Thats the most you can do without PHP mailer
<?php
//--------------------------Set these paramaters--------------------------
// Subject of email sent to you.
$subject = 'TEAM:BARIATRICS Informational Packet Request';
// Your email address. This is where the form information will be sent.
$emailadd = 'aubreyburkhart@comcast.net';
// Where to redirect after form is processed.
$url = 'http://www.butneveragain.org/info/thankyou.html';
// Makes all fields required. If set to '1' no field can not be empty. If set to '0' any or all fields can be empty.
$req = '0';
// Email address put into Email Field
$email_field = $_POST["Email"];
$headers = 'MIME-Version: 1.0' . "\r\n";
$headers .= 'Content-type: text/html; charset=iso-8859-1' . "\r\n";
// Additional headers
$headers .= 'From: TEAM:BARIATRICS <ghsfiles@box394.bluehost.comcom>';
// --------------------------Do not edit below this line--------------------------
$auto_respond_subject = 'TEAM:BARIATRICS Informational Packet Request';
$auto_respond_body = "Thank you for requesting your free TEAM:BARIATRICS Informational Packet. \n
You should recieve your packet within 5-10 business days.\n If you would like additional information, call 574.537.TEAM or visit us online at www.butneveragain.org.";
mail($email_field, $auto_respond_subject, $auto_respond_body,$header);
$text = "Results from form:\n\n";
$space = ' ';
$line = '
';
foreach ($_POST as $key => $value)
{
if ($req == '1')
{
if ($value == '')
{
echo "$key is empty";
die;
}
}
$j = strlen($key);
if ($j >= 20)
{
echo "Name of form element $key cannot be longer than 20 characters";
die;
}
$j = 20 - $j;
for ($i = 1; $i <= $j; $i++)
{
$space .= ' ';
}
$value = str_replace('\n', "$line", $value);
$conc = "{$key}:$space{$value}$line";
$text .= $conc;
$space = ' ';
}
mail($emailadd, $subject, $text, "From: Online Request");
echo '<META HTTP-EQUIV=Refresh CONTENT="0; URL='.$url.'">';
?>