diff --git a/.env.template b/.env.template
index 0f9f6dd1c..db44da62f 100644
--- a/.env.template
+++ b/.env.template
@@ -26,3 +26,5 @@ STIMULUS_DEBUG=false
 POSTHOG_DEBUG=false
 ASSISTANT_MATOMO_ID=82
 ASSISTANT_POSTHOG_KEY=phc_fSfhoWDOUxZdKWty16Z3XfRiAoWd1qdJK0N0z9kQHJr # [DEV] project
+NOTION_TOKEN=
+NOTION_CONTACT_FORM_DATABASE_ID=17c6523d57d78140b87f000cd3ecef4b # Correspond à https://www.notion.so/accelerateur-transition-ecologique-ademe/17c6523d57d7808b8cc5f5ccae264f7c?v=17c6523d57d78140b87f000cd3ecef4b&pvs=4
diff --git a/core/notion.py b/core/notion.py
new file mode 100644
index 000000000..f93fa2fa2
--- /dev/null
+++ b/core/notion.py
@@ -0,0 +1,40 @@
+import logging
+
+import requests
+from django.conf import settings
+from django.utils import timezone
+
+logger = logging.getLogger(__name__)
+
+
+def create_new_row_in_notion_table(database_id, data):
+    notion_token = settings.NOTION.get("TOKEN")
+    if not notion_token:
+        logging.error("The notion token is not set in local environment")
+        return
+
+    headers = {
+        "Authorization": f"Bearer {notion_token}",
+        "Content-Type": "application/json",
+        "Notion-Version": "2022-06-28",
+    }
+
+    payload = {
+        "parent": {"database_id": database_id},
+        "properties": {
+            "Nom": {"title": [{"text": {"content": data.get("name")}}]},
+            "Email": {"email": data.get("email")},
+            "Objet": {"rich_text": [{"text": {"content": data.get("subject")}}]},
+            "Message": {"rich_text": [{"text": {"content": data.get("message")}}]},
+            "Date": {"date": {"start": timezone.now().isoformat()}},
+        },
+    }
+
+    response = requests.post(
+        "https://api.notion.com/v1/pages", headers=headers, json=payload
+    )
+
+    if response.status_code == 200:
+        logger.info("New contact form submission")
+    else:
+        logger.error(f"Failed to add row:{response.status_code=}, {response.text=}")
diff --git a/core/settings.py b/core/settings.py
index de5a7a448..3903da36b 100644
--- a/core/settings.py
+++ b/core/settings.py
@@ -388,3 +388,10 @@ def context_processors():
         cast=str,
     ),
 }
+
+NOTION = {
+    "TOKEN": decouple.config("NOTION_TOKEN", default=""),
+    "CONTACT_FORM_DATABASE_ID": decouple.config(
+        "NOTION_CONTACT_FORM_DATABASE_ID", default=""
+    ),
+}
diff --git a/qfdmd/forms.py b/qfdmd/forms.py
index 8ccc2c5df..a5eee6e40 100644
--- a/qfdmd/forms.py
+++ b/qfdmd/forms.py
@@ -47,3 +47,39 @@ def search(self) -> dict[str, str]:
             .values("slug", "nom")[:10]
         )
         return self.results
+
+
+class ContactForm(DsfrBaseForm):
+    name = forms.CharField(label="Votre nom")
+    email = forms.EmailField(label="Votre email")
+    subject = forms.ChoiceField(
+        label="Votre sujet",
+        choices=[
+            ("", ""),
+            (
+                "integration",
+                "Je souhaite obtenir de l'aide pour intégrer le simulateur",
+            ),
+            (
+                "erreur",
+                "Je souhaite signaler une erreur pour un déchet",
+            ),
+            (
+                "manquant",
+                "Je souhaite signaler un déchet manquant",
+            ),
+            (
+                "bug",
+                "J'ai trouvé un bug",
+            ),
+            (
+                "amelioration",
+                "Je souhaite proposer une amélioration",
+            ),
+            (
+                "autre",
+                "Autre",
+            ),
+        ],
+    )
+    message = forms.CharField(label="Votre message", widget=forms.Textarea)
diff --git a/qfdmd/urls.py b/qfdmd/urls.py
index 0a563fb67..435a9609e 100644
--- a/qfdmd/urls.py
+++ b/qfdmd/urls.py
@@ -4,7 +4,13 @@
 from django.urls import path
 from django.views.generic import RedirectView
 
