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<!DOCTYPE html> <html lang="it"> <head> <meta charset="utf-8"> <meta name="viewport" content="width=device-width, initial-scale=1, shrink-to-fit=no"> <meta name="theme-color" content="#660000"> <title > Richiesta d&#39;assistenza - Comune di Busto Garolfo </title> <link rel="canonical" href="https://www.comune.bustogarolfo.mi.it/it-it/richiesta-assistenza" /> <link rel="stylesheet" href="/it-it/bootstrap-italia/css/bi-rosso-660000.min.css"> <link rel="stylesheet" href="/it-it/fontawesome/css/all.min.css"> <style> :root { --ColorePrimario: #660000; --BgPrimarioChiaro: rgba(102,0,0,0.075); --ColoreSecondario: #850000; --ColoreScuro: #330000; } .has-bg-grey, .it-header-wrapper .navbar .navbar-collapsable .navbar-nav li a.nav-link.active, .ico-color { background-color: rgba(102,0,0,0.075) !important; } .it-page-section .card.card-teaser-info { border-left-color: rgba(102,0,0,0.15) !important; } .collapse-readmore:before { content: 'Mostra tutto'; } 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Busto Garolfo"> <div class="it-brand-text"> <div class="it-brand-title">Comune di Busto Garolfo</div> </div> </a> <ul data-element="main-navigation" class="navbar-nav"> <li class="nav-item"> <a href="/it-it/amministrazione" data-element="management" class="nav-link text-nowrap " >Amministrazione</a> </li> <li class="nav-item"> <a href="/it-it/novita" data-element="news" class="nav-link text-nowrap " >Novit&#224;</a> </li> <li class="nav-item"> <a href="/it-it/servizi" data-element="all-services" class="nav-link text-nowrap " >Servizi</a> </li> <li class="nav-item"> <a href="/it-it/vivere-il-comune" data-element="live" class="nav-link text-nowrap " >Vivere il Comune</a> </li> </ul> <span class="d-block d-lg-none pt-4 px-4 pb-2">Argomenti:</span> <ul class="navbar-nav navbar-secondary pt-0"> <li class="nav-item"> <a class="nav-link font-md " href="/it-it/argomenti/tempo-libero">Tempo libero</a> </li> <li class="nav-item"> <a class="nav-link font-md " 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RSS</span> </a> </li> </ul> </div> </div> </div> </nav> <!--end nav--> </div> </div> </div> </div> </div> </header> <main> <div class="container" id="main-container"> <div class="row justify-content-center"> <div class="col-12 col-lg-10"> <div class="cmp-breadcrumbs" role="navigation"> <nav class="breadcrumb-container"> <ol class="breadcrumb p-0" data-element="breadcrumb"> <li class="breadcrumb-item"> <a href="/it-it/home" class="fw-normal">Home</a><span class="separator">/</span> </li> <li class="breadcrumb-item active" aria-current="page">Richiesta d'assistenza</li> </ol> </nav> </div> </div> </div> </div> <div class="container"> <div class="row justify-content-center "> <div class="col-lg-10"> <div class="cmp-hero"> <section class="it-hero-wrapper bg-white align-items-start"> <div class="it-hero-text-wrapper pt-0 ps-0"> <h1 class="hero-title text-body" data-element="page-name" data-audio>Richiesta d'assistenza</h1> <div class="hero-text" >Potete usare questo spazio per richiedere assistenza o informazioni su qualunque ambito che riguarda la vita nel comune ed il lavoro dell'amministrazione.<br /> Tutti i messaggi inviati tramite questa pagina verranno smistati agli uffici competenti per una opportuna valutazione.</div> </div> </section> </div> </div> </div> </div> <div class="container"> <div class="row border-top border-light row-column-border row-column-menu-left"> <aside class="col-lg-4"> <div class="cmp-navscroll sticky-top" aria-labelledby="accordion-title-navscroll"> <nav class="navbar it-navscroll-wrapper navbar-expand-lg" data-bs-navscroll> <div class="navbar-custom" id="navbarNavProgress"> <div class="menu-wrapper"> <div class="link-list-wrapper"> <div class="accordion"> <div class="accordion-item"> <span class="accordion-header" id="accordion-title-navscroll"> <button class="accordion-button pb-10 px-3" type="button" data-bs-toggle="collapse" data-bs-target="#collapse-navscroll" aria-expanded="true" aria-controls="collapse-navscroll"> Indice