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<html lang="en">
<head>
    <meta charset="UTF-8">
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <title>Customer Satisfaction Survey</title>
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    <style>
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        body { font-family: 'Inter', 'Noto Kufi Arabic', sans-serif; }
        [dir="rtl"] body,
        [dir="rtl"] input,
        [dir="rtl"] textarea,
        [dir="rtl"] select,
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            font-family: 'Noto Kufi Arabic', sans-serif;
        }
        .input-line { border-bottom: 1px solid #94a3b8; outline: none; }
    </style>
</head>
<body class="bg-gray-100 p-4 md:p-10">

    <div class="max-w-4xl mx-auto bg-white shadow-2xl relative overflow-hidden border-t-[20px] border-[#3498db]">
        
        <div class="p-8 pb-4 flex justify-between items-start">
            <div class="flex items-center gap-2">
                <div class="text-[#3498db]">
                    <svg width="40" height="40" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2.5" stroke-linecap="round" stroke-linejoin="round"><path d="M12 2L2 7l10 5 10-5-10-5zM2 17l10 5 10-5M2 12l10 5 10-5"/></svg>
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                <div>
                    <h2 class="text-xl font-bold text-[#2c3e50] leading-tight tracking-tighter">INGOUDE</h2>
                    <p class="text-sm font-semibold text-[#2c3e50] tracking-[0.2em] -mt-1">COMPANY</p>
                </div>
            </div>
            <div class="text-right">
                <h1 class="text-2xl font-bold text-[#2c3e50]">Customer</h1>
                <h1 class="text-2xl font-bold text-[#2c3e50]">Satisfaction Survey</h1>
            </div>
        </div>

        <form class="px-10 py-6 space-y-8 text-[#2c3e50]">
            
            <div class="grid grid-cols-1 md:grid-cols-12 gap-y-6 gap-x-4">
                <div class="md:col-span-5 flex items-end">
                    <label class="font-semibold whitespace-nowrap mr-2">Full Name</label>
                    <input type="text" class="input-line flex-grow pb-1">
                </div>
                <div class="md:col-span-2 flex items-end">
                    <label class="font-semibold whitespace-nowrap mr-2">Age</label>
                    <input type="text" class="input-line flex-grow pb-1">
                </div>
                <div class="md:col-span-5 flex items-end">
                    <label class="font-semibold whitespace-nowrap mr-2">Contact Phone</label>
                    <input type="text" class="input-line flex-grow pb-1">
                </div>
                <div class="md:col-span-7 flex items-end">
                    <label class="font-semibold whitespace-nowrap mr-2">Address</label>
                    <input type="text" class="input-line flex-grow pb-1">
                </div>
                <div class="md:col-span-5 flex items-center gap-6">
                    <label class="font-semibold">Gender</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="gender" class="mr-2 accent-[#3498db]"> Male</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="gender" class="mr-2 accent-[#3498db]"> Female</label>
                </div>
            </div>

            <div class="space-y-3">
                <p class="font-bold">How did you hear about our product/service?</p>
                <div class="grid grid-cols-1 md:grid-cols-3 gap-y-3">
                    <label class="flex items-center cursor-pointer"><input type="radio" name="source" class="mr-2 accent-[#3498db]"> Social Media</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="source" class="mr-2 accent-[#3498db]"> Search Engine</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="source" class="mr-2 accent-[#3498db]"> Advertisement</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="source" class="mr-2 accent-[#3498db]"> Word of Mouth</label>
                    <div class="md:col-span-2 flex items-center">
                        <label class="flex items-center cursor-pointer mr-2"><input type="radio" name="source" class="mr-2 accent-[#3498db]"> Other (Please specify)</label>
                        <input type="text" class="input-line flex-grow">
                    </div>
                </div>
            </div>

            <div class="space-y-3">
                <p class="font-bold">How would you rate your overall satisfaction with our product?</p>
                <div class="flex flex-wrap gap-x-6 gap-y-2">
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q2" class="mr-2 accent-[#3498db]"> Very Satisfied</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q2" class="mr-2 accent-[#3498db]"> Satisfied</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q2" class="mr-2 accent-[#3498db]"> Neutral</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q2" class="mr-2 accent-[#3498db]"> Dissatisfied</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q2" class="mr-2 accent-[#3498db]"> Very Dissatisfied</label>
                </div>
            </div>

