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$30-250 USD

Completed
Posted about 8 years ago

$30-250 USD

Paid on delivery
Hello, I'm looking for a three step process to sign up customers while they are in my medical office. 1. We would fill out an initial form and select the plan they want, they would need to be able to sign it on an ipad or touch-screen laptop. 2. Based on the plan they selected on page one, 1 of 12 pages would appear with the specifics of their plan which would need to be signed again. 3. Last page would then appear for CC information and signature. Once those three steps are completed, there would be an administrative page to manage all the new sign ups as well as a email confirmation page that gets sent to the customer. My initial idea was to have this built in Google Forms, but I'm open to whatever will work easiest and cheapest to build. Security and cloud based storage of this information is important. Attached is an example of the first page.
Project ID: 10255808

About the project

26 proposals
Remote project
Active 8 yrs ago

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$155 USD in 3 days
4.6 (56 reviews)
5.3
5.3
26 freelancers are bidding on average $220 USD for this job
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Hi there, I am interested in more details that you can provide for the project. Message me to discuss in details. Please take a look at our client's experience with us here https://www.freelancer.com/u/marchingantssl.html Looking forward to hear from you, Regards,
$200 USD in 4 days
5.0 (213 reviews)
7.7
7.7
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Hi I am interested in your project. I can complete the functionality that you mentioned in your requirement. Please accept the bid. Thanks Shihan
$188 USD in 3 days
4.9 (302 reviews)
6.8
6.8
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Hi, I understand your requirement and I'm ready to do this for you
$354 USD in 7 days
4.9 (191 reviews)
6.9
6.9
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We can develop a three step process for customers, we have more than 5 years of experience in Website development, we are sure that we can give you the best, Please take a look at our Portfolio and Reviews. Looking forward from you Thanks and Regards Krishna
$166 USD in 5 days
4.9 (69 reviews)
6.1
6.1
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Hello, I have good Google forms experience and can help you doing this project. could you please provide more info about the project? Best regards.
$55 USD in 3 days
4.9 (77 reviews)
6.0
6.0
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Hello Sir, This is steve from intellectpark, I would like to show my interest in your project. we have great experience in EMR and EHR field. We would love to provide you a better solution. Please message us for discuss more.
$288 USD in 15 days
5.0 (12 reviews)
4.6
4.6
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Dear Sir, Hope you are doing well, I have read your job description, I am willing to work with you. I have already done similar job. - I ll complete all of your requirements - I ll do more tweaks for you as well Sir i ensure you that i am best suit for this post. Please open chat with me so we can discuss more in details Looking forward to hear from you. Best Regards
$155 USD in 3 days
4.9 (17 reviews)
4.2
4.2
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All complete with smart design and gui
$190 USD in 6 days
0.0 (0 reviews)
0.0
0.0
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A proposal has not yet been provided
$222 USD in 3 days
0.0 (0 reviews)
0.0
0.0

About the client

Flag of UNITED STATES
Sarasota, United States
5.0
1
Payment method verified
Member since Sep 13, 2011

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