Web Form Creation

Closed - This job posting has been filled and work has been completed.
Web, Mobile & Software Dev Web Development Posted 3 years ago


Hours to be determined
Less than 1 week

Start Date

January 28, 2013


Hello there! I currently have a web form that my clients fill out: https://vhds.wufoo.com/forms/start-your-virtual-implant-rx-express/

However, one client has expressed her desire to have it so the area that has the Restorative Doctor/Surgical Specalist Information remembers information.

For example, she wishes to have it so if she types a Restorative Doctor and all the information below, she can have the option to save that information and have it in a drop down so it can auto fill if she needs to use that information again.

The same needs to happen with the Surgical Specialist fields.

In sum, I am looking to have the form recreated so that this is a new, separate form. When the information is submitted, the results should be emailed to an email address.

If there are any questions, please let me know and I can clarify.

About the Client

(5.00) 19 reviews

United States
Tempe 04:49 AM

20 Jobs Posted
95% Hire Rate, 1 Open Job

$877 Total Spent
23 Hires, 1 Active

$9.01/hr Avg Hourly Rate Paid
87 Hours

Member Since Aug 14, 2012