Custom Report Page

[tacodelivery]

Post HTML Suite Plugin's DEMO

*** If you are looking for an affordable hosting with great support quality, click here! ***

Basically, I'd like to create a page which lists custom form fields that I can create in the AdminCP. Once a user fills out these fields, the results can be sent to an area within the AdminCP or an email.

For example, take the MyBB "Contact us form" mod. I'd like something similar to that but customizable. I like the fact that it has Captcha as to prevent spammers.

Optionally, the form could be brought up in a pop-up window instead of being another page on the site.

Thanks!

EDIT: I forgot to add that only users who are logged into the forums should be able to use the report form.