diff --git a/feedback.php b/feedback.php
new file mode 100644
--- /dev/null
+++ b/feedback.php
@@ -0,0 +1,34 @@
+<?php 
+	include_once 'inc/class.page.php'; 
+	$mypage = new page('Feedback');
+
+	$ipi = $_SERVER['REMOTE_ADDR'];
+	$fromdom = $_SERVER['HTTP_HOST'] . $_SERVER['REQUEST_URI'];
+	$httpagenti = $_SERVER['HTTP_USER_AGENT'];
+?>
+<form action="feedback-submit.php" method="post">
+<input type="hidden" name="ip" value="<?php echo $ipi ?>" />
+<input type="hidden" name="fromdom" value="<?php echo $fromdom ?>" />
+<input type="hidden" name="httpagent" value="<?php echo $httpagenti ?>" />
+<h2>Feedback Form</h2>
+Name: <input type="text" name="nameis" size="20" /><br />
+Email:&nbsp; <input type="text" name="visitormail" size="20" /><br />
+
+
+<br/> Overall Rating:<br/> <input checked="checked" name="rating" type="radio" value="Good" />Good <input name="rating" type="radio" value="Buggy" />Buggy  <input name="rating" type="radio" value="Needs more features" />Needs more features <input name="rating" type="radio" value="Don't know" />Don't Know
+
+<br /><br />
+<h3>General Comments</h3>
+<p>
+<textarea name="feedback" rows="6" cols="40"></textarea>
+</p>
+<input type="submit" value="Submit Feedback" />
+</form>
+
+
+
+
+
+
+<?php
+$mypage->foot();