I have a website similar [url removed, login to view]
On the front page of the above website, there is a user input module requesting user name, medical insurance, phone number... etc.
I need the exact same module that emails the content to my email address and is also recorded in a database.
29 freelancers are bidding on average $160 for this job
HI, I can make this form for user details within a day Соответствующие навыки и опыт 12 years PHP Предлагаемые промежуточные платежи $100 USD - full escrow
Hi. I have reviewed your project and can do your job within 3 days. I will show good skills. Relevant Skills and Experience php Proposed Milestones $155 USD - one time.