mod_borang_maklumbalas.php

<?php
defined('_JEXEC') or die;
if(!empty($_REQUEST['act'])) {
  $act = $_REQUEST['act'];
  $nama = $_REQUEST['nama'];
  $email = $_REQUEST['email'];
  $phone = $_REQUEST['phone'];
  $mesej = $_REQUEST['mesej'];
  $soalan = $_REQUEST['soalan'];
  $mesej = stripcslashes($mesej);
  $message = "Nama: $nama
  E.Mail: $email
  No. Telefon: $phone
  Maklum Balas: $mesej";
  $from = "From: $email";
  
  if($act=="h") {
    mail("alamat_email@email.com", "Borang Maklum Balas", $message, $from);
  }
}
?>

<?php if($act!="h") { ?>
<form name="maklumbalas" method="post" class="uk-form uk-form-horizontal">

<div class="uk-form-row">
    <label class="uk-form-label" for="nama">Nama</label>
    <div><input id="nama" name="nama" type="text" required></div>
</div>
    
<div class="uk-form-row">
    <label class="uk-form-label" for="email">Email</label>
    <div><input id="email" name="email" type="email" required></div>
</div>

<div class="uk-form-row">
    <label class="uk-form-label" for="phone">No. Telefon</label>
    <div><input id="phone" name="phone" type="text"></div>
</div>

<div class="uk-form-row">
    <label class="uk-form-label" for="mesej">Maklum Balas</label>
    <div><textarea id="mesej" name="mesej" rows="7" cols="50" required></textarea></div>
</div>

<div class="uk-form-row">
    <label class="uk-form-label" for=""></label>
    <div><button class="uk-button uk-button-large" type="submit">Hantar</button> <button class="uk-button uk-button-large" type="reset">Reset</button></div>
</div>

<input name="act" type="hidden" value="h">
                                
</form>

<?php } else { ?>

<div class="uk-alert uk-alert-success" data-uk-alert="">
<a class="uk-alert-close uk-close"></a>
<p>Terima kasih di atas maklum balas anda.</p>
</div>

<?php } ?>