-from qfdmd.views import CMSPageDetailView, HomeView, SynonymeDetailView, search_view
+from qfdmd.views import (
+    CMSPageDetailView,
+    ContactFormView,
+    HomeView,
+    SynonymeDetailView,
+    search_view,
+)
 
 
 def get_assistant_script(request):
@@ -15,6 +21,12 @@ def get_assistant_script(request):
     path("dechet/", HomeView.as_view(), name="home"),
     path("assistant/recherche", search_view, name="search"),
     path("<slug:slug>/", SynonymeDetailView.as_view(), name="synonyme-detail"),
+    path("assistant/nous-contacter", ContactFormView.as_view(), name="nous-contacter"),
+    path(
+        "assistant/nous-contacter/confirmation",
+        ContactFormView.as_view(),
+        name="nous-contacter-confirmation",
+    ),
     # The URL here needs to be kept as is because it was used in the previous
     # Gatsby website. If changed, a redirect need to be created to keep the
     # legacy behaviour.
diff --git a/qfdmd/views.py b/qfdmd/views.py
index bdf0af8b4..09788d31b 100644
--- a/qfdmd/views.py
+++ b/qfdmd/views.py
@@ -4,9 +4,11 @@
 from django.conf import settings
 from django.http import HttpResponse
 from django.shortcuts import render
-from django.views.generic import DetailView, ListView
+from django.urls import reverse_lazy
+from django.views.generic import DetailView, FormView, ListView
 
-from qfdmd.forms import SearchForm
+from core.notion import create_new_row_in_notion_table
+from qfdmd.forms import ContactForm, SearchForm
 from qfdmd.models import CMSPage, Suggestion, Synonyme
 
 logger = logging.getLogger(__name__)
@@ -39,6 +41,23 @@ def search_view(request) -> HttpResponse:
     return render(request, template_name, context=context)
 
 
+class ContactFormView(FormView):
+    template_name = "forms/contact.html"
+    form_class = ContactForm
+    success_url = reverse_lazy("qfdmd:nous-contacter-confirmation")
+
+    def form_valid(self, form):
+        cleaned_data = form.cleaned_data
+        submitted_subject = cleaned_data.get("subject")
+        cleaned_data["subject"] = dict(self.form_class().fields["subject"].choices)[
+            submitted_subject
+        ]
+        create_new_row_in_notion_table(
+            settings.NOTION.get("CONTACT_FORM_DATABASE_ID"), cleaned_data
+        )
+        return super().form_valid(form)
+
+
 class BaseView:
     """Base view that provides templates used on all pages.
     TODO: this could be moved to a context processor"""
diff --git a/templates/components/sidebar/email/action.html b/templates/components/sidebar/email/action.html
index f47cdb827..323eccc18 100644
--- a/templates/components/sidebar/email/action.html
+++ b/templates/components/sidebar/email/action.html
@@ -1,5 +1,7 @@
 {% extends "../action.html" %}
 
+{% load dsfr_tags %}
+
 {% block icon %}
 {% include "./icon.html" %}
 {% endblock icon %}
@@ -13,7 +15,10 @@
 {% endblock modal_title %}
 
 {% block modal_content %}
-Formulaire de contact
+<turbo-frame id="contact-form"
+        src="{% url 'qfdmd:nous-contacter' %}"
+>
+</turbo-frame>
 {% endblock modal_content %}
 
 {% block modal_wrapper_for_id %}
diff --git a/templates/forms/contact.html b/templates/forms/contact.html
new file mode 100644
index 000000000..78d238b17
--- /dev/null
+++ b/templates/forms/contact.html
@@ -0,0 +1,22 @@
+<turbo-frame id='contact-form'>
+ <form
+method="post"
+        action="{% url 'qfdmd:nous-contacter' %}"
+    >
+        {% csrf_token %}
+        {% if request.resolver_match.url_name == 'nous-contacter' %}
+          {{ form }}
+          <button class="fr-btn" type="submit">
+              Envoyer mon message
+          </button>
+        {% else %}
+          <div class="qf-flex qf-flex-row qf-gap-1w qf-items-center">
+            <span class="fr-icon--lg fr-icon fr-icon-success-fill" aria-hidden="true"></span>
+
+            <span>
+              Votre message a bien été envoyé
+            </span>
+          </div>
+        {% endif %}
+    </form>
+</turbo-frame>