I'm sorry to say that I don't really like this.
The design doesn't have one big problem, just lots of little things.
Given the positive feedback other reviewers have posted, I will be the first to admit that I am in the minority, so you should probably disregard my comments. However, sometimes a view from the 'other side' can be helpful, so hopefully my review will have something useful for you.
Here are some contact forms that I like, which have a style that is broadly similar to yours (I must stress the broad part).
^ This site is no longer around. However, I like the page, because it has a strong focus. (Although it is perhaps a bit too busy with too many columns).
^ This contact form has a number of weaknesses. However, I like how they have used the light to focus the users attention to the top. (I think the use of light is accidental and so could be exploited more).
^ Click on the "send us an email link". I think this one makes a good use of the space. It doesn't feel unbalanced.
^ This form has too many borders. But it does make good use of lighting and space for dramatic effect.
Sorry again for being so negative. I did spend a long time looking at it but couldn't find anything I like. 'Different strokes for different folks', I guess.