waterfall-agent-1-contact.html

<form action="floodsmart.com/some/special/page" method="POST">
  <!-- setup some redirects -->
  <input type="hidden" name="error_redirect" value="http://waterfall/agent/1/unknown_error.html">
  <input type="hidden" name="success_redirect" value="http://waterfall/agent/1/thankyou.html">
  
  <!-- note the agents site -->
  <input type="hidden" name="agent_id" value="something_unique">
  
  <!-- actual form inputs go here -->
  
  <input type=submit>
</form>