Create online patient intake form for website

Closed

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.

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.

Skills: Electronic Forms, Graphic Design, PDF, Website Design, WordPress

See more: wp freelancers, wordpress website mobile plugin, wordpress online design plugin, wordpress monthly service, website with freelancers, website design testing, website design template input, website design template godaddy, the best template for website, template design for freelancers, project intake form, patient data entry, online editable graphic design, online data entry testing, i work online, IT website, http www freelancers com au, graphic word design online, graphic design project fees, graphic design online service, graphic design create online, getting data entry experience online, freelancers website for it, freelancers online it, freelancers for website design

Project ID: #5111980

Awarded to:

try67

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) More

$133 AUD in 3 days
(22 Reviews)
5.5

25 freelancers are bidding on average $183 for this job

nmans

We are highly interested to work with you on this project and can assure you quality results ready to start immediately some of our developed websites are listed below Wordpress: http://www.africancomics.co More

$257 AUD in 3 days
(319 Reviews)
7.8
wildCat

Hi, My name is Marat, I am CEO of WEB4PRO company located in Ukraine. We offer the services of web development on WordPress. I am interested in your project and able to perform tasks with different level of comple More

$81 AUD in 3 days
(88 Reviews)
7.4
DeamonBizz

We can make this form. ""Please have a look on below links: www.kwikfundme.com http://zooeymagazine.com http://lifeinsurancequotes-online.org www.facelook.com www.miketyson.com http:/ More

$147 AUD in 7 days
(97 Reviews)
6.9
guruwebsolutions

Dear Sir, We have 8 years of experience in providing website solutions. Our expertise are in wordpress, wp plugins, php, ecommerce, responsive & mobile compatible websites. Given below are links to some of our works: More

$195 AUD in 8 days
(65 Reviews)
6.8
sritechnocrat

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 lay More

$263 AUD in 20 days
(36 Reviews)
6.8
exactprecisions

I have years experience working with WordPress. I am a professional who will pay attention to details, give you a great experience, good communication and meet deadlines! Let me know if you have any questions. More

$154 AUD in 3 days
(121 Reviews)
6.7
WebSolutionWorld

Hi, I am ready to work for you. I have 10 years of experience. See some of my works also check my reviews you will get better idea about my skill. Wordpress work http://www.planodr.com/blog/ http://li More

$154 AUD in 3 days
(91 Reviews)
6.5
sandyIN

Hello Sir, Below is some theme created by us , you can view it all mobile devices (IPHONE,IPAD,ANDROID) http://fortepeople.com/ http://www.spahuset.no/ http://www.cssrender.com/clients/brt/ http://www.cssrende More

$210 AUD in 3 days
(82 Reviews)
6.2
raju51279

Hi, Thanks for allowing us to place proposal in your project. We have gone through your project details. we have developed such form , where form will be saved in admin pane , and copy will be sent to admin More

$184 AUD in 4 days
(28 Reviews)
6.3
harmonyinfotech

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
(178 Reviews)
6.0
bdweb

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 More

$250 AUD in 10 days
(88 Reviews)
5.9
eperfections

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
(22 Reviews)
5.1
sparkeye

We are an US based website design & development company since 10 years successfully deliver and specialize in high quality design & development. If you're looking for an award winning website Development Company then y More

$180 AUD in 5 days
(16 Reviews)
5.1
Mezh

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 th More

$242 AUD in 7 days
(11 Reviews)
4.9
WEBUNCLE

With over 7+ years of experience, I have acquired the comprehensive experience with PHP, MySQL, AJAX (particularly JQuery) programming, mobile websites & mobile apps design development. I have developed be-spoke web a More

$130 AUD in 3 days
(36 Reviews)
4.9
retribution1979

Hi, I have extensive knowledge designing forms, and would love the chance to work you on developing a patient intake form for your website. I can develop a form that's flexible and can easily be changed down the road, More

$166 AUD in 3 days
(12 Reviews)
4.0
AndroPetre

Hello SamsMarks, I am Peter, nice to meet you. I am the leader of MediaHeart WEB Agency (mediaheart.ro) and an experienced web developer. Your actual project is similar to another project one doctor gave me to finish i More

$150 AUD in 5 days
(10 Reviews)
3.8
UDSSL

I am an experienced WordPress developer. I can help you to install the form on your WordPress website. I will provide you support during the service guarantee period. Please see my code sample:https://github.com/UDS More

$50 AUD in 2 days
(1 Review)
2.0
bsoft89

Hello, WordPress expert here. I am dedicated and honest freelancer having record of completing the project in time. I checked your project and found it interesting because this best fits to my skill-set. I am ready More

$88 AUD in 2 days
(2 Reviews)
1.0
acutetech10

Our company has more concern on Web Development and Software Development, since we put our effort on it. We and our developers are highly skilled in this area, the performance and delivery are being good to the clients More

$195 AUD in 7 days
(2 Reviews)
1.1