<p>Your Name (required)<br />
    [text* your-name] </p>

<p>Your Email (required)<br />
    [email* your-email] </p>

<p>Product Name<br />
    [text product-name] </p>

<p>Rating <br />
[radio rating use_label_element "1" "2" "3" "4" "5"]

<p>Your Message<br />
    [textarea your-message] </p>

<p>[submit "Send Review"]</p>