance

Email address to which form data will be sent

CC Email address to which form data will be sent

Subject line of the email

Subject line of the Acknowledgement

File Upload Messages Configuration

Virus Scan in Progress

File Size Limit Error

Virus Found Message

Invalid File Type Error message

File Count

Upload More

Service Down

Form Title  Panel

To help us understand your complaint(s), kindly provide the following details:

User Input Panel

All fields are required

Name

NRIC

Phone Number

Email

Correspondence Address

Policy Number

Policy Owner

Life Assured

Please provide details of your complaint and how can we help you with regards to your complaint.

Your complaint or feedback will be reviewed and, where appropriate, it will be referred to the relevant departments for further handling.

  

Please read and accept the Privacy Policy and Terms and Conditions of AmMetLife

I have read and agreed to both the Privacy Policy and Terms and Conditions.

SUBMIT

Thank You/Error Panel Configuration

Message Option Same page-fadeout Same page-fixed New page

Settings for same page thank you/error message

Message Delay

Something went wrong. Your feedback has not been sent.

Thank you for your feedback.

Settings for separate page thank you/error message

Error Page

Thank You Page

Page Target

Page Target Same Tab New Tab

Hidden Panel

Name Of The Template