Need a 'toolbar' like plugin which can collect leads

hi there,

I am looking around for a ‘toolbar’ like plugin that can collect leads. I need this to be positioned at the bottom much similar to the social toolbars. I would like to add a few fields in this toolbar which can collect the requirement of the customers i.e. name, contact number, budget, etc which can be simple text fields or drop down fields, etc.

Is there such a plugin? I would imagine that a lot of websites would need such a thing where the toolbar follows wherever the customer goes on the site reminding him to enter his details i.e. leads for us.

Please help if you can.

Regards,
contentyogi