<textarea name="reportReason" id="reportReason" cols="60" rows="10"></textarea>

			<?php 
    if ($this->params->get('recaptcha') && $this->user->guest) {
        ?>
			<label class="formRecaptcha"><?php 
        echo JText::_('K2_PLEASE_VERIFY_THAT_YOU_ARE_HUMAN');
        ?>
</label>
			<div id="recaptcha"></div>
			<?php 
    }
    ?>
			
			<?php 
    echo K2HelperCaptcha::display();
    ?>
			
			<button data-action="report.send"><?php 
    echo JText::_('K2_SEND_REPORT');
    ?>
</button>
			<span data-role="log"></span>
			<input type="hidden" name="id" value="" />
			<input type="hidden" name="task" value="comments.report" />
			<input type="hidden" name="format" value="json" />
			<?php 
    echo JHTML::_('form.token');
    ?>
		</form>