source: main/adopters/nj/branches/3.0/src/main/webapps/doh-shad-content/xml/html_content/home/ContactInformation.xml @ 25268

Last change on this file since 25268 was 25268, checked in by GarthBraithwaite_STG, 3 months ago

nj - s&r view requests to content file. Cleaned out 2.3 content dirs. added 2.3 _topic.css as a temp solution for home page icon formatting.

File size: 9.9 KB
1<?xml version="1.0" encoding="ISO-8859-1"?>
3<HTML_CONTENT xmlns:ibis="">
5        <ibis:doc>
6                <name>home/ContactInformation</name>
7                <summary>Contact info</summary>
8                <description>
9                </description>
11                <author>Maria Baron</author>
12                <company>NJ Department of Health</company>
13                <versions>
14                        <version><number>3.0</number><date>12/10/20</date><who>Maria</who>
15                                <description>added form</description>
16                        </version>
17                        <version><number>2.3</number><date>10/7/16</date><who>Maria</who>
18                                <description>updated to DOH tile style</description>
19                        </version>
20                </versions>
21        </ibis:doc>
23        <!--OTHER_HEAD_CONTENT>
24                <style>
25                        section#content .has-sidebar {
26                          float: left;
27                          width: 55%;
28                          padding-right: 15px;
29                        }
30                        section#content #Sidebar-Wrapper {
31                          float: right;
32                          width: 45%;
33                        }
34                </style>
35        </OTHER_HEAD_CONTENT-->
37        <TITLE>Contact Information</TITLE>
39        <CONTENT>
40                <!--br/>
41                <For inquiries regarding NJSHAD, please
42                <b>e-mail</b>: <SCRIPT TYPE="text/javascript">
43                        emailE=('njshad@' + '')
44                        document.write('<a href="mailto:' + emailE + '">' + emailE + '</a>')
45                        </SCRIPT>
46                        <NOSCRIPT>
47                                <em>Email address protected by JavaScript.  Protected email script by Joe Maller.
48                                        JavaScripts available at</em>
49                        </NOSCRIPT>. E-mails are usually responded to within one or two business days.
51                <br/-->
52                <!--h3>Information for or about:</h3>
53                <br/>
54                        <h5>COVID-19</h5>
55                        <ul><li><b>Go to <a href="" class="Bold"></a> for all things related to COVID-19.</b>  NJSHAD has no involvement with the COVID-19 <a href="">dashboard</a> or response efforts.</li></ul><br/>
57                        <h5>Press/Media</h5>
58                        <ul><li>If you are a <strong>member of the press/media</strong>, please use the <a href="" class="Bold">Media Intake Form</a> for the fastest service.</li></ul><br/>
60                        <h5>Certificates (Vital Records)</h5>
61                        <ul><li>Individual <b>Birth, Death, and Marriage certificates</b> are maintained by the <a href="" class="Bold">Office of Vital Statistics and Registry</a>. Go to their website to <a href="" class="Bold">order certificates</a> and <a href="" class="Bold">check on requests</a>.</li></ul><br/>
63                        <h5>Request a link to your website</h5>
64                        <ul><li>Requests to post links to non-governmental websites <b>will not be granted.</b></li></ul><br/>
66                        <h5>Non-NJSHAD questions and feedback</h5>
67                        <ul><li>If you have questions or feedback about any issues other than those related to NJSHAD, please use the <strong>NJDOH Feedback</strong> form at <a href=""  class="Bold" target="_blank"></a> so that your inquiry will reach the correct office.</li></ul><br/-->
69                Click the bars below for information for or about:
70                <br/>
71                <ibis:ExpandableContent titleLevel="2"><HIDE/>
72                        <TITLE>COVID-19</TITLE>
73                        <CONTENT><b>Go to <a href="" class="Bold"></a> for all things related to COVID-19.</b>  NJSHAD has no involvement with the COVID-19 <a href="">dashboard</a> or response efforts.
74                        </CONTENT>
75                </ibis:ExpandableContent>
76                <ibis:ExpandableContent titleLevel="2"><HIDE/>
77                        <TITLE>Press/Media</TITLE>
78                        <CONTENT>If you are a <strong>member of the press/media</strong>, please use the <a href="" class="Bold">Media Intake Form</a> for the fastest service.
79                        </CONTENT>
80                </ibis:ExpandableContent>
81                <ibis:ExpandableContent titleLevel="2"><HIDE/>
82                        <TITLE>Certificates (Vital Records)</TITLE>
83                        <CONTENT>                                       
84                        Individual <b>Birth, Death, and Marriage certificates</b> are maintained by the <a href="" class="Bold">Office of Vital Statistics and Registry</a>.
85                        <br/> 
86                        Go to their website to <a href="" class="Bold">order certificates</a> and <a href="" class="Bold">check on requests</a>.
87                        </CONTENT>
88                </ibis:ExpandableContent>
89                <ibis:ExpandableContent titleLevel="2"><HIDE/>
90                        <TITLE>Requesting a link to your website</TITLE>
91                        <CONTENT>Requests to post links to non-governmental websites <b>will not be granted.</b>
92                        </CONTENT>
93                </ibis:ExpandableContent>
94                <ibis:ExpandableContent titleLevel="2"><HIDE/>
95                        <TITLE>Non-NJSHAD questions and feedback</TITLE>
96                        <CONTENT>
97                        If you have questions or feedback about any issues other than those related to the NJSHAD data portal, please use the <strong>NJDOH Feedback</strong> form at <a href=""  class="Bold" target="_blank"></a> so that your inquiry will reach the correct office.
