Đã Đóng

Treatment Form

I run a LASIK surgery center. We have a treatment form that we require referring doctors to complete and send to us for every patient that we treat. I'm having trouble getting doctors to complete the entire form, so what I would like to do is have someone build our EXACT form electronically and make it so doctors cannot submit the form to us without every data field required being completed. it would be great if they could also electronically sign the form stating that the data is accurate and complete.

Kĩ năng: Lập trình C, Electronic Forms, Y khoa

Xem nhiều hơn: programming center, treatment, form sign, build accurate, form build, submit form data without, lasik, data form submit, electronic data, programming patient, required field form, electronic sign, sign forms, doctors required, data doctors, build electronic forms, swish treatment plastic surgery, registration form click submit button store data password field genarated automatically php mysql, make submit form iphone web app, make submit form flash, make money build quizzes, build sign form, build php scraper entire domain, form field required php, jquery form validation status check submit click

Về Bên Thuê:
( 0 nhận xét ) United States

ID dự án: #1657357

12 freelancer đang chào giá trung bình $195 cho công việc này


I am interested doing your project, for more details kindly see your mail box. Thanks, Faisal.

$250 USD trong 20 ngày
(3 Nhận xét)

Want to delivery a quality work with reduced [login to view URL] PM for sample form. Thanks.

$50 USD trong 4 ngày
(4 Nhận xét)

Hello Dear Sir / Ma'am. I am a highly qualified & certified Adobe Acrobat , Adobe LiveCycle Form Designer and MS OFFICE professional with more than 4 years of teaching experience for these softwares in an institute. Thêm

$60 USD trong 0 ngày
(9 Nhận xét)

hi this is a long form. it is not clear whether doctors have to fill all the fields or their are some alternate fields , i.e., doctors must fill either of them , e.g. LEFT EYE Sphere Cylinder Axis Date will a d Thêm

$250 USD trong 30 ngày
(0 Nhận xét)

Please check PMB

$250 USD trong 5 ngày
(0 Nhận xét)

plz check you PM.

$250 USD trong 10 ngày
(0 Nhận xét)

Hi there! I can get the job done for you in a matter of day. The only thing I need to is if you want the form electronically on the web(online) or you need it as an application that's executable on a click on any Windo Thêm

$200 USD trong 1 ngày
(0 Nhận xét)

Custom software development - <b><i>Removed by Admin</i></b>

$250 USD trong 1 ngày
(0 Nhận xét)

Greetings, I assume that you have a web-site with database. I have done a lot of similar tasks using various technologies (PHP, .NET, ColdFusion) so I think I can easily do the job for you. If you'd prefer a l Thêm

$500 USD trong 7 ngày
(0 Nhận xét)

Expert in software development. Hope have a great business together.

$175 USD trong 2 ngày
(0 Nhận xét)

I have created a demo of your form. Please check your PMB for details

$150 USD trong 5 ngày
(0 Nhận xét)

Hello. I can have this built electronically and validation of the form when the doctor tries to submit it. Check pmb for questions. Regards, -Arthur

$150 USD trong 4 ngày
(0 Nhận xét)

I can do [login to view URL] check pm for details.

$60 USD trong 1 ngày
(0 Nhận xét)