Online Patient Registration/ Intake Form

Greetings- I would like to have a Patient Registration Form incorporated into an existing Flash Website. The pages will open in a new window. The pages will contain fields for the patient to fill in & upon submission, a completed registraion/appointment page will be emailed to a specific location in printable form. This project was already started by another coder, but the work was not completed. I will provide all files to the winning bidder. There is a interactive flash illustration of the body that needs to be completed also. I have attached it. This project needs to be completed within 7 days after bid acceptance (earlier is better). I prefer to have daily contact via IM (instant messenger)...I use Yahoo. All correspondence will be noted on RAC after IM chat. If you have any questions, feel free to ask, and I will do my best to respond promptly. Happy Bidding! ## Deliverables *Progress of work must be submitted every other day (every day is preferable). Then the final work must be submitted on day 7. (additional samples of progress preferred before required dates) *All finished images/files to be offered for approval before acceptance of project being complete. *If additional time is required throughout the course of the project, sufficient notice must be given. *Delivery via WinZip file *Format - .PSD; .FLA; .SWF; .JPG; *SAMPLES OF PREVIOUS WORK REQUIRED!!! Completion: * Project to be completed no more than 7 days after bid is accepted. Copyright: * Plagiarism and use of content from another website is not acceptable. * Content must NOT be subject to royalties. * No Watermarks etc. * If freely available images are used ??" they must be edited sufficiently to prevent duplication of material. * Once completed ‘you may not’ re-distribute / use the material. * Rights to edit, redistribute, claim ‘authorship’ is relinquished upon completion 1) Complete and fully-functional working program(s) in executable form as well as complete source code of all work done. 2) Deliverables must be in ready-to-run condition, as follows (depending on the nature of the deliverables): a) For web sites or other server-side deliverables intended to only ever exist in one place in the Buyer's environment--Deliverables must be installed by the Seller in ready-to-run condition in the Buyer's environment. b) For all others including desktop software or software the buyer intends to distribute: A software installation package that will install the software in ready-to-run condition on the platform(s) specified in this bid request. 3) All deliverables will be considered "work made for hire" under U.S. Copyright law. Buyer will receive exclusive and complete copyrights to all work purchased. (No GPL, GNU, 3rd party components, etc. unless all copyright ramifications are explained AND AGREED TO by the buyer on the site per the coder's Seller Legal Agreement). ## Platform SOFTWARE REQUIRED: Macromedia Flash MX+; *Format - .PSD; .FLA; .SWF; .JPG; SOURCES AVAILABLE: .fla, .jpg, .psd All files delivered via WinZip.