Data from currently displayed page (Photo Gallery)

I'm using Nextgen Gallery on a project where I'm placing 10 years of photos up and want to have a form available from the page that when selected opens in a new window and is pre-populated with the referring URL and photo name at least. The photo name is available via variable (echo $image->filename) as are other variables (title, description, etc.)

I want to have that so corrections can be submitted and the filename/description text can be captured so that they don't have to figure that out themselves (and we get correct information), and the user can edit the existing text and submit it.

Would I be able to populate form data with php variables as such, ( $iptc['location'], $image->filename, etc.)?

Since the form would be short coded from the portion of the page that is generated when the variables are active.. at least that part of the problem would be solved, I'd think. :)

Sorry for the post 'n run- I had some other issues with the project that this is for, and have passed that now, so I can move on.

The intent is for corrections to be submitted on images, for example:

http://sq47.org/photo-gallery/2013-activities

If someone knows who that is, or wants to submit any other information about the photo being viewed, I want to have a GF that is pre-populated with the image filename, caption/title/description that is there now. The entries would either be displayed as a read only fields, or perhaps editable, I have not decided. If one is read only, I'll just have a blank below it. Some fields, like the event name will be static so that it's referenced the same on the local image library, where updates can be made and then the site updated.

The things I'd like to integrate into the form that would be linked to from that gallery page would be: (What / it's variable) IE: <?php echo $meta['filename'] ?>

page url (Get the Permalink to the referred page?)
file name: $meta['filename']
description $iptc['description']
headline $iptc['headline']

I tried putting the <?php echo $variable ..statement into the field for filling dynamically, I didn't expect it to work but ...

The Gallery page is a template, with the form embedded in it:
http://pastebin.com/kPBdHS8U - I may turn that into a link so that the fields are not visible unless the user logs in, or specifically clicks the link to view that image with the form present, as I don't really want it to have it all there on every link. For now, this is a 'hidden' page, for sandboxing.