            <div class="space-y-3">
                <p class="font-bold">How likely are you to recommend our product/service to a friend or colleague?</p>
                <div class="flex flex-wrap gap-x-6 gap-y-2">
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q3" class="mr-2 accent-[#3498db]"> Very Likely</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q3" class="mr-2 accent-[#3498db]"> Likely</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q3" class="mr-2 accent-[#3498db]"> Neutral</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q3" class="mr-2 accent-[#3498db]"> Unlikely</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q3" class="mr-2 accent-[#3498db]"> Very Unlikely</label>
                </div>
            </div>

            <div class="space-y-3">
                <p class="font-bold">How likely are you to recommend our product/service to a friend or colleague?</p>
                <div class="flex flex-wrap gap-x-6 gap-y-2">
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q4" class="mr-2 accent-[#3498db]"> Very Likely</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q4" class="mr-2 accent-[#3498db]"> Likely</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q4" class="mr-2 accent-[#3498db]"> Neutral</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q4" class="mr-2 accent-[#3498db]"> Unlikely</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q4" class="mr-2 accent-[#3498db]"> Very Unlikely</label>
                </div>
            </div>

            <div class="space-y-3">
                <p class="font-bold">How was your experience with our customer service team?</p>
                <div class="flex flex-wrap gap-x-6 gap-y-2">
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q5" class="mr-2 accent-[#3498db]"> Excellent</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q5" class="mr-2 accent-[#3498db]"> Good</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q5" class="mr-2 accent-[#3498db]"> Average</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q5" class="mr-2 accent-[#3498db]"> Poor</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q5" class="mr-2 accent-[#3498db]"> Very Poor</label>
                </div>
            </div>

            <div class="space-y-3">
                <p class="font-bold">How easy was it to navigate our website/app?</p>
                <div class="flex flex-wrap gap-x-6 gap-y-2">
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q6" class="mr-2 accent-[#3498db]"> Very Easy</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q6" class="mr-2 accent-[#3498db]"> Easy</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q6" class="mr-2 accent-[#3498db]"> Neutral</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q6" class="mr-2 accent-[#3498db]"> Difficult</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q6" class="mr-2 accent-[#3498db]"> Very Difficult</label>
                </div>
            </div>

            <div class="space-y-3">
                <p class="font-bold">How would you rate the quality of our product/service?</p>
                <div class="flex flex-wrap gap-x-6 gap-y-2">
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q7" class="mr-2 accent-[#3498db]"> Excellent</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q7" class="mr-2 accent-[#3498db]"> Good</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q7" class="mr-2 accent-[#3498db]"> Average</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q7" class="mr-2 accent-[#3498db]"> Poor</label>
                    <label class="flex items-center cursor-pointer"><input type="radio" name="q7" class="mr-2 accent-[#3498db]"> Very Poor</label>
                </div>
            </div>

            <div class="space-y-4">
                <p class="text-sm font-semibold text-gray-500">Do you have any suggestions for how we can improve our product/service or customer experience? (Open-ended response)</p>
                <div class="space-y-6">
                    <div class="border-b border-[#94a3b8] w-full h-2"></div>
                    <div class="border-b border-[#94a3b8] w-full h-2"></div>
                    <div class="border-b border-[#94a3b8] w-full h-2"></div>
                </div>
            </div>

        </form>

        <div class="mt-8 bg-[#3498db] text-white p-8 text-center space-y-1">
            <p class="text-sm font-medium">Thank you for taking the time to complete our customer satisfaction survey.</p>
            <p class="text-sm font-medium">Your feedback will help us improve our product/service.</p>
        </div>

        <div class="absolute bottom-0 left-0 w-full h-12 pointer-events-none">
            <div class="absolute bottom-0 left-0 border-r-[100px] border-b-[50px] border-r-transparent border-b-[#2980b9]"></div>
            <div class="absolute bottom-0 right-0 border-l-[100px] border-b-[50px] border-l-transparent border-b-[#2980b9]"></div>
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