Simple Customer Feedback Form for website contact page | Sanwebcorner

Simple Customer Feedback Form for website contact page

Below you can find a basic website form using only HTML and PHP for the form processing.
Along-side the HTML form you will find a basic PHP script which will capture the form submissions and send the form feedback contents to your email address.

This is one of the useful script for customer feedback form. All the website contains the feedback form or contact form to get valuable information from the client. This script is used to send the form information to the particular email using php mail function.

Html Code:

<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
<title>Untitled Document</title>
</head>

<body>
<form name="contactform" method="post" action="send_form_email.php">
<table width="450px">
<tr>
 <td valign="top">
  <label for="first_name">First Name *</label>
 </td>
 <td valign="top">
  <input  type="text" name="first_name" maxlength="50" size="30">
 </td>
</tr>
<tr>
 <td valign="top">
  <label for="last_name">Last Name *</label>
 </td>
 <td valign="top">
  <input  type="text" name="last_name" maxlength="50" size="30">
 </td>
</tr>
<tr>
 <td valign="top">
  <label for="email">Email Address *</label>
 </td>
 <td valign="top">
  <input  type="text" name="email" maxlength="80" size="30">
 </td>
</tr>
<tr>
 <td valign="top">
  <label for="telephone">Telephone Number</label>
 </td>
 <td valign="top">
  <input  type="text" name="telephone" maxlength="30" size="30">
 </td>
</tr>
<tr>
 <td valign="top">
  <label for="comments">Comments *</label>
 </td>
 <td valign="top">
  <textarea  name="comments" maxlength="1000" cols="25" rows="6"></textarea>
 </td>
</tr>
<tr>
 <td colspan="2" style="text-align:center">
  <input type="submit" value="Submit">   <a href="http://sanwebtutorials.blogspot.in/">Email Form From</a>
 </td>
</tr>
</table>
</form>
</body>
</html>

send_form_email.php

<?php
if(isset($_POST['email'])) {
     
    // EDIT THE 2 LINES BELOW AS REQUIRED
    $email_to = "sandilyan.sand@gmail.com";
    $email_subject = "form details";
     
     
    function died($error) {
        // your error code can go here
        echo "We are very sorry, but there were error(s) found with the form you submitted. ";
        echo "These errors appear below.<br /><br />";
        echo $error."<br /><br />";
        echo "Please go back and fix these errors.<br /><br />";
        die();
    }
     
    // validation expected data exists
    if(!isset($_POST['first_name']) ||
        !isset($_POST['last_name']) ||
        !isset($_POST['email']) ||
        !isset($_POST['telephone']) ||
        !isset($_POST['comments'])) {
        died('We are sorry, but there appears to be a problem with the form you submitted.');       
    }
     
    $first_name = $_POST['first_name']; // required
    $last_name = $_POST['last_name']; // required
    $email_from = $_POST['email']; // required
    $telephone = $_POST['telephone']; // not required
    $comments = $_POST['comments']; // required
     
    $error_message = "";
    $email_exp = '/^[A-Za-z0-9._%-]+@[A-Za-z0-9.-]+\.[A-Za-z]{2,4}$/';
  if(!preg_match($email_exp,$email_from)) {
    $error_message .= 'The Email Address you entered does not appear to be valid.<br />';
  }
    $string_exp = "/^[A-Za-z .'-]+$/";
  if(!preg_match($string_exp,$first_name)) {
    $error_message .= 'The First Name you entered does not appear to be valid.<br />';
  }
  if(!preg_match($string_exp,$last_name)) {
    $error_message .= 'The Last Name you entered does not appear to be valid.<br />';
  }
  if(strlen($comments) < 2) {
    $error_message .= 'The Comments you entered do not appear to be valid.<br />';
  }
  if(strlen($error_message) > 0) {
    died($error_message);
  }
    $email_message = "Form details below.\n\n";
     
    function clean_string($string) {
      $bad = array("content-type","bcc:","to:","cc:","href");
      return str_replace($bad,"",$string);
    }
     
    $email_message .= "First Name: ".clean_string($first_name)."\n";
    $email_message .= "Last Name: ".clean_string($last_name)."\n";
    $email_message .= "Email: ".clean_string($email_from)."\n";
    $email_message .= "Telephone: ".clean_string($telephone)."\n";
    $email_message .= "Comments: ".clean_string($comments)."\n";
     
     
// create email headers
$headers = 'From: '.$email_from."\r\n".
'Reply-To: '.$email_from."\r\n" .
'X-Mailer: PHP/' . phpversion();
@mail($email_to, $email_subject, $email_message, $headers);  
?>
<!-- include your own success html here -->
Thank you for contacting us. We will be in touch with you very soon.
<?php
}
?>



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