diff --git a/index.html b/index.html
index c422fd0..a70ca9e 100644
--- a/index.html
+++ b/index.html
@@ -440,7 +440,10 @@ <h4 class="modal-title" id="myModalLabel">Send us your feedback!</h4>
               <li>Please do not add any sensitive personal information</li>
             </ul>
             <form id="feedback-form" class="form-horizontal" action="#" role="form" method="post">
-              <textarea id="feedback-text" class="form-control" aria-describedby="feedback-label"></textarea>
+              <label>Message:</label>
+              <textarea id="feedback-text" class="form-control" required="required" aria-describedby="feedback-label"></textarea>
+              <label>E-Mail:</label>
+              <input class="form-control" type="email" placeholder="user@mydomain.com">
               <div>
                 <label><input type="checkbox" required="required"> I have read the
                   <a data-toggle="collapse" href="#feedback-disclaimer" aria-expanded="false" aria-controls="disclaimer">disclaimer</a>