1. System Generated Field Panel
2. Author Entered Field Panel
3. Form Title Panel
4. End-user Entered Field Panel
5. Thank You and Error Message Panel
6. Hidden Panel

• System Generated Field Panel
• Author Entered Field Panel
• Form Title Panel
• End-user Entered Field Panel
• Thank You and Error Message Panel
• Hidden Panel

System Generated Field Panel 

MCID

Sort Order

Required Fields

Page From

Site

 Author Entered Field Panel

Author Input Panel - Required fields

Select the form layout

*Type of Form Integration siteComponent slider contactCardForm

Analytics form title

Email address to which form data will be sent

Subject line of the email

Select the market region

*Region ASIA APAC EMEA LATAM USA

Select the country

*Country Bangladesh Australia Hongkong United Kingdom Turkey Kuwait Bahrain Egypt Jordan Greece Oman Lebanon Romania Bulgaria France Poland Portugal Spain UAE Italy Russia Portugal Argentina Columbia Brazil USA

Analytics form type

*Type Of Form Contactform Inquiry Grievance

Backend Integration Type

Select the Backend Integration - Email or KANA (US Only) email kana

Form Title  Panel

End-user Entered Field Panel

*Fields are required

*First Name

*Last Name

*State

*State

*Company Name

*Company Size

1-99

100 - 4,999

5,000 or more

*Contact Phone Number

*Email

Are you a consultant/broker/agent?

Yes

No

Organization

Client's Name

Your Firm or Brokerage Name:

Broker Name

Do you use an employee benefits broker or consultant?

Yes

No

*Tell us how we can help

SUBMIT

Thank You/Error Panel Configuration

Message Option Same page-fadeout Same page-fixed New page

Settings for same page thank you/error message

Message Delay

Error

An error has occurred. Please try again later.

Thank You

Thank you for submitting your questions. A MetLife Legal Plans representative will contact you within one business day. Please call 800-821-6400 if you need immediate assistance.

Settings for separate page thank you/error message

Error Page

Thank You Page

Page Target

Page Target Same Tab New Tab

Hidden Panel

Name Of The Template