This form uses Google Forms in the backend, and can be styled in any way. It’s served through the Ceros embed function, and is written in HTML, CSS, and Javascript. Clients can see and export all the emails in their “responses” tab in their Google Form.

Client will need to set up their own Google Form, and I can pull the values from the form page

Sources:
https://docs.google.com/forms/d/1OOO7Qid7hZa7XT5zGGl9Exv1zqTC4NkAzjNhTd5exM0/edit
https://docs.google.com/forms/d/e/1FAIpQLSdVraLgTS-rRM5qgNc8Uk3wGkGv4Qw6YXGJvRTpsoF-6juNVw/viewform
https://blog.webjeda.com/google-form-customize/
https://stackoverflow.com/questions/8184440/how-do-i-change-style-display-from-none-to-inline-when-button-is-clicked