della pagina <svg class="icon icon-xs right"> <use href="/it-it/bootstrap-italia/svg/sprites.svg#it-expand"></use> </svg> </button> </span> <div class="progress"> <div class="progress-bar it-navscroll-progressbar" role="progressbar" aria-valuenow="0" aria-valuemin="0" aria-valuemax="100"></div> </div> <div id="collapse-navscroll" class="accordion-collapse collapse show" role="region" aria-labelledby="accordion-title-navscroll"> <div class="accordion-body"> <ul class="link-list" data-element="page-index"> <li class="nav-item" id="nav-richiedente"> <a class="nav-link" href="#richiedente"> <span class="font-ml fw-normal">Richiedente</span> </a> </li> <li class="nav-item" id="nav-richiesta"> <a class="nav-link" href="#richiesta"> <span class="font-ml fw-normal">Richiesta</span> </a> </li> </ul> </div> </div> </div> </div> </div> </div> </div> </nav> </div> </aside> <div class="col-lg-8 it-page-sections-container border-light"> <div><div class="validation-summary-valid" data-valmsg-summary="true"><ul> </ul></div></div> <form id="assistenzaForm" action="/it-it/richiesta-assistenza#assistenzaForm" method="POST" aria-live="polite"> <input name="__RequestVerificationToken" type="hidden" value="-_IM0dsA9ASay5LZJWJl6uDo1rJEPSsq_2HvpNj6NRGyMTOudkjTunBBkYrbLS3p9CDcjKRKmt3Dbz9zRP9IPVGZgeY5jT5XIMrS7W5bPeQ1" /> <div class="it-page-sections-container"> <section class="it-page-section" id="richiedente"> <div class="cmp-card mb-40"> <div class="card has-bkg-grey shadow-sm"> <div class="card-header border-0 p-0 mb-lg-30"> <div class="d-flex"> <h2 class="title-xlarge mb-0">Richiedente</h2> </div> </div> <div class="card-body p-0"> <div class="form-wrapper bg-white p-4"> <div class="form-group cmp-input"> <label for="NomeCognome" class="cmp-input__label">Nome e cognome <span aria-describedby="formRequired">*</span></label> <input type="text" class="form-control" id="NomeCognome" name="NomeCognome" value="" aria-describedby="nomecognomeHelp" required> <small id="nomecognomeHelp" class="form-text text-muted">Inserisci il tuo nome e cognome</small> </div> <div class="form-group cmp-input"> <label for="Email" class="cmp-input__label">Email <span aria-describedby="formRequired">*</span></label> <input type="email" class="form-control" id="Email" name="Email" value="" aria-describedby="emailHelp" required> <small id="emailHelp" class="form-text text-muted">Inserisci il tuo indirizzo email</small> </div> <div class="form-group cmp-input"> <label for="Telefono" class="cmp-input__label">Telefono</label> <input type="tel" class="form-control" id="Telefono" name="Telefono" value="" aria-describedby="telHelp"> <small id="telHelp" class="form-text text-muted">Inserisci il tuo numero di telefono</small> </div> <div class="form-group cmp-input" style="display: none"> <label for="Address" class="cmp-input__label">Indirizzo</label> <input type="text" class="form-control" id="Address" name="Address" value=""> </div> <div class="privacy-wrapper"> <div class="form-check"> <input type="checkbox" id="privacyCheck" name="privacyCheck" value="1" required> <label for="privacyCheck" class="font-md">Confermo di aver letto e compreso l'<a href="/it-it/privacy" class="fw-semibold" target="_blank" rel="noopener" aria-label="apre il link in una nuova scheda">informativa sulla privacy</a> <span aria-describedby="formRequired">*</span></label> </div> </div> </div> </div> </div> </div> </section> <section class="it-page-section" id="richiesta"> <div class="cmp-card mb-40"> <div class="card has-bkg-grey shadow-sm p-big"> <div class="card-header border-0 p-0 mb-lg-30"> <div class="d-flex"> <h2 class="title-xlarge mb-0">Richiesta</h2> </div> </div> <div class="card-body p-0"> <div class="form-wrapper bg-white p-4"> <div class="select-wrapper form-group mb-40 mt-4 bg-transparent p-0"> <label for="Tipo" class="cmp-input__label">Tipo richiesta <span aria-describedby="formRequired">*</span></label> <select class="form-control