Feedback/Contact Email Form

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Average Score	6.0
Scores Submitted	1
Date Added	Sep 04, 2004
Last Updated	Mar 31, 2007
Tags	contact contact form email feedback form

Introduction

This is a ready to go PHP script that can be pasted into a blank .php document. Run it through your webserver after changing $myemail to the value of your E-Mail address. It also sends the referring URL to help you know where the visitor was before he clicked to contact you.

Grab the Code

<?php

// Change these two variables to meet your needs.

$myemail = 'myemail@domain.com';
$subject = 'Contact form Subject';

$op = $_POST[op];

if($op == 'contact')
{
    $name = stripslashes($_POST[name]);
    $email = stripslashes($_POST[email]);
    $text = stripslashes($_POST[text]);
    $referer = $_POST[referer];
    $remote_host = $_SERVER[REMOTE_ADDR];
    $server = $_SERVER[SERVER_NAME];
    $browser = $_SERVER[HTTP_USER_AGENT];

if(!eregi("^[_a-z0-9-]+(.[_a-z0-9-]+)*@[a-z0-9-]+(.[a-z0-9-]+)*(.[a-z]{2,3})$",$email)) 
    { 
        $status = "We're sorry, but you've entered an incorrect email address.<br>";
    }
    if(!$name)
    {
        $status .= "Please enter your name.<br>";
    }
    if(!$text)
    {
        $status .= "Please enter a message.<br>";
    }

if(!$status)
    {
        $header = "From: $emailrnReply-To: $emailrn";

$message = "
            Name: $name
            Referer: $referer
            Site: $server
            Remote Host: $remote_host
            Remote Browser: $browser

$text
        ";

if(mail($myemail, $subject, $message, $header))
        {
            $status = "Thank you for your Feedback!!<br><br>";
        }
        else
        {
            $status = "There was a problem sending your feedback, please try again later.<br><br>";
        }

}
    else
    {
        $status .= "<br>Please press <u>back</u> on your browser to resubmit.<br><br>";
    }
}

// Now check the referer page and ensure it's a proper URL

$referer = $_SERVER[HTTP_REFERER];

if(!preg_match('#^http\:\/\/[a-z0-9-]+.([a-z0-9-]+.)?[a-z]+#i', $referer))
{
    unset($referer);
}

<?php print $status; ?>

<form method="post" action="<?php print $_SELF; ?>">
<input type="hidden" name="op" value="contact">
<input type="hidden" name="referer" value="<?php print $referer; ?>">
Name<br><input name="name" size="35" value=""><br>
E-mail address<br><input name="email" size="35" value=""><br>
<br>Message<br><textarea name="text" cols="50" rows="10"></textarea><br><br>
<input type="submit" value="Send message!">
</form>

Comments

(16) RSS

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TeQh

Comments: 19

Posted on Sep 4, 2004 1:57 am

nice man

Setementor

Comments: 2

Posted on Sep 4, 2004 4:31 pm

Awesome.

AndrewMiller17

Comments: 31

Posted on Oct 31, 2005 11:03 pm

I have a freewebs account and when I entered this code and tested it, it said abouve the form "This code is inoperational!". Don't know what that means.

AndrewMiller17

Comments: 31

Posted on Nov 1, 2005 3:52 pm

Is anyone able to help me on this?

Hawkee

Comments: 564

Posted on Nov 2, 2005 9:21 pm

Hmm, that's odd. Does your host allow PHP scripts? Also, do they allow you to use the mail() function? You might want to talk to them about it.

AndrewMiller17

Comments: 31

Posted on Nov 3, 2005 7:59 pm

Well, I investigated, and freewebs makes every acount wait 7 days before it can post any forms, to make sure people aren't just sing them for that.

markmck

Comments: 1

Posted on Feb 1, 2007 1:52 am

Wonderfully simple, clean, easy to use and fit for purpose. Well done and thanks.

wizkidweb16

Comments: 4

Posted on Mar 28, 2007 9:28 pm

For those who are having trouble, perhaps it's because you need to put the </form> tag at the end of the script.

Hawkee

Comments: 564

Posted on Mar 31, 2007 8:35 pm

Thanks wizkid! Don't know how that got cut off. I've corrected it.

roryflyguy

Comments: 2

Posted on May 12, 2007 7:27 am

Why is it that none of my browsers will show the page?

I use RapidWeaver, i have pasted it into the html code.

But Firefox prompts me to download the PHP file, safari just displays the code as text.

Am i doing something wrong? =(

Please help!

-Rory

j-and-f123

Comments: 1

Posted on May 13, 2007 4:40 am

Hello, we are having trouble with your script because the e-mailing part doesnt work. We have tried the form out and we don't get any e-mails. We have tried over 4 email addresses! Plz help!

Hawkee

Comments: 564

Posted on May 17, 2007 1:45 am

Quote:

rory, Are you running it on an Apache server with PHP? If you are just loading the .php document through explorer it won't run.

Quote:

Hello, we are having trouble with your script because the e-mailing part doesnt work. We have tried the form out and we don't get any e-mails. We have tried over 4 email addresses! Plz help!

j-and-f, Maybe check with your web host and see if they allow you to send mail with PHP.

jmitton

Comments: 1

Posted on Jul 15, 2007 9:45 am

Brilliant form. But can anyone tell me how to send the error text to a popup?

chopper72

Comments: 1

Posted on Jul 17, 2007 8:33 am

Thanks for this nice, easy bit of php.

How can you add multiple email addresses for the $myemail ?
thanks

Lyle

Comments: 1

Posted on Aug 20, 2007 9:20 am

Answer for chopper: within the quotes, multiple emails seperated by comma works.

eg: 'aaaa@somewhere.com, bbb@somewhereelse.org, ccc@another.com'

Question - How do we get the 'from' header in these emails to not be blank? Can we specify a from address??

aldog

Comments: 2

Posted on Nov 7, 2007 10:02 am

This code is working great for me, and it was very simple to figure out. But I have one question. I just tested the form and it showed up in my email right away, but I was wondering what the "Referer" are was meant for (because it's blank for me) and when I try to reply to the person that sent it the reply to address is this

"-To:"@node4.c15

again, great script

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Feedback/Contact Email Form

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Hawkee

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