How to create a contact form

  • Profile Image
    Angel Castro 
    Asked on February 24, 2016 at 02:56 AM

    Need to add a Contact Form to our website but need it customized with several fields

    Can you help ?

    Something like this:

    Workers Compensation Insurance Quote Request

    1. Contact Name:

    2. Legal Name of your Entity:

    3. Address:

    4. Phone #

    5. E-mail:

    6. Your line of business (type of work you do):

    7. # of employees:

    8. Estimated Annual Payroll per Job Categories (indicate below)

    a. Your Lines of Business:

    b. Clerical (confined to an office):

    c. Outside Sales:

    c. Drivers:


  • Profile Image
    Answered on February 24, 2016 at 09:10 AM

    You can create your form easily with JotForm. I will show you how to do it. You can drag and drop your fields easily as you see below:

    In addition to that, you can use form templates that are ready-to use forms. You can also modify these form templates.

    I've created a demo form. Feel free to clone it.


    Here is your form:

    If you have any question or issues, please do not hesitate contacting us. We will be glad to assist you.