<div class="row row-no-gutters">
<div class="col-sm-9 col-md-6 col-lg-5">
<details class="brdr-0">
<summary class="btn btn-default text-center">Report a problem on this page</summary>
<div class="well row">
<div class="gc-rprt-prblm">
<div class="gc-rprt-prblm-frm gc-rprt-prblm-tggl">
<form action="/sites/feedback/feedback-form-destination.html" id="gc-rprt-prblm-form" class="wb-postback"
data-wb-postback='{
"success": ".success-message",
"failure": ".failure-message"}'
data-wb-jsonmanager='{
"name": "rap",
"extractor": [
{ "selector": "title", "path": "pageTitle" },
{ "interface": "locationHref", "path": "submissionPage" },
{ "selector": "html", "attr": "lang", "path": "lang" },
{ "selector": "meta[name=\"dcterms.creator\"]", "attr": "content", "path": "pageOwner" }
]
}'>
<div data-wb-json='{
"url": "#[rap]",
"mapping": [
{ "selector": "input", "attr": "name", "value": "/@id" },
{ "selector": "input", "attr": "value", "value": "/@value" }
]
}'>
<template>
<input type="hidden" name="" value="" />
</template>
</div>
<input type="hidden" name="externalReferer" value="">
<input type="hidden" name="subject" value="Report a problem or mistake on this page">
<fieldset>
<legend>
<span class="field-name">Please select all that apply:</span>
</legend>
<div class="checkbox">
<label for="problem1">
<input name="problem1" id="problem1" type="checkbox" value="Yes" >A link, button or video is not working
</label>
<input name="problem1" type="hidden" value="">
</div>
<div class="checkbox">
<label for="problem2">
<input name="problem2" id="problem2" type="checkbox" value="Yes" >It has a spelling mistake
</label>
<input name="problem2" type="hidden" value="">
</div>
<div class="checkbox">
<label for="problem3">
<input name="problem3" id="problem3" type="checkbox" value="Yes" >Information is missing
</label>
<input name="problem3" type="hidden" value="">
</div>
<div class="checkbox">
<label for="problem4">
<input name="problem4" id="problem4" type="checkbox" value="Yes" >Information is outdated or wrong
</label>
<input name="problem4" type="hidden" value="">
</div>
<div class="checkbox">
<label for="problem5">
<input name="problem5" id="problem5" type="checkbox" value="Yes" >Login error when trying to access an account
</label>
<input name="problem5" type="hidden" value="">
</div>
<div class="checkbox">
<label for="problem11">
<input name="problem11" id="problem11" type="checkbox" value="Yes" >I can't find what I'm looking for
</label>
<input name="problem11" type="hidden" value="">
</div>
<div class="checkbox">
<label for="problem12">
<input name="problem12" id="problem12" type="checkbox" value="Yes" >Other issue not in this list
</label>
<input name="problem12" type="hidden" value="">
</div>
</fieldset>
<button type="submit" class="btn btn-primary">Submit</button>
</form>
</div>
<div class="success-message hide">
<h3>Thank you for your help!</h3>
<p>You will not receive a reply. For enquiries, please <a href="https://www.canada.ca/en/contact.html">contact us</a>.</p>
</div>
<p class="failure-message hide">Something went wrong. Please submit your information via an alternative method.</p>
</div>
</div>
</details>
</div>
</div>
