Inventory Capture

The Inventory Capture form is the primary means by which our users provide us with contents data for their claims. We use this form not only for new items added to a claim, but for existing or previously added items, as well.

Design Sample

Description

Please include a description Description*

Cost

Please include a cost per item Cost Per Item*

Quantity

Please include a quantity Quantity*

Age: Years

How old is this item (in years)? Age: In Years*

Age: Months

How old is this item (in months)? Age: In Months*

Condition

Please select an option

Condition

html

<form>
  <fieldset>
    <legend>Description</legend>
    <div class="field"> <!-- change to 'field valid' or 'field invalid' as necessary -->
      <span class="error-message">Please include a description</span>
      <input type="text" name="description" id="description" placeholder="Describe your item&nbsp;&#40;including brand&#41;" required>
      <label for="description">Description&#42;</label>
    </div>
  </fieldset>
  <fieldset class="half">
    <legend>Cost</legend>
    <div class="field"> <!-- change to 'field valid' or 'field invalid' as necessary -->
      <span class="error-message">Please include a cost per item</span>
      <input type="text" name="cost" id="cost" placeholder="Cost per item" required>
      <label for="cost">Cost Per Item&#42;</label>
    </div>
  </fieldset>
  <fieldset class="half">
    <legend>Quantity</legend>
    <div class="field"> <!-- change to 'field valid' or 'field invalid' as necessary -->
      <span class="error-message">Please include a quantity</span>
      <input type="number" name="quantity" id="quantity" placeholder="Quantity" required>
      <label for="quantity">Quantity&#42;</label>
    </div>
  </fieldset>
  <fieldset class="half">
    <legend>Age: Years</legend>
    <div class="field"> <!-- change to 'field valid' or 'field invalid' as necessary -->
      <span class="error-message">How old is this item &#40;in years&#41;?</span>
      <input type="number" name="years" id="years" placeholder="Years" required>
      <label for="years">Age: In Years&#42;</label>
    </div>
  </fieldset>
  <fieldset class="half">
    <legend>Age: Months</legend>
    <div class="field"> <!-- change to 'field valid' or 'field invalid' as necessary -->
      <span class="error-message">How old is this item &#40;in months&#41;?</span>
      <input type="number" name="months" id="months" placeholder="Months" required>
      <label for="months">Age: In Months&#42;</label>
    </div>
  </fieldset>
  <fieldset>
    <legend>Condition</legend>
    <div class="field"> <!-- change to 'field valid' or 'field invalid' as necessary -->
      <span class="error-message">Please select an option</span>
      <select name="condition" id="condition">
        <option value="0">Choose a Condition</option>
        <option value="New">New</option>
        <option value="Excellent">Excellent</option>
        <option value="Good">Good</option>
        <option value="Fair">Fair</option>
        <option value="Poor">Poor</option>
      </select>
      <div class="select-icon"><i class="la la-angle-down"></i></div>
      <span class="valid select"><i class="la la-check-circle-o"></i></span>
      <label for="condition">Condition</label>
    </div>
  </fieldset>
  <div class="button-box left">
    <button class="button color-one"><span class="button-label">Add Item To Inventory</span></button>
    <button class="button color-two"><span class="button-label">Add Attachments<span class="post"><i class="la la-paperclip"></i></span></span></button>
    <button id="submit-button" class="button secondary color-one submit"><span class="button-label">Submit Inventory<span class="post"><span class="processing"><i class="la la-refresh la-spin"></i></span></span></span></button>
  </div>
</form>