Website Services — Lead Requirement Form
Tell us about your project & goals
Contact Information
All fields marked * are required.
Step 1 of 5
Service Required
Click to select one or more services for your project.
Primary service *
✓
New Website Development
Brand new website built from scratch
✓
Website Redesign / Revamp
Improve look, feel, and UX of existing site
✓
E-Commerce Development
Online store with payments, cart & inventory
✓
Website Speed & Performance Optimization
Core Web Vitals, load time, SEO health
✓
SEO & Digital Marketing Integration
On-page SEO, analytics, conversion tracking
✓
Website Maintenance & Support
Ongoing updates, backups, security patches
✓
Landing Page / Microsite
Single page for campaigns or product launch
✓
Custom Web Application
Portal, dashboard, booking system, etc.
Please select at least one service.
Step 2 of 5
Project Details
Help us understand the scope and goals of your project.
Please describe your project goal (min. 10 characters).
Please describe your target audience.
Please select an estimated page count.
Please select a timeline.
Budget range (USD) *
$3,000 – $5,000
Drag slider to set your approximate budget
$1,000$5,000$15,000$30,000+
Step 3 of 5
Technical Requirements
Platform preferences and integrations needed.
Please select a platform.
Please select a hosting preference.
Required features & integrations *
✓
Contact / Lead Form
Capture visitor inquiries
✓
Live Chat / Chatbot
Real-time communication widget
✓
Blog / News Section
Content management for posts
✓
Booking / Appointment
Online scheduling system
✓
Payment Gateway
Stripe, PayPal, Square…
✓
Multilingual Support
Spanish, French, Chinese, etc.
✓
Google Analytics / Pixel
Traffic & conversion tracking
✓
Social Media Integration
Feeds, sharing, login
✓
Newsletter / Email List
Mailchimp, Klaviyo, HubSpot…
✓
Member / User Login
Accounts & gated content
✓
Mobile App (PWA)
Installable progressive web app
✓
CRM / ERP Integration
Salesforce, HubSpot, etc.
Please select at least one feature or integration.
Step 4 of 5
Final Details & Submit
Last step — add any extra notes and send your requirement.
Please tell us how you heard about us.
Please select a contact method.
Please select the best contact time.
Ready to submit your requirement
I agree to be contacted by Techverdi regarding this project. My information will be kept strictly confidential and not shared with third parties.
Sends to contact@techverdi.com · Response within 24 business hours
Step 5 of 5
✓
Requirement Submitted!
Thank you for contacting Techverdi. Your email client has opened with your requirement pre-filled — please send it to complete your submission.
Our team will review and respond within 24 business hours.
contact@techverdi.com
2025 Techverdi. All Rights Reserved
${(function(){
(function () {
'use strict';
/* ── STATE ── */
var cur = 1;
var consent = false;
var svcSel = {};
var featSel = {};
var budgetMap = [
"$1,000 – $2,000","$2,000 – $3,000","$3,000 – $5,000","$5,000 – $7,500",
"$7,500 – $10,000","$10,000 – $12,500","$12,500 – $15,000","$15,000 – $18,000",
"$18,000 – $22,000","$22,000 – $26,000","$26,000 – $30,000","$30,000 – $40,000","$40,000+"
];
/* ── HELPERS ── */
function $(id) { return document.getElementById(id); }
function gv(id) { return $(id) ? $(id).value.trim() : ''; }
function isEmail(v) { return /^[^\s@]+@[^\s@]+\.[^\s@]{2,}$/.test(v); }
function isPhone(v) { return /^\d{7,15}$/.test(v.replace(/[\s\-\+\(\)]/g, '')); }
function isUrl(v) { return !v || /^https?:\/\/.+\..+/.test(v); }
function setInv(id, bad, errId) {
var el = $(id);
if (!el) return;
if (bad) el.classList.add('tv-invalid'); else el.classList.remove('tv-invalid');
if (errId) {
var e = $(errId);
if (e) { if (bad) e.classList.add('show'); else e.classList.remove('show'); }
}
}
/* ── STEP NAV ── */
function goStep(n) {
$('step' + cur).classList.remove('active');
$('step' + n).classList.add('active');
cur = n;
for (var i = 1; i <= 5; i++) {
var d = $('dot' + i), l = $('lbl' + i);
d.classList.remove('active', 'done');
l.classList.remove('active');
if (i < n) { d.classList.add('done'); d.textContent = ''; }
else if (i === n) { d.classList.add('active'); d.textContent = i; l.classList.add('active'); }
else { d.textContent = i; }
}
window.scrollTo({ top: 0, behavior: 'smooth' });
}
/* ── VALIDATE PER STEP ── */
function validateStep(s) {
var ok = true;
