Hello,
I'm first wondering what you're requesting. Would you be wanting a Desktop application that can just run on a computer locally, or are you looking for a deployed Service on the internet that your users would be able to use?
1. Desktop Application - I think this would be the simplest approach, given that you've already done the research into the legal issues of electronically signing a document, then I'll assume all we need is a small application to A) Figure out which doctor to choose, B) Choose the doctor and auto-fill the information and lastly C) Generate the non-editable PDF.
2. Service on the internet - (Unlikely) If you're looking for an application hosted on the internet, I think we'd have a lot more requirements to go over before we could even agree on something.