138 lines
7.1 KiB
HTML
138 lines
7.1 KiB
HTML
<!DOCTYPE html>
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<html lang="en">
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<head>
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<meta charset="UTF-8">
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<meta name="viewport" content="width=device-width, initial-scale=1.0">
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<title>CCAH IT Assessment Questionnaire</title>
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<!-- Bootstrap CDN -->
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<link rel="stylesheet" href="https://cdn.jsdelivr.net/npm/bootstrap@5.3.2/dist/css/bootstrap.min.css">
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<link rel="stylesheet" href="../assets/css/styles.css">
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</head>
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<body>
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<div class="container mt-4">
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<div class="text-center mb-4">
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<img src="../assets/img/ccah-logo.png" alt="CCAH Logo" style="max-height:100px;">
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</div>
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<h3 class="text-center">CCAH IT Assessment Questionnaire</h3>
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<form id="assessment-form">
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<div id="form-message" class="alert d-none mt-3"></div>
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<!-- General Information -->
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<div class="mb-3">
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<label class="form-label">Role/Title at CCAH</label>
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<input type="text" class="form-control" name="role" required>
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</div>
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<div class="mb-3">
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<label class="form-label">Briefly describe your role function</label>
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<textarea class="form-control" name="role_function" required></textarea>
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</div>
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<div class="mb-3">
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<label class="form-label">Devices Used For CCAH Work</label>
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<div class="form-check">
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<input class="form-check-input" type="checkbox" name="devices" value="PC" id="device-pc">
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<label class="form-check-label" for="device-pc">PC</label>
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</div>
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<div class="form-check">
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<input class="form-check-input" type="checkbox" name="devices" value="Mac" id="device-mac">
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<label class="form-check-label" for="device-mac">Mac</label>
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</div>
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<div class="form-check">
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<input class="form-check-input" type="checkbox" name="devices" value="Tablet" id="device-tablet">
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<label class="form-check-label" for="device-tablet">Tablet</label>
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</div>
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<div class="form-check">
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<input class="form-check-input" type="checkbox" name="devices" value="Phone" id="device-phone">
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<label class="form-check-label" for="device-phone">Phone</label>
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</div>
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<div class="form-check">
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<input class="form-check-input" type="checkbox" name="devices" value="Other" id="device-other"
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onclick="toggleOtherField(this, 'device-other-text')">
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<label class="form-check-label" for="device-other">Other</label>
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</div>
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<input type="text" class="form-control mt-2" id="device-other-text" name="device_other"
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placeholder="Specify other device" style="display: none;">
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</div>
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<!-- Work Location -->
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<div class="mb-3">
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<label class="form-label">Work Location</label>
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<select class="form-control" name="work_location" required>
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<option value="">Select...</option>
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<option value="100% Office">100% Office</option>
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<option value="Mostly Office">Mostly office with some remote work</option>
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<option value="Balanced">Balanced (50/50 office & remote)</option>
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<option value="Mostly Remote">Mostly remote with some office work</option>
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<option value="100% Remote">100% Remote</option>
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</select>
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</div>
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<!-- Email Access -->
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<div class="mb-3">
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<label class="form-label">How do you access your email?</label>
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<select class="form-control" name="email_access" required>
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<option value="">Select...</option>
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<option value="Outlook">Outlook (Installed)</option>
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<option value="Webmail">Webmail (Browser)</option>
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<option value="Mobile">Mobile (Phone/Tablet)</option>
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<option value="All Methods">I use all 3 methods</option>
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</select>
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</div>
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<!-- Multi-Factor Authentication (MFA) -->
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<div class="mb-3">
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<label class="form-label">Do you use Multi-Factor Authentication (MFA)?</label>
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<select class="form-control" name="mfa" id="mfa-select" onchange="toggleDependentField(this, 'Yes', 'mfa-types')">
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<option value="No">No</option>
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<option value="Yes">Yes</option>
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</select>
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</div>
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<div id="mfa-types" class="mt-3" style="display: none;">
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<label class="form-label">What type of MFA do you use?</label>
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<div class="form-check">
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<input class="form-check-input" type="checkbox" name="mfa_types" value="Email">
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<label class="form-check-label">Email</label>
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</div>
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<div class="form-check">
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<input class="form-check-input" type="checkbox" name="mfa_types" value="Text">
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<label class="form-check-label">Text</label>
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</div>
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<div class="form-check">
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<input class="form-check-input" type="checkbox" name="mfa_types" value="Authenticator App"
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onclick="toggleOtherField(this, 'mfa-app-name')">
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<label class="form-check-label">Authenticator App</label>
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</div>
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<input type="text" class="form-control mt-2" id="mfa-app-name" name="mfa_apps"
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placeholder="Specify MFA App" style="display: none;">
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</div>
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<!-- IT Challenges -->
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<div class="mb-3">
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<label class="form-label">Are there any IT challenges you face regularly?</label>
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<div class="form-check">
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<input class="form-check-input" type="checkbox" name="it_challenges" value="Slow Performance">
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<label class="form-check-label">Slow Computer Performance</label>
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</div>
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<div class="form-check">
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<input class="form-check-input" type="checkbox" name="it_challenges" value="Software Issues">
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<label class="form-check-label">Software Issues</label>
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</div>
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<div class="form-check">
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<input class="form-check-input" type="checkbox" name="it_challenges" value="Other"
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onclick="toggleOtherField(this, 'it-other-text')">
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<label class="form-check-label">Other</label>
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</div>
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<input type="text" class="form-control mt-2" id="it-other-text" name="it_other"
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placeholder="Specify other challenges" style="display: none;">
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</div>
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<button type="submit" class="btn btn-primary">Submit</button>
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</form>
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</div>
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<script src="../assets/js/main.js"></script>
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</body>
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</html>
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