Create online patient intake form for website

  • Status Completed
  • Budget $30 - $250 AUD
  • Total Bids 31

Project Description

Project Scope

Digitise patient intake form (see link here [url removed, login to view]) 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.


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.

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