Need Help moving FORM from post to template

I’m a novice with PHP, which is probably why I can’t do this effectively on my own — but a form that I have embedded in a few posts has apparently “BROKEN” several readers’ RSS feeds. I can’t seem to figure out how to embed the form itself as a regular part of the template, i.e. in the Main INdex and/or single post templates. An example of this form is here:

http://smallprint.netzoo.net/your-experiences

Thanks