Feedback Form in HTML — Working Code for Product Teams

<form action="https://splitforms.com/api/submit" method="POST">
  <input type="hidden" name="access_key" value="YOUR_ACCESS_KEY" />
  <input type="hidden" name="_subject"   value="New feedback" />
  <input type="hidden" name="page_url"   value="" id="page_url" />

  <fieldset>
    <legend>How would you rate your experience?</legend>
    <label><input type="radio" name="rating" value="1" required /> 1 — Bad</label>
    <label><input type="radio" name="rating" value="2" /> 2</label>
    <label><input type="radio" name="rating" value="3" /> 3</label>
    <label><input type="radio" name="rating" value="4" /> 4</label>
    <label><input type="radio" name="rating" value="5" /> 5 — Great</label>
  </fieldset>

  <label>
    Category
    <select name="category" required>
      <option value="">— select —</option>
      <option>Bug report</option>
      <option>Feature request</option>
      <option>Praise</option>
      <option>Other</option>
    </select>
  </label>

  <label>Tell us more<textarea name="feedback" rows="5" required></textarea></label>

  <label>Email (optional — if you want a reply)
    <input name="email" type="email" />
  </label>

  <input type="checkbox" name="botcheck" style="display:none" tabindex="-1" />
  <button type="submit">Send feedback</button>
</form>

<script>
  document.getElementById("page_url").value = location.href;
</script>

A feedback form is a contact form with one structural difference: the user shouldn't be required to give their email. Many users want to leave feedback but don't want a reply — making email required tanks completion rate. Capture it as optional; if they leave it, follow up; if they don't, you got the data anyway.

Include a 1-5 rating scale (radio buttons) and a category select. The rating gives you a quantitative signal you can aggregate over time; the category tells you whether to route to engineering (bug), product (feature request), or just file (praise). Together, they make triage trivial.

Capture the page URL automatically — 3 lines of JS that copy `location.href` into a hidden field. When the feedback arrives in splitforms, you know exactly which page the user was on when they sent it. Essential for bug reports.

The form POSTs to splitforms. Configure a webhook into your bug-tracking tool (Linear, GitHub Issues, Jira) for category=Bug submissions. For feature requests, webhook into Productboard or Canny. Triage happens automatically based on the category.

Rating + category + optional email + page URL. Triage on autopilot.