<link href="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/js/bootstrap.min.js"></script> <script src="//code.jquery.com/jquery-1.11.1.min.js"></script> <!------ Include the above in your HEAD tag ----------> <b>ATENÇÃO, O TÍTULO DO EMAIL SERÁ FORMADO AUTOMÁTICAMENTE PELOS CAMPOS "CLASSIFICAÇÃO DE SEVERIDADE" - "NÚMERO DO RI" - "NOME DO SERVIÇO"</b> <form class="form-horizontal"> <fieldset> <!-- Form Name --> <legend>Form Name</legend> <!-- Multiple Radios (inline) --> <div class="form-group"> <label class="col-md-4 control-label" for="radios">Classificação de Severidade</label> <div class="col-md-4"> <label class="radio-inline" for="radios-0"> <input type="radio" name="radios" id="radios-0" value="Alta" checked="checked"> Alta </label> <label class="radio-inline" for="radios-1"> <input type="radio" name="radios" id="radios-1" value="Altissima"> Altíssima </label> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="Infra"> Infra </label> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="Equipe">Equipe</label> <div class="col-md-4"> <select id="Equipe" name="Equipe" class="form-control"> <option value="">Selecione uma equipe</option> </select> </div> <div class="col-md-4"> <select id="Equipe" name="Equipe" class="form-control"> <option value="">Selecione uma equipe</option> </select> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="email">E-mail</label> <div class="col-md-4"> <input id="email" name="email" type="text" placeholder="e-mail" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="equipe">Aos cuidados:</label> <div class="col-md-4"> <input id="equipe" name="equipe" type="text" placeholder="Aos cuidados" class="form-control input-md"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="servico">Nome do Serviço</label> <div class="col-md-4"> <input id="servico" name="servico" type="text" placeholder="Nome do Serviço" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">Text Input</label> <div class="col-md-4"> <input id="textinput" name="textinput" type="text" placeholder="placeholder" class="form-control input-md"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">Text Input</label> <div class="col-md-4"> <input id="textinput" name="textinput" type="text" placeholder="placeholder" class="form-control input-md"> </div> </div> <!-- Textarea --> <div class="form-group"> <label class="col-md-4 control-label" for="textarea">Text Area</label> <div class="col-md-4"> <textarea class="form-control" id="textarea" name="textarea">default text</textarea> </div> </div> <!-- Textarea --> <div class="form-group"> <label class="col-md-4 control-label" for="textarea">Text Area</label> <div class="col-md-4"> <textarea class="form-control" id="textarea" name="textarea">default text</textarea> </div> </div> <!-- Prepended text--> <div class="form-group"> <label class="col-md-4 control-label" for="prependedtext">Prepended Text</label> <div class="col-md-4"> <div class="input-group"> <span class="input-group-addon">prepend</span> <input id="prependedtext" name="prependedtext" class="form-control" placeholder="placeholder" type="text"> </div> </div> </div> <!-- Button --> <div class="form-group"> <label class="col-md-4 control-label" for="singlebutton"></label> <div class="col-md-4"> <button id="singlebutton" name="singlebutton" class="btn btn-primary">Enviar</button> </div> </div> </fieldset> </form>