diff --git a/suivi/templates/suivi/appel_form.html b/suivi/templates/suivi/appel_form.html
new file mode 100644
index 0000000..d8be95a
--- /dev/null
+++ b/suivi/templates/suivi/appel_form.html
@@ -0,0 +1,9 @@
+
+<div class="panel panel-primary">
+    <div class="panel-heading">
+      <h4 class="panel-title">Enregistrer un appel</h4>
+    </div>
+    <div class="panel-body">
+    {% include "suivi/appel_form_inner.html" %}
+    </div>
+  </div>
diff --git a/suivi/templates/suivi/appel_form_inner.html b/suivi/templates/suivi/appel_form_inner.html
new file mode 100644
index 0000000..2457b84
--- /dev/null
+++ b/suivi/templates/suivi/appel_form_inner.html
@@ -0,0 +1,15 @@
+{% load bootstrap3 %}
+<form action="" method="POST">{% csrf_token %}
+  {% with "inline" as layout %}
+  <div class="form-group form-{{layout}} well col-md-10 col-md-offset-2">
+    {% bootstrap_field  form.created_date layout=layout %}
+    {% bootstrap_field  form.created_time layout=layout %}
+    {% bootstrap_field  form.entrant layout=layout %}
+  </div>  {% endwith %}
+  {% with "horizontal" as layout %}
+  <div class="form-group form-{{layout}}">
+    {% bootstrap_field  form.sujet layout=layout %}
+    {% bootstrap_field  form.text layout=layout %}
+  </div>  {% endwith %}
+  <div class="pull-right">{% bootstrap_button "Enregistrer l'appel" button_type="submit" %}</div>
+</form>