Thank you for reaching out to us. To help our team resolve your issue as quickly as possible, please provide as much detail as you can in the form below.
Full Name:
Email Address:
Phone Number:
Account ID / Policy Number:
App Name:
App Version:
Device Model:
Operating System Version:
How is your device connected to the internet?
Wi-Fi
Cellular data
Please describe the issue you are experiencing in detail. What were you trying to do, and what happened instead?
When did this issue first occur? (Date and Time)
Please select the category that best describes your problem (check all that apply):
Account/Login Issue (e.g., can't log in, password reset not working)
Policy Information (e.g., policy details are incorrect or missing)
Claims (e.g., issue with submitting a new claim or checking an existing one)
Payments/Billing (e.g., payment failed, cannot view billing history)
Document Access (e.g., can't download insurance card or policy documents)
Technical/Performance (e.g., app crashes, freezing, slow performance)
Other:
If you selected "Claims," please provide the following:
Claim Number (if available):
Date of Incident:
Brief description of the claim:
If you selected "Payments/Billing," please provide the following:
Transaction Date:
Payment Amount:
Last 4 digits of the payment method used:
If you selected "Account Issue," please provide the following:
What is the exact error message you are seeing?
Can you log in to your account on any other device or platform?
Yes, I can log in elsewhere.
No, I cannot log in anywhere else.
I haven't tried or I don't have other devices/platforms.
To help our developers, please list the exact steps you took that led to the problem. (For example: "1. Opened the app. 2. Tapped on 'My Policies'. 3. Tapped on my auto policy. 4. The app froze and closed.")
If possible, please attach any relevant screenshots or screen recordings. These are extremely helpful for our team to see exactly what you are seeing.
Description / File Name | Upload File | ||
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A | B | ||
1 | |||
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Thank you for your time. A support agent will be in touch with you shortly.
App Support Form Insights
Please remove this app support form insights section before publishing.
This is an excellent and well-structured form. It's designed to be comprehensive without being overly intimidating to the user, and it effectively guides them to provide the specific details a support team needs.
Here are some detailed insights into each section:
This section's primary strength is its directness. Collecting the user's name and email is standard, but asking for the Account ID / Policy Number upfront is a huge time-saver. It allows the support agent to immediately pull up the customer's information and bypass the initial back-and-forth of "Can you please verify your account?" This is especially critical for apps with a large user base.
This is a goldmine for technical teams. Problems in mobile apps are often specific to a particular device, operating system, or app version. By collecting App Version, Device Model, and Operating System Version, the form helps developers:
Combining a detailed, open-ended description with a categorized checklist is a powerful approach.
This section is a great example of a form that anticipates user needs. Instead of asking every user for their Claim Number or Transaction Date, it uses conditional logic to ask for specific information only when it's relevant. This keeps the form from feeling bloated and reduces the cognitive load on the user. The targeted questions help gather the exact data points needed to begin an investigation.
This is arguably the most important part of the form for a developer. A clear, step-by-step list is essential for bug replication. Without this, a developer might not be able to find the issue and the user would have to be contacted for more details. Providing an example helps the user understand exactly what's needed.
The ability to attach screenshots or screen recordings is invaluable. A picture is often worth a thousand words when troubleshooting a user interface or error message. It removes any ambiguity from the problem description and allows the support team to see the issue exactly as the customer sees it.
Overall, the form is designed to capture the necessary information on the first attempt, minimizing back-and-forth and creating a more efficient and positive support experience for both the customer and the support team.
Mandatory Questions Recommendation
Please remove this mandatory questions recommendation before publishing.
Based on the support form you provided, the following questions are mandatory for a support team to effectively begin investigating an issue:
These are fundamental for two reasons:
This is essential for technical diagnostics.
This is the core of the entire form.
This is a critical triage question for support operations.
This question is a developer's best friend.
To configure an element, select it on the form.