<?
php
// Set headers to handle AJAX requests
header('Content-Type: application/json');
// Get form data
$name = filter_input(INPUT_POST, 'name', FILTER_SANITIZE_STRING);
$email = filter_input(INPUT_POST, 'email', FILTER_SANITIZE_EMAIL);
$phone = filter_input(INPUT_POST, 'phone', FILTER_SANITIZE_STRING);
$subject = filter_input(INPUT_POST, 'subject', FILTER_SANITIZE_STRING);
$message = filter_input(INPUT_POST, 'message', FILTER_SANITIZE_STRING);
// Validate required fields
if (empty($name) || empty($email) || empty($subject) || empty($message)) {
echo json_encode([
'success' => false,
'message' => 'Please fill in all required fields.'
]);
exit;
// Validate email
if (!filter_var($email, FILTER_VALIDATE_EMAIL)) {
echo json_encode([
'success' => false,
'message' => 'Please enter a valid email address.'
]);
exit;
// Prepare email content
$to = '[email protected]'; // Replace with your email
$email_subject = "Contact Form: $subject";
$email_body = "You have received a new message from your website contact form.\n\n";
$email_body .= "Name: $name\n";
$email_body .= "Email: $email\n";
$email_body .= "Phone: $phone\n";
$email_body .= "Subject: $subject\n\n";
$email_body .= "Message:\n$message\n";
$headers = "From: $email\n";
$headers .= "Reply-To: $email\n";
// Send email
$mail_success = mail($to, $email_subject, $email_body, $headers);
// Store in database (optional)
$db_success = storeContactInDatabase($name, $email, $phone, $subject, $message);
// Return response
if ($mail_success || $db_success) {
echo json_encode([
'success' => true,
'message' => 'Thank you for your message! We will get back to you soon.'
]);
} else {
echo json_encode([
'success' => false,
'message' => 'There was an error sending your message. Please try again later.'
]);
/**
* Store contact form submission in database
* @param string $name
* @param string $email
* @param string $phone
* @param string $subject
* @param string $message
* @return bool
*/
function storeContactInDatabase($name, $email, $phone, $subject, $message) {
// Database connection details
$host = 'localhost';
$db_username = 'db_username';
$db_password = 'db_password';
$db_name = 'radiology_db';
try {
// Create connection
$conn = new mysqli($host, $db_username, $db_password, $db_name);
// Check connection
if ($conn->connect_error) {
error_log("Connection failed: " . $conn->connect_error);
return false;
// Prepare statement
$stmt = $conn->prepare("INSERT INTO contact_messages (name, email, phone, subject, message,
created_at) VALUES (?, ?, ?, ?, ?, NOW())");
$stmt->bind_param("sssss", $name, $email, $phone, $subject, $message);
// Execute statement
$result = $stmt->execute();
// Close connection
$stmt->close();
$conn->close();
return $result;
} catch (Exception $e) {
error_log("Database error: " . $e->getMessage());
return false;
?>
