Fill-able form template in Word

  • Status Closed
  • Budget $30 - $100 USD
  • Total Bids 7

Project Description

**Project description

**Develop an electronic fill-able form in Microsoft word 2003 that can be emailed to our clients and saved for our records.


**We are a medical practice specialising in occupational medicine. As part of the injury management process our doctors must complete medical certificates for injured workers. Currently this is done manually using a paper certificate pad, copied for the worker and faxed to the employer. We’d like to automate this process.


**Develop a fill-able form in Microsoft Word 2003 for our use in the short term

Long term we want to integrate this form into our CRM system Must fit on one page

We must be able to pdf or encrypt the form for emailing to clients - we’d like the coder’s advice on the best way to do this

We will need to save a copy of the form for our records

We have developed a version of this form in adobe acrobat that I will send separately to show the content and layout we require

The form will be used by several different doctors

We will need to tab through the form in order, field by field

Most fields will be text fields, but we will require:

o drop down list for some fields ??" we will fill in and modify the options for the drop down lists

o date fields with calendar pop-up for some fields

o check boxes for some fields

o some fields to be automatically populated with data

We need to be able to add drop down fields into the form should things change over time

The specific requirements of each field will be sent separately We need the form to be completed within a couple of days

## Deliverables

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

We want the form developed in Microsoft Word 2003

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