This is a PHP contact form in HTML5/CSS3 with Google maps using the canvas feature, This uses the Modernizr and Bootstrap features meaning that this contact form is fully responsive.
This is ready for instant use once you change the email addresses in the contact.php in the core folder, It can be used as a full page or embed into a existing page, Just simply remove the relevant tags and do a few css updates to make it fit the page or with your themes style.
I've also only added the most basic of information needed from the contact form, you could also include location/time/referrer etc, I've also added a few html tags that will be stripped inside the form, you can add more if you wish, This is to combat against XSS attacks.
I now have this same form live on all of my websites for easy contact. ###Live working demo