bg-transparent" id="Tipo" name="Tipo" aria-describedby="selectHelp" required> <option >Informazioni</option> <option >Proposta o suggerimento</option> <option >Complimento</option> <option >Critica o reclamo</option> <option >Altro</option> </select> <small id="selectHelp" class="form-text text-muted">Seleziona la tipologia</small> </div> <div class="form-group cmp-input"> <label for="Oggetto" class="cmp-input__label">Oggetto <span aria-describedby="formRequired">*</span></label> <input type="text" class="form-control" id="Oggetto" name="Oggetto" value="" aria-describedby="oggettoHelp" required> <small id="oggettoHelp" class="form-text text-muted">Indica l'oggetto della richiesta</small> </div> <div class="cmp-text-area p-0"> <div class="form-group"> <label for="Testo" class="d-block">Testo <span aria-describedby="formRequired">*</span></label> <textarea class="text-area form-control" id="Testo" name="Testo" maxlength="2000" rows="5" aria-describedby="richiestaHelp" required></textarea> <small id="richiestaHelp" class="form-text text-muted">Inserire la richiesta (massimo 2000 caratteri)</small> </div> </div> </div> </div> </div> </div> </section> <p class="mt-4"><small id="formRequired">* I campi contrassegnati da un asterisco sono obbligatori</small></p> <p><small>Non sono consentiti: attacchi e insulti personali diretti agli utenti e/o a terzi; linguaggio offensivo, volgare, razzista e osceno; messaggi di tipo razzista o, comunque, inneggianti alla violenza e alla discriminazione; offese alle istituzioni o alla religione di qualunque fede; messaggi falsi e/o diffamatori.</small></p> <div class="form-group float-end"> <button type="submit" class="btn btn-primary"><span class="fas fa-check ico-left me-2" aria-hidden="true"></span>Invia</button> <button type="reset" class="btn btn-outline-primary" title="Resetta il modulo" onkeypress="#mainContent"><span class="far fa-trash-alt" aria-hidden="true"></span><span class="visually-hidden">Resetta il modulo</span></button> </div> </div> </form> </div> </div> </div> <div class="section bg-primary py-lg-6"> <div class="container"> <div class="row d-flex justify-content-center bg-primary"> <div class="col-12 col-lg-8 col-xxl-6 px-0"> <form id="rating-form" action="#" method="post"> <input name="__RequestVerificationToken" type="hidden" value="8Ia1kxpUBUMDjs1HZkERyPdyFTZWmXO-zUqe1C1q1wrJjgNgH3omaLfmiC-WqdKFLgl8Dv9gOfHJekfEL7LKFJ6YHamiS0tu4sLYT2xQMDA1" /> <div data-element="feedback" class="cmp-rating p-0"> <div class="card shadow card-wrapper"> <div class="cmp-rating__card-first"> <div class="card-header border-0"> <h2 data-element="feedback-title" class="title-medium-large fw-semibold lh-sm mb-0">Quanto sono chiare le informazioni su questa pagina?</h2> </div> <div class="card-body"> <fieldset class="rating"> <legend class="visually-hidden">Valuta da 1 a 5 stelle la pagina</legend> <input type="radio" id="star5a" name="ratingA" value="5"> <label data-element="feedback-rate-5" class="full rating-star active" for="star5a"> <svg class="icon icon-sm" role="img" aria-labelledby="first-star" viewBox="0 0 24 24" xmlns="http://www.w3.org/2000/svg"> <path d="M12 1.7L9.5 9.2H1.6L8 13.9l-2.4 7.6 6.4-4.7 6.4 4.7-2.4-7.6 6.4-4.7h-7.9L12 1.7z" /> <path fill="none" d="M0 0h24v24H0z" /> </svg> <span class="visually-hidden" id="first-star">Valuta 5 stelle su 5</span> </label> <input type="radio" id="star4a" name="ratingA" value="4"> <label data-element="feedback-rate-4" class="full rating-star active" for="star4a"> <svg class="icon icon-sm" role="img" aria-labelledby="second-star" viewBox="0 0 24 24" xmlns="http://www.w3.org/2000/svg"> <path d="M12 1.7L9.5 9.2H1.6L8 13.9l-2.4 7.6 6.4-4.7 6.4 4.7-2.4-7.6 6.4-4.7h-7.9L12 1.7z" /> <path fill="none" d="M0 0h24v24H0z" /> </svg> <span class="visually-hidden" id="second-star">Valuta 4 stelle su 5</span> </label> <input data-element="feedback-rate-3" type="radio" id="star3a" name="ratingA" value="3"> <label class="full rating-star active" for="star3a"> <svg class="icon