There are probably more elegant ways, but this will work for most people.
Create a file called login.php and put this in it (make sure there is no whilte space before any of this:
&?php
header(&location:http://$_POST[user]:$_POST[pass]@www.domain.com:2095/&

;
?&
Now create the form with text field for the Username and pass it user, and also with a password field and name it pass. Have that form post to the login.php page. I haven't tried this yet, but it should work.