You can create any form with any field you want and have those form input submitted trough email to you or even store the submitted data in a MySQL table. To do this just go to the Dynamic Forms section in the admin and start creting your own forms. To include a form just use {forms}formid{/forms} in your post and the form will show up immediately. See the example below.

Example
Form area with more inputs
This is a static text so you can enter comments to the fields.