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PHP-mysql form programming

$30-250 USD

In Progress
Posted over 11 years ago

$30-250 USD

Paid on delivery
[login to view URL] Contact us form - programming simply show confirmation and client side validation and send all requests to an email we will give you and confirmation email to user and online message 2. Urgent Submit Flat Pay request programming [login to view URL] with Db insert and Db CMS login to show all requests with admin login and ability to change admin and pass in the interface with basic show all of all records by order date Descending and ability to change status from pending to Active by CMS admin and also you need to send emails to user and admin when there is a new record insert this is php/mysql and we will give you access and u create the Requests table for now we need to program all fields and validation based on what optional or not and i need to see all CMS + Validation also when in DB also an email to send to admin and user for the request made with confirmation also You need to make sure after user register in this form when he click the login button on home page he will have a username and password login and when he enter he can submit the same request without requiring him to enter all his info(provider) info again and just the actual request info with patient info [login to view URL]://[login to view URL] program this for all states CA selection will show different set of documents we will give you You need to add all states and program the next page selection based on state selection CA or all others after this project you will program a new registration form in a new project
Project ID: 4073824

About the project

17 proposals
Remote project
Active 11 yrs ago

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Ready to get started right away.
$80 USD in 1 day
4.9 (107 reviews)
5.8
5.8
17 freelancers are bidding on average $125 USD for this job
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understood your requirement and ready to start..................
$250 USD in 12 days
4.9 (107 reviews)
7.0
7.0
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Hello Sir, Ready to start now. We have excellent team of programmers and designers to work on your project efficiently and complete job in time. Please check "Private Message Box" for more details. Thanks
$40 USD in 1 day
4.7 (147 reviews)
7.0
7.0
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I am ready and expert in PHP and WordPress.
$150 USD in 5 days
4.9 (87 reviews)
6.8
6.8
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Hello, Thanks for your post. Kindly check our PMB.
$200 USD in 5 days
4.9 (18 reviews)
6.1
6.1
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Hi, Please check pm for detail.
$150 USD in 5 days
5.0 (91 reviews)
5.8
5.8
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Hello sir,3+ year of experience in Core php development. Ready to start. Thanks
$120 USD in 2 days
4.9 (38 reviews)
5.6
5.6
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Sir, we are ready to work in your project. Plz check private message for details. Thanks
$100 USD in 4 days
4.6 (9 reviews)
5.5
5.5
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See My PM Please!!!
$80 USD in 1 day
5.0 (16 reviews)
5.2
5.2
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Hello Buyer, I am Noddy from central India, I have gone through with the requirement and I understand it well. It will be a great experience to work with a buyer like you .... Kind Regards Noddy
$149 USD in 7 days
3.9 (49 reviews)
5.5
5.5
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Hi, Hope you are doing great!! Thanks for your time and consideration. For more details, please see your private message box. Regards, Anshika
$130 USD in 4 days
4.6 (21 reviews)
4.5
4.5
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hello, let program all your forms as per your requirements...i can provide you a nicely designed and password protected admin area where you can manage all the data that is submitted. i am web developer having 3 years of experience. you can check my profile in order to get an idea about my skills in web development. thanks, waiting you
$250 USD in 3 days
4.9 (16 reviews)
4.1
4.1
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Requirements clear
$100 USD in 2 days
5.0 (4 reviews)
3.3
3.3
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Hello, We would like to work on this with you to program form as we have done for many others in Website development. Check PMB for more details. Thanks,
$160 USD in 5 days
5.0 (1 review)
1.6
1.6
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Dear sir After reading your project details,we are interested in this project and would like to bid on this project. we take care of our every client personally and has always long term relationship. we will do as many revision till you get satisfied. please check your PMB thanks
$30 USD in 2 days
0.0 (0 reviews)
0.0
0.0
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Hi, We have gone through with your requirements and we would like to state that we would be able to develop your project according to your exact specification immediately. God bless you. Thanks & Regards Techno Web Solution
$100 USD in 2 days
0.0 (0 reviews)
0.0
0.0

About the client

Flag of UNITED STATES
Valencia, United States
4.9
333
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Member since Mar 3, 2010

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