Web Base Canned Respond

we are looking for a web based for multi users access for canned massages programmed, that we can customize with different categories, with mixed of text and photo. This is how it should work : Our agent will log in with his user name and password ( created by the administrator ) customer calls, the agent must fill out the following cusotmer info before starting the questions ( customer name, phone number and email address ) these must be customized as needed ( add or remove items ) when all the info are filled, the agent will click on Next ( to start the canned questions ) based on the category selected, trouble shooting questions starts. at the end of form ( when the agent is done all the steps) either its fixed and results will be saved as a ticket in the database, or still needs to be looked at and sent to level 2 then it will be sent to another email address. the email must be sent with all the results including the customer info and the agent name with the date and time, plus the time it was started and the time it was sent or stored. requirements 1-web base program with multi user access 2-easy modifications and must be user friendly to be updated and to add the info. 3-administrator creates users with limited access to them 4-tickets can not be deleted, only can be done by the admin. 5-all documentations and steps how to add and modify the canned respond. 6-agents can not go to the next question with out answering the present one. time frame for the job 2-3 weeks if you have samples please provide it .