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

User Input Panel

Customer Type

Customer Type New Existing

Contact Preference

Contact Preference Email me Call me

Salutation

Salutation Mr Mrs Ms Dr

First Name

Last Name

Phone (971xxxxxxxxx)

Email

Best time to call

Best time to call 8:30 AM to 10:00 AM 10:00 AM to 11:30 AM 11:30 AM to 1:00 PM 1:00 PM to 2:30 PM 2:30 PM to 4:00 PM 4:00 PM to 5:00 PM

Product Type

Product Type Individual (Personal) Group of employees Insurance purchased by you Insurance provided by your employer

Is your query related to an existing case?

Yes

No

Reference Number of previous ticket

Date of Birth (DD/MM/YYYY)

Policy Number

Certificate Number

My complaint is related to

My complaint is related to

Frequency of Payment

Frequency of Payment Monthly Quarterly Semi-annually Annually Single Payment Other

Message (Max. 1000 Characters)

File attachment (if any)

UPLOAD

pdf, doc, jpg, png - A maximum of 8 files can be attached. Each file should not exceed 8 MB in size.

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

Error

An error has occurred. Please try again later.

Thank you

Your request has been submitted successfully. We will revert to you within 2 working days. For any questions, please contact MetLife at the numbers below:

• UAE: 800 6385433
• Qatar: 800 9711
• Bahrain: 800 08033
• Kuwait: +965 2 2089333
• Oman: 800 70708
• Any other country: +971 4 415 4555

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