Currently, this gadget doesn't allow to include the actual page name in the feedback. As a result, if we want users' feedback from a wiki page, we cannot know where the feedback comes from.
As an example, I use this feedback feature in a gadget that simplifies the process of adding translations to the Wiktionary (https://fr.wiktionary.org/wiki/MediaWiki:Gadget-translation_editor.js)
You can see an example of use in https://fr.wiktionary.org/wiki/mangue by clicking the translations box, then clicking the blue "Plus", then by clicking at the bottom of the form "Signaler une anomalie – Suggérer une amélioration". I removed (via CSS) the button to send a bug to the bug tracker – since it is designed just to local bug reports –, but couldn't find an easy way to add the page name in the message box seamlessly (without pre-filling the box).
Have I missed a way to do it, or would it be possible to add this possibility to the feedback module?