Modifying an Embedded JS COde

I am trying to implement an embedded code for an Audit tool. This code by itself has a url box, email, phone, and submit. When someone clicks on submit it shows them the errors associated with their website (seo)

Here are the changes I want:

  1. I want only the URL box. NO Email Box.
  2. When user clicks on “submit”, he would be shown a custom contact page

I will share the Code once I hear from someone in this field who can help.

Thanks
Nad