icon-sm" role="img" aria-labelledby="third-star" viewBox="0 0 24 24" xmlns="http://www.w3.org/2000/svg"> <path d="M12 1.7L9.5 9.2H1.6L8 13.9l-2.4 7.6 6.4-4.7 6.4 4.7-2.4-7.6 6.4-4.7h-7.9L12 1.7z" /> <path fill="none" d="M0 0h24v24H0z" /> </svg> <span class="visually-hidden" id="third-star">Valuta 3 stelle su 5</span> </label> <input type="radio" id="star2a" name="ratingA" value="2"> <label data-element="feedback-rate-2" class="full rating-star active" for="star2a"> <svg class="icon icon-sm" role="img" aria-labelledby="fourth-star" viewBox="0 0 24 24" xmlns="http://www.w3.org/2000/svg"> <path d="M12 1.7L9.5 9.2H1.6L8 13.9l-2.4 7.6 6.4-4.7 6.4 4.7-2.4-7.6 6.4-4.7h-7.9L12 1.7z" /> <path fill="none" d="M0 0h24v24H0z" /> </svg> <span class="visually-hidden" id="fourth-star">Valuta 2 stelle su 5</span> </label> <input data-element="feedback-rate-1" type="radio" id="star1a" name="ratingA" value="1"> <label class="full rating-star active" for="star1a"> <svg class="icon icon-sm" role="img" aria-labelledby="fifth-star" viewBox="0 0 24 24" xmlns="http://www.w3.org/2000/svg"> <path d="M12 1.7L9.5 9.2H1.6L8 13.9l-2.4 7.6 6.4-4.7 6.4 4.7-2.4-7.6 6.4-4.7h-7.9L12 1.7z" /> <path fill="none" d="M0 0h24v24H0z" /> </svg> <span class="visually-hidden" id="fifth-star">Valuta 1 stelle su 5</span> </label> </fieldset> </div> </div> <div class="cmp-rating__card-second d-none" data-step="3"> <div class="card-header border-0 mb-0"> <h2 class="title-medium-large lh-sm mb-0" id="rating-feedback"> Grazie, il tuo parere ci aiuter脿 a migliorare il servizio! </h2> </div> </div> <div class="form-rating d-none"> <div class="d-none" data-step="1"> <div class="cmp-steps-rating"> <fieldset data-element="feedback-rating-positive" class="fieldset-rating-one d-none mt-3"> <legend class="iscrizioni-header w-100"> <span class="step-title d-flex flex-column flex-lg-row align-items-lg-center justify-content-between drop-shadow lh-base mb-40"> <span class="d-block text-wrap" data-element="feedback-rating-question"> Quali sono stati gli aspetti che hai preferito? </span> <span class="step">1/2</span> </span> </legend> <div class="cmp-steps-rating__body"> <div class="cmp-radio-list"> <div class="card card-teaser shadow-rating"> <div class="card-body"> <div class="form-check m-0"> <div class="radio-body border-bottom border-light cmp-radio-list__item"> <input name="rating1" type="radio" id="radio-1" value="1"> <label data-element="feedback-rating-answer" for="radio-1" class="active">Le indicazioni erano chiare</label> </div> <div class="radio-body border-bottom border-light cmp-radio-list__item"> <input name="rating1" type="radio" id="radio-2" value="2"> <label data-element="feedback-rating-answer" for="radio-2" class="active">Le indicazioni erano complete</label> </div> <div class="radio-body border-bottom border-light cmp-radio-list__item"> <input name="rating1" type="radio" id="radio-3" value="3"> <label data-element="feedback-rating-answer" for="radio-3" class="active">Capivo sempre che stavo procedendo correttamente</label> </div> <div class="radio-body border-bottom border-light cmp-radio-list__item"> <input name="rating1" type="radio" id="radio-4" value="4"> <label data-element="feedback-rating-answer" for="radio-4" class="active">Non ho avuto problemi tecnici</label> </div> <div class="radio-body border-bottom border-light cmp-radio-list__item"> <input name="rating1" type="radio" id="radio-5" value="5"> <label data-element="feedback-rating-answer" for="radio-5" class="active">Altro</label> </div> </div> </div> </div> </div> </div> </fieldset> <fieldset data-element="feedback-rating-negative" class="fieldset-rating-two d-none mt-3"> <legend class="iscrizioni-header w-100"> <span class="step-title d-flex align-items-center justify-content-between drop-shadow lh-base mb-40"> <span class="d-block text-wrap" data-element="feedback-rating-question"> Dove hai incontrato le maggiori difficolt脿? </span> <span class="step">1/2</span> </span> 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