diff --git a/parts/callback-modal.php b/parts/callback-modal.php
new file mode 100644
index 0000000..1999d73
--- /dev/null
+++ b/parts/callback-modal.php
@@ -0,0 +1,23 @@
+<div class="callback-modal">
+    <div class="callback-modal__layout"></div>
+
+    <div class="callback-modal__body">
+      <div class="callback-modal__close"><i class="fa fa-times" aria-hidden="true"></i></div>
+
+      <form  method="POST" action="<?php echo admin_url('admin-ajax.php?action=send_callback')?>">
+        <h2>Заказать звонок</h2>
+        
+        <div class="form-group">
+          <label for="callback-name">Ваше имя</label>
+          <input type="text" class="form-control" id="callback-name" required>
+        </div>
+
+        <div class="form-group">
+          <label for="callback-phone">Ваш телефон</label>
+          <input type="tel" class="form-control" id="callback-phone" required>
+        </div>
+
+        <button type="submit" class="btn btn-danger">Подтвердить</button>
+      </form>
+    </div>
+</div>
\ No newline at end of file