if (s === 1) {
var checks = [
['f_name', 'err_name', function(v){ return v.length >= 2; }],
['f_role', 'err_role', function(v){ return v.length >= 2; }],
['f_email', 'err_email', function(v){ return isEmail(v); }],
['f_phone', 'err_phone', function(v){ return isPhone(v); }],
['f_company', 'err_company', function(v){ return v.length >= 2; }],
['f_industry','err_industry',function(v){ return v !== ''; }],
['f_url', 'err_url', function(v){ return isUrl(v); }],
['f_location','err_location',function(v){ return v.length >= 2; }]
];
checks.forEach(function(c) {
var val = gv(c[0]), pass = c[2](val);
setInv(c[0], !pass, c[1]);
if (!pass) ok = false;
});
}
if (s === 2) {
var hasSvc = Object.keys(svcSel).some(function(k) { return svcSel[k]; });
if (!hasSvc) { $('err_services').classList.add('show'); ok = false; }
}
if (s === 3) {
var g = gv('f_goal').length >= 10;
var a = gv('f_audience').length >= 5;
var p = gv('f_pages') !== '';
var t = gv('f_timeline') !== '';
var br = gv('f_branding') !== '';
setInv('f_goal', !g, 'err_goal');
setInv('f_audience',!a, 'err_audience');
setInv('f_pages', !p, 'err_pages');
setInv('f_timeline',!t, 'err_timeline');
setInv('f_branding',!br, 'err_branding');
if (!g || !a || !p || !t || !br) ok = false;
}
if (s === 4) {
var cms = gv('f_cms') !== '';
var host = gv('f_hosting') !== '';
var hasFeat = Object.keys(featSel).some(function(k) { return featSel[k]; });
setInv('f_cms', !cms, 'err_cms');
setInv('f_hosting',!host, 'err_hosting');
if (!hasFeat) $('err_features').classList.add('show');
if (!cms || !host || !hasFeat) ok = false;
}
if (ok) goStep(s + 1);
}
/* ── SUBMIT ── */
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var src = gv('f_source');
var cp = gv('f_contact_pref');
var ct = gv('f_contact_time');
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setInv('f_contact_time',!ct, 'err_contact_time');if (!ct) ok = false;
if (!consent) {
$('consent_row').classList.add('c-invalid');
ok = false;
}
if (!ok) {
ge.textContent = 'Please complete all required fields and accept the consent checkbox.';
ge.classList.add('show');
return;
}
ge.classList.remove('show');
/* gather selections */
var svcLabels = [
'New Website Development','Website Redesign / Revamp','E-Commerce Development',
'Website Speed & Performance Optimization','SEO & Digital Marketing Integration',
'Website Maintenance & Support','Landing Page / Microsite','Custom Web Application'
];
var featLabels = [
'Contact / Lead Form','Live Chat / Chatbot','Blog / News Section','Booking / Appointment',
'Payment Gateway','Multilingual Support','Google Analytics / Pixel','Social Media Integration',
'Newsletter / Email List','Member / User Login','Mobile App (PWA)','CRM / ERP Integration'
];
var svcs = [], feats = [];
for (var i = 0; i < 8; i++) if (svcSel[i]) svcs.push(svcLabels[i]);
for (var j = 0; j < 12; j++) if (featSel[j]) feats.push(featLabels[j]);
var body =
'TECHVERDI - WEBSITE REQUIREMENT FORM\n' +
'=====================================\n\n' +
'SECTION 1 - CONTACT INFORMATION\n' +
'Full Name : ' + gv('f_name') + '\n' +
'Job Title : ' + gv('f_role') + '\n' +
'Email : ' + gv('f_email') + '\n' +
'Phone Number : ' + gv('f_phone') + '\n' +
'Company : ' + gv('f_company') + '\n' +
'Industry : ' + gv('f_industry') + '\n' +
'Website : ' + (gv('f_url') || 'N/A') + '\n' +
'City / State : ' + gv('f_location') + '\n\n' +
'SECTION 2 - SERVICES REQUIRED\n' +
'Services : ' + (svcs.join(', ') || 'N/A') + '\n' +
'Other : ' + (gv('f_other_svc') || 'N/A') + '\n\n' +
'SECTION 3 - PROJECT DETAILS\n' +
'Project Goal : ' + gv('f_goal') + '\n' +
'Target Audience : ' + gv('f_audience') + '\n' +
'No. of Pages : ' + gv('f_pages') + '\n' +
'Timeline : ' + gv('f_timeline') + '\n' +
'Budget (USD) : ' + $('budget_label').textContent + '\n' +
'Reference Sites : ' + (gv('f_refs') || 'N/A') + '\n' +
'Branding : ' + gv('f_branding') + '\n\n' +
'SECTION 4 - TECHNICAL REQUIREMENTS\n' +
'Platform / CMS : ' + gv('f_cms') + '\n' +
'Hosting : ' + gv('f_hosting') + '\n' +
'Features : ' + (feats.join(', ') || 'N/A') + '\n' +
'Other Tech : ' + (gv('f_tech_other') || 'N/A') + '\n\n' +
'SECTION 5 - FINAL DETAILS\n' +
'Notes : ' + (gv('f_notes') || 'N/A') + '\n' +
'Heard About Us : ' + src + '\n' +
'Contact Method : ' + cp + '\n' +
'Best Time : ' + ct + '\n\n' +
'=====================================\n' +
'Submitted via Techverdi Website Requirement Form';
