There are 2 important things with this form:
1. The canvas and its size are located in the "Maps" fieldset description text (see the html source of it in the editor)
2. The logic, like how the fields are called and how they should re-draw the map is located in form => advanced => more options => pieces => before form The form updates on every address change.You can adjust the form and extend it to your requirements!
1. Download and unzip the form
2. In BreezingForms go to Configuration => Package Installer
3. Upload the xml from the zip
4. Go to manage forms, select the right package, enter the form and test/edit it