Download Flexi Custom Code Module from the JED.
Install the module and publish it to the position of your choice.
Below the custom code box leave the option to use PHP on and disable the cleanup of html, js, and css.
Enter this code into the custom code box:
<?php
JHtml::_('behavior.formvalidation');
$JInput = JFactory::getApplication()->input;
$sendMail = $JInput->get('sendMail', '', 'string');
$userName = $JInput->get('username', '', 'string');
$userEmail = $JInput->get('email', '', 'string');
$user = JFactory::getUser();
if(isset($sendMail) && $sendMail == 'sendNow'){
JFactory::getApplication()->enqueueMessage('Contact request successfully submitted.', 'message' );
//GENERATE DATA TO EMAIL TO ADMINS
$html = "";
$html .= "<h2>New Contact Request Received</h2>";
$html .= "<p>A new contact request has been sent by " . $userName . ". The user's email address is: ".$userEmail.".</p>";
$subject = "Contact Request";
$from = array("[email protected]", "Website Contact");
//SEND THE EMAIL
$mailer = JFactory::getMailer();
$mailer->setSender($from);
$mailer->addRecipient("YOUR EMAIL ADDRESS");
$mailer->setSubject($subject);
$mailer->setBody($html);
$mailer->isHTML();
$mailer->send();
//GENERATE DATA TO DISPLAY TO THE USER
$submitted = "";
$submitted .= "Your contact request has been successfully received. Someone will contact you soon.";
echo $submitted;
}else{?>
<form action="<?php echo JUri::current();?>" method="post" name="adminForm" id="adminForm" class="form-validate">
<input type="hidden" name="sendMail" value="sendNow" />
<input type="hidden" name="username" value="<?php echo $user->username;?>" />
<input type="hidden" name="userEmail" value="<?php echo $user->email;?>" />
<input type="submit" value="Request Contact" />
</form>
<?php } ?>
Replace the email appropriate code to match your domain and email address settings.
I haven't tested this but it should work for what you are looking for.