<div class="form-author-wrap">
  <div class="form-field">
    [text* your-name default:user_display_name placeholder "Your Name"]<br>
  </div>

  <div class="form-field">
    [email* your-email default:user_email placeholder "Your Email"]<br>
  </div>

  <div class="form-field">
    [tel* your-phone placeholder "Your Phone"]<br>
  </div>

  <div class="form-field">
    [textarea your-message x5]<br>
  </div>

  <div class="form-field hidden">
    [email* author-email default:shortcode_attr]<be>
    [textarea information]<br>
  </div>

  <div class="form-submit">
    [submit class:btn-block "Request Details"]
  </div>

</div>