var subj = 'Website Requirement - ' + gv('f_company') + ' (' + gv('f_name') + ')';
window.location.href = 'mailto:contact@techverdi.com?subject=' +
encodeURIComponent(subj) + '&body=' + encodeURIComponent(body);
setTimeout(function () {
$('step5').classList.remove('active');
$('success_panel').classList.add('active');
for (var k = 1; k <= 5; k++) {
var d = $('dot' + k);
d.classList.remove('active');
d.classList.add('done');
d.textContent = '';
}
}, 400);
}
/* ── RESET ── */
function resetForm() {
$('success_panel').classList.remove('active');
cur = 5;
goStep(1);
document.querySelectorAll('.tv-wrap input, .tv-wrap textarea').forEach(function(e) {
e.value = ''; e.classList.remove('tv-invalid');
});
document.querySelectorAll('.tv-wrap select').forEach(function(e) {
e.selectedIndex = 0; e.classList.remove('tv-invalid');
});
document.querySelectorAll('.tv-wrap .field-error').forEach(function(e) {
e.classList.remove('show');
});
svcSel = {}; featSel = {};
document.querySelectorAll('.tv-wrap .svc-item').forEach(function(e) { e.classList.remove('sel'); });
document.querySelectorAll('.tv-wrap .feat-card').forEach(function(e) { e.classList.remove('sel'); });
$('budget_label').textContent = budgetMap[2];
$('budget_range').value = 2;
consent = false;
var b = $('consent_box');
b.textContent = ''; b.style.background = ''; b.style.borderColor = '';
$('consent_row').classList.remove('consented', 'c-invalid');
$('global_error').classList.remove('show');
$('err_features').classList.remove('show');
$('err_services').classList.remove('show');
}
/* ── WIRE UP ALL EVENTS after DOM ready ── */
function init() {
/* Next buttons */
document.querySelectorAll('.tv-wrap [data-next]').forEach(function(btn) {
btn.addEventListener('click', function() {
validateStep(parseInt(btn.getAttribute('data-next')));
});
});
/* Back buttons */
document.querySelectorAll('.tv-wrap [data-back]').forEach(function(btn) {
btn.addEventListener('click', function() {
goStep(parseInt(btn.getAttribute('data-back')) - 1);
});
});
/* Service items */
document.querySelectorAll('.tv-wrap .svc-item').forEach(function(el) {
el.addEventListener('click', function() {
var i = parseInt(el.getAttribute('data-svc'));
svcSel[i] = !svcSel[i];
if (svcSel[i]) el.classList.add('sel'); else el.classList.remove('sel');
$('err_services').classList.remove('show');
});
});
/* Feature cards */
document.querySelectorAll('.tv-wrap .feat-card').forEach(function(el) {
el.addEventListener('click', function() {
var i = parseInt(el.getAttribute('data-feat'));
featSel[i] = !featSel[i];
if (featSel[i]) el.classList.add('sel'); else el.classList.remove('sel');
$('err_features').classList.remove('show');
});
});
/* Budget slider */
$('budget_range').addEventListener('input', function() {
$('budget_label').textContent = budgetMap[parseInt(this.value)];
});
/* Consent */
$('consent_row').addEventListener('click', function() {
consent = !consent;
var b = $('consent_box'), r = $('consent_row');
if (consent) {
b.textContent = '\u2713';
b.style.background = 'var(--tv-green)';
b.style.borderColor = 'var(--tv-green)';
b.style.color = '#fff';
b.style.display = 'flex';
b.style.alignItems = 'center';
b.style.justifyContent = 'center';
r.classList.add('consented');
r.classList.remove('c-invalid');
} else {
b.textContent = '';
b.style.background = '';
b.style.borderColor = '';
r.classList.remove('consented');
}
});
/* Submit */
$('btn_submit').addEventListener('click', submitForm);
/* Reset */
$('btn_reset').addEventListener('click', resetForm);
/* Live clear on input */
['f_name','f_role','f_email','f_phone','f_company','f_location','f_goal','f_audience'].forEach(function(id) {
var el = $(id);
if (el) {
el.addEventListener('input', function() {
el.classList.remove('tv-invalid');
var errEl = $('err_' + id.replace('f_', ''));
if (errEl) errEl.classList.remove('show');
});
}
});
['f_industry','f_pages','f_timeline','f_branding','f_cms','f_hosting','f_source','f_contact_pref','f_contact_time'].forEach(function(id) {
var el = $(id);
if (el) {
el.addEventListener('change', function() {
el.classList.remove('tv-invalid');
var errEl = $('err_' + id.replace('f_', ''));
if (errEl) errEl.classList.remove('show');
});
}
});
}
/* Run init when DOM is ready */
if (document.readyState === 'loading') {
document.addEventListener('DOMContentLoaded', init);
} else {
init();
}
}());
})()}
