This looks to be a Google Docs form (used for making surveys), it just has a single question which is a “paragraph text” field. It shouldn’t take long to do the same thing for yourself.
Have a look at this help topic for details on making a form.
That worked fairly well for me; I have what I think is a working feedback form. (I mostly copied lukeprog’s wording, but omitting the parts about SIAI and hopefully wording it more friendly.)
The tricky part was figuring out how to set up email notifications: you have to go to the spreadsheet version of the form, click on Tools->Notifications and work from there.
This looks to be a Google Docs form (used for making surveys), it just has a single question which is a “paragraph text” field. It shouldn’t take long to do the same thing for yourself.
Have a look at this help topic for details on making a form.
That worked fairly well for me; I have what I think is a working feedback form. (I mostly copied lukeprog’s wording, but omitting the parts about SIAI and hopefully wording it more friendly.)
The tricky part was figuring out how to set up email notifications: you have to go to the spreadsheet version of the form, click on Tools->Notifications and work from there.