98                        </CONTENT>
99                </ibis:ExpandableContent>
101<div class="col-12">
102        <h5>To contact the NJSHAD team:</h5>   
105<form id="resource" action="" method="post" name="resource">
106        <!--div class="form-group row bg-light py-3">
107                <div class="col-12">
108                        <p><span style="color: #ff0000;">**</span>Required Fields</p>
109                        <p><strong> Please write your message</strong></p>
110                </div>
111        </div-->
112        <div class="form-group row"><label class="col-sm-3" for="subject"> <span style="color: #ff0000;"> **</span> Subject:</label>
113                <div class="col-sm-9 px-2"><select id="subject" class="fieldInput form-control" name="subject">
114                        <option selected="selected" value="">Select One</option>
115                        <option value="Data on NJSHAD">Data on NJSHAD</option>
116                        <option value="Data not on NJSHAD">Data not on NJSHAD</option>
117                        <option value="Demo request">NJSHAD demonstration request</option>
118                        <option value="Website issue">NJSHAD website issue</option>
119                        <option value="Success story">Tell us your NJSHAD user story</option>
120                        <option value="Other">Other</option>
121                        </select>
122                </div>
123                <p>If your subject is not listed, please select one of the blue bars above to properly direct your question.</p>
124        </div>
125        <div class="form-group row bg-light py-2"><label class="col-sm-3" for="message"> <span style="color: #ff0000;"> **</span> Message:</label>
126                <div class="col-sm-9 px-2"><textarea class="fieldInput form-control" cols="41" name="message" rows="5" wrap="soft"></textarea> <br /> <span class="black11"> Limit 250 characters.</span></div>
127        </div>
128        <div class="form-group row"><label class="col-sm-3" for="fname"> First Name:</label>
129                <div class="col-sm-9 px-2"><input id="fname" class="fieldInput form-control" maxlength="40" name="fname" size="50" type="text" /></div>
130        </div>
131        <div class="form-group row bg-light py-2"><label class="col-sm-3" for="lname"> Last Name:</label>
132                <div class="col-sm-9 px-2"><input id="lname" class="fieldInput form-control" maxlength="40" name="lname" size="50" type="text" /></div>
133        </div>
134        <div class="form-group row"><label class="col-sm-3" for="org"> Organization:</label>
135                <div class="col-sm-9 px-2"><input id="org" class="fieldInput form-control" maxlength="40" name="org" size="50" type="text" /></div>
136        </div>
137        <div class="form-group row bg-light py-2">
138                <div class="col-12">
139                        <p><strong> If you would like a reply, please provide your email address.</strong></p>
140                </div>
141                <label class="col-sm-3" for="email"> E-mail Address:</label>
142                <div class="col-sm-9 px-2"><input id="email" class="fieldInput form-control" maxlength="40" name="email" size="50" type="text" /></div>
143        </div>
144        <div class="form-group  form-check row ">
145                <div class="col-12"><input class="form-check-input" name="copy" type="checkbox" value="Y" /> <label for="copy"> Check if you would like to have a copy of this email sent to you.</label></div>
146        </div>
147        <div class="SmallerFont">
148                <span style="color: #ff0000;">**</span>Required Fields
149        </div>
150        <div class="form-group row bg-light py-2">
151                <div class="col-12"><input name="contact" type="hidden" value="" /> <input class="btn btn-primary" name="continue" type="submit" value="Submit" />     <input class="btn btn-primary" name="reset" type="reset" value="Start Over" /></div>
152        </div>
154        <div class="form-group row">
155                <div class="col-12">
156                <p>Please note that this is not a general Department of Health contact form.  If you have questions or feedback about any issues other than those related to <strong> NJSHAD</strong>, please use the main NJDOH contact form at <a title="DOH Feedback" href="" target="_blank"></a>.</p>
157                </div>
158        </div>
159<!--div class="container clearfix">
160        <section id="content">
161                <div class="row" style="margin-top:-10px;">
162                        <div class="col-md-11">
163                                <div class="panel green">
164                                        <table>
165                                                <tr>
166                                                        <td style="width:20% vertical-align:bottom">
167                                                                <a href="" target="_blank" title="Go to EPHT site">
168                                                                <img src="contentfile/image/home/NewJersey_Tracking.png" style="display:block; padding:15px 15px 15px 15px; width:90%" title="NJEPHT logo" alt="NJEPHT"/></a>
169                                                        </td>
170                                                        <td width="80%">
171                                                                <br/>
172                                                                NJSHAD is a collaborative effort involving multiple offices and divisions in the New Jersey Department of Health.<br/><br/>
173                                                                Funding for NJSHAD enhancement is provided in part through the NJDOH Consumer, Environmental, and Occupational Health Service's <a href="">Environmental Public Health Tracking (EPHT)</a> Cooperative Agreement from the Centers for Disease Control and Prevention.
174                                                        </td>
175                                                </tr>
176                                        </table>
177                                </div>
178                        </div>
179                </div>
180        </section>
182        </CONTENT>
Note: See TracBrowser for help on using the repository browser.