Website design with a form filled and e-signed



I am looking for a web designer to convert a medical authorization form into a website to be made.

The form is an authorization linked between doctors and vendors.

The site will need doctors to login and create a login using their license number and npi number and be able to electronically sign the form.

The form will then be able to be pulled up and printed by a vendor that is assigned to that form.

Skills: Graphic Design, HTML, PHP, Website Design

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Project ID: #5492329

64 freelancers are bidding on average $2532 for this job


Warm Greetings We have mentioned a place holder bid to initiate a discussion . Do let us know your availability on chat for us to discuss the project in more detail. We will be quoting the final price once we are c More

$4948 USD in 60 days
(486 Reviews)

----Waiting for your response----- Greetings!! We have gone through your requirement of having "form filled and e-signed" website, where doctors will be able to create their account by providing License number an More

$2577 USD in 30 days
(314 Reviews)

I have created similar kind of e-signed form website for a lawyers portal so Kindly accept my bid for your website project and be assured of a high quality work with our highly experienced and dedicated developers. Th More

$3092 USD in 30 days
(175 Reviews)

Dear Sir/Madam, We are interested in your project and very confident to fulfil project. This is a temporary bid. - Could you please send your project details to us? - Could you please provide site map to us ? More

$3092 USD in 30 days
(144 Reviews)

Dear Sir, We would love to get this opportunity of working with you. We always strive to satisfy our customers as much as possible. Our account has recently transferred here from vWorker.We had joined vWorker ab More

$2319 USD in 30 days
(352 Reviews)

Hello, We have read the project requirements in complete detail. We have noticed that you are seeking highly skilled and expert professional personnel to develop medical related website with form and e-signature. Th More

$2577 USD in 25 days
(135 Reviews)

Hello Mate, I am in the process to prepare the proposal of this project,Please allow me some time to complete it,Will send you soon,Please keep in touch. Regards Krish

$2488 USD in 48 days
(161 Reviews)

**********************.. YOUR SEARCH ENDS HERE .. ********************** GET IT DONE RIGHT THE FIRST TIME! Hello Sir/Ma'am, I look forward to talking to you further and getting started. I've been working in simple and More

$2680 USD in 15 days
(131 Reviews)

Hi I am a Web designer and developer with 8 years of experience. I have gone through the given requirements and will develop the website as specified. I am flexible and more than willing to work around whatever More

$2061 USD in 20 days
(139 Reviews)

A proposal has not yet been provided

$2947 USD in 30 days
(25 Reviews)

Good day, we can do this job done for you!!! Make an impact with top notch designs, we are ready to work on your project. We offer professional services of innovative graphic and logo design and at a very reasonab More

$2989 USD in 25 days
(815 Reviews)

Hello, I'm Anna - a project manager in a Russian-Canadian web development company - A2Design. We have recently completed a similar project ( in terms of complexity. You can check our More

$4210 USD in 35 days
(59 Reviews)

1. Crowd Funding Site In these days we are already near to finish a full CMS based crowd funding site which is a clone of kickstarter but we implemented many unique features in this project to distinguish it from kic More

$2458 USD in 30 days
(95 Reviews)

I am Allen and I'm leading a team of professionals developing web based applications for past 9 yrs located in Delware, USA! I have read your project requirements and we will provide you with the following : 1 - Re More

$3500 USD in 30 days
(198 Reviews)

Hi, We have read your Requirements and would like to discuss further as we have strong hands in web, desktop & mobile application development & completed over 150 projects in last 5 years. Please check below some More

$3092 USD in 28 days
(52 Reviews)

Hello, We have a strong experience in developing & designing websites and developed lot of projects in this regard. We use core coding/designing standards & techniques in whole development process and provide 100% More

$2577 USD in 30 days
(114 Reviews)

Hi, I have gone through your project description and could assure you the best of the solution. I am taking it as an opportunity and ready to deliver my best. we have done several complex business software like More

$3000 USD in 55 days
(153 Reviews)

hi , i went through your script you given in your proejct post and understand the concept of your proejct . we a re eagerly interested in your project and ready to work on it. we are ready to provide you all the funct More

$1958 USD in 30 days
(67 Reviews)

Hello! I am interest your project and willing to have long terms relation with you. I hope to work with you. I have enough experience with WEB developing for 5+ years. Client satisfaction is my top priority. I wi More

$2577 USD in 30 days
(121 Reviews)

Hi, We have reviewed your requirement for building the web with form with authorization between doc & vendors. We will provide the login and authorization as requested. We have exp. building such medical domai More

$2473 USD in 30 days
(159 Reviews)