In Progress

HTML / PHP Survey Script Need TODAY - Simple!

I need this completed in the next few hours. An experienced coder can do this very quickly. Please indicate you can finish today when bidding.

I need a survey page done with a logo at the top of the page and the following 3 questions centered on the page. Please use radio buttons for each selection. If the user selects 3 or below for any of the answers, they should be redirected to another PHP page ([url removed, login to view]) that asks them for their email address and phone number, and then sends me an email with their information. Otherwise, they should be redirected to a thank you page ([url removed, login to view]) that will have 3 links [url removed, login to view], [url removed, login to view] and bing.com.

I also need you to provide mobile-friendly templates of all these pages that will fit an iPhone or Android screen.

Survey:

How would you rate your experience with your Dentist?

1 2 3 4 5

How would you rate your experience with your Technician?

1 2 3 4 5

How would you rate your overall experience at the Dentistry?

1 2 3 4 5

Skills: HTML, PHP

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About the Employer:
( 83 reviews ) Boston, United States

Project ID: #2552799

Awarded to:

AStowell

Hello to you! I can have this work completed liquid fast. Choose me for professional, reliable results.

$60 USD in 0 days
(4 Reviews)
4.0

7 freelancers are bidding on average $61 for this job

Infenixwebs

Hi, I have experience in PHP projects, please check your inbox, thanks.

$50 USD in 0 days
(88 Reviews)
6.4
TheInnoVibes

Please check private message .

$40 USD in 0 days
(39 Reviews)
5.8
AdamsK

Already done. Please check pm.

$30 USD in 1 day
(66 Reviews)
5.5
kazimdekram

Can do it in few hours. Just now did this for my client http://www.kaziekram.com/mfs/survey/index.php?survey_id=survey_507472d66c94f

$110 USD in 1 day
(12 Reviews)
4.4
softwareIndia

I can finish it by today itself. Please send me the details to start working

$100 USD in 1 day
(12 Reviews)
4.2
webdeverdotnet

Hi, I'm a web programmer from Southern California, I can have this ready for you within an hour or two. Please PM me and lets get started!

$35 USD in 1 day
(3 Reviews)
3.3