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form2.html
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form2.html
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>Mental health Form</title>
<style>
body {
background-image: url('https://png.pngtree.com/thumb_back/fh260/background/20210324/pngtree-abstract-portfolio-pink-memphis-playful-image_593414.jpg');
background-size: cover;
background-repeat: no-repeat;
background-attachment: fixed;
background-color: #f0f0f0;
color: #333;
font-family: Arial, sans-serif;
}
.title-bar {
background-color: #ff6600;
color: #fff;
text-align: center;
padding: 10px;
font-size: 24px;
}
form {
background-color: rgba(255, 255, 255, 0.9);
padding: 20px;
border-radius: 10px;
}
label {
font-weight: bold;
}
input, textarea {
width: 100%;
padding: 10px;
margin-bottom: 10px;
border: 1px solid #ccc;
border-radius: 5px;
}
input[type="submit"] {
background-color: #ff6600;
color: #fff;
border: none;
padding: 10px 20px;
border-radius: 5px;
cursor: pointer;
}
input[type="submit"]:hover {
background-color: #cc5500;
}
</style>
</head>
<body>
<div class="title-bar">Form 2</div>
<h1>Mental health Form</h1>
<form action="volunteer_submit.php" method="post">
<label for="name">How are you feeling about you acedemic-self currently?:</label>
<input type="text" id="name" name="name" required><br><br>
<label for="email">On the scale 1-10 would you rate your overall mental health being? 1- worst, 10-best:</label>
<input type="email" id="email" name "email" required><br><br>
<label for="phone">Are you often anxious or worried about various aspects of your life, including work, family, or personal issues?:</label>
<input type="tel" id="phone" name="phone" required><br><br>
<label for="interests">Do you feel persistently sad or down, or have you experienced a loss of interest or pleasure in activities you used to enjoy?</label>
<textarea id="interests" name="interests" rows="4" cols="50"></textarea><br><br>
<label for="availability">Do you have difficulty concentrating or making decisions?</label>
<input type="text" id="availability" name="availability" required><br><br>
<label for="availability">Have you experienced physical symptoms like headaches, muscle tension, or digestive issues that may be related to stress or anxiety?</label>
<input type="text" id="availability" name="availability" required><br><br>
<input type="submit" value="SUBMIT RESPONSE">
</form>
</body>
</html>