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<!DOCTYPE html>
<html>
<head>
  <meta charset="utf-8">
  <meta name="viewport" content="width=device-width">
  <title>JS Bin</title>
</head>
<body>
<form action="" method="post" id="form">
 
    <div class="form-group">
        <label for="firstname">Фамилия:</label>
        <input type="text" name="firstname" class="form-control" id="firstname" placeholder="Ваша фамилия" required>
    </div>
 
    <div class="form-group">
        <label for="name">Имя:</label>
        <input type="text" name="name" class="form-control" id="name" placeholder="Ваше имя" required></p>
    </div>
 
    <div class="form-group">
        <label for="lastname">Отчество:</label>
        <input type="text" name="lastname" class="form-control" id="lastname" placeholder="Ваше отчество" required>
    </div>
 
    <div class="form-group">
        <label for="comment">Ваш отзыв:</label>
        <textarea name="comment" cols="80" rows="10" class="form-control" id="comment" required></textarea>
        <br>
    </div>
 
    <div class="form-group">
        <input type="submit" value="Отправить" name="create_comm" class="btn btn-success pull-right">
    </div>
</form>
</body>
</html>
Output

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anonymouspro
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