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Create online patient intake form for website

$30-250 AUD

Completed
Posted over 10 years ago

$30-250 AUD

Paid on delivery
Project Scope Digitise patient intake form (see link here [login to view URL]) on website so it can be completed online and emailed to me. Would prefer if you were able utilise existing template (MS Word version will be emailed to successful bidder) but happy to vary for design/data entry purposes. Scope includes uploading form to website and testing, and negotiable service guarantee period (during which time you will address faults, queries etc in relation to the form). I would like the form to be optimised for mobile/tablet viewing but appreciate this may not be possible given amount of data to input. IT Website is designed with Wordpress and hosted on GoDaddy. I have only a rudimental knowledge of Wordpress so rely on your expertise in loading form and getting it to work. I envisaged that an editable PDF form may be used or perhaps a form plugin for Wordpress but I will rely on your recommendation. I do not want to paying additional monthly plugin fees. I work best with freelancers that are patient, experienced, good communicators and responsive. If you think you fit the bill and have the necessary experience please bid. Preference will be given to those freelancers who can link to similar completed work. Thanks for reading.
Project ID: 5111980

About the project

24 proposals
Remote project
Active 10 yrs ago

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Hi! I suggest converting the PDF file that you have to a PDF form, so the users will be able to download it, fill it in at their convinience and then submit it back to you by email (using a button I'll add to the file). That way you won't have to re-create what you already have, and you could use the PDF both for online and offline users... I specialize in creating custom-made, interactive PDF forms, including all the required scripting involved, and can do this for you quickly and professionally. Regards, Gilad (try67)
$133 AUD in 3 days
4.9 (107 reviews)
6.6
6.6
24 freelancers are bidding on average $184 AUD for this job
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Hello Sri Technocrat will provide fully interactive application/website for your project. As per the detail, Sri Technocrat will provide three template functional schemes and sample pages to make your choice for layout. It will be developed as per your requirement document. We would invite your feedback and suggestions on the selected format so as to make it exactly as per your requirements. The timeline for development is stated along with the bid. During development period, the site would be visible on one of our test servers. At the time of transfer of complete application to your control, we will send you complete code and documentation. We will provide a copy of complete site management manual. The total cost of the development is stated along with the bid. Sri Technocrat takes services of professionals in the fields of graphic designer, site management and programming. In order to provide best performance and in time, we accept milestone payment along with contract. We transfer all source codes, security protocols and password management to the client. We carryout site development in a modular form, so that and additional feature / facility can be added without disturbing the existing site. Thanking you for considering Sri Technocrat as a partner in development. With regards, Sri Technocrat
$263 AUD in 20 days
4.7 (62 reviews)
7.4
7.4
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Dear Client, Thanks for giving me the opportunity to place a bid on your project. I would very much happy to work with you on your project and I have already checked detail your requirement and found this match well with my skill and expertise level. First I would like to introduce my self as a professional freelancer and director of a small web design company. I am not only a freelancer and also I have a small team and I am team leader of my small office and virtual team for similar task. I am available with Email, Skype, yahoo messenger, MSN, Gtalk and phone to communicate during project working time. Send me a message in PMB to detail more and start working with you, Warm Regards, Md. Nasirul Huq
$250 AUD in 10 days
4.8 (148 reviews)
6.6
6.6
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Looks like a pretty straightforward job. We are interested to create the form for your site. We are well versed in wordpress.
$84 AUD in 3 days
4.7 (338 reviews)
6.5
6.5
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10+ years experience. 500+ projects completed successfully. I am very interested in this project. Please send me complete details. Ready to start ASAP.
$147 AUD in 3 days
5.0 (27 reviews)
5.3
5.3
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Hello, I've read attentively and checked the PDF file itself, your task seems clear and I can help you with that. About things I intended to use - embedding PDF somehow isn't a good idea, I'll have to recreate whole that form in HTML. As well, I don't think that using some 3rd party WP plugin for forms will help a lot, I'll do it just on html/css/js without any additional tools. Feel free to ask your questions. Thanks, Alex
$242 AUD in 7 days
4.9 (13 reviews)
4.9
4.9
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A proposal has not yet been provided
$250 AUD in 3 days
5.0 (1 review)
2.6
2.6
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Návrh doposud nebyl poskytnut
$555 AUD in 12 days
0.0 (0 reviews)
0.0
0.0
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A proposal has not yet been provided
$155 AUD in 2 days
0.0 (0 reviews)
0.0
0.0
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A proposal has not yet been provided
$133 AUD in 3 days
0.0 (0 reviews)
0.0
0.0

About the client

Flag of AUSTRALIA
Moonee Ponds, Australia
5.0
3
Member since Jun 30, 2013

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