Google form with image and other HTML elements

Design

1. Create new form in Google form
2. Open form in Online view (e.g. this one) and save this as HTML page on your computer.
3. Open saved HTML with some text editor and change its content to desired.
4. If necessary, include your own style for this form.
5. Save this page in some public place (e.g. here)
6. You  can include this form as a iframe in your pages, as it is done below:

Updates

1. When you change form, you need to merge generated code from Google form and your customizations.
2. It is recommended to do this using text comparison and merging tools (e.g. LibreOffice Writer, Eclipse IDE, Meld, etc.)

Sample

Known bugs

1. When "Back" button is pressed in browser or mandatory fields are not filled, user is redirected to original Google form, not customized one.