Problema con envió de formulario

[tampon]

Esto me arroja.

Error, verifica los campos.array(11) { ["serial"]=> string(10) "6ZeZZ9ZM1C" ["name"]=> string(0) "" ["tag"]=> string(0) "" ["email"]=> string(0) "" ["telephone"]=> string(0) "" ["reason"]=> string(1) "0" ["question"]=> string(19) " Elegir opción... " ["ddate"]=> string(0) "" ["texto"]=> string(0) "" ["age"]=> string(0) "" ["nick"]=> string(0) "" }