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Convert Claim Form (ID:615)
| Project Creator: |
knittingguy
FC Member For 6938 Days
Credits 20 Completed Proj. Num. 1 / 2 Total payment USD 100.00 Avg Daily Online 0.00 h (From 21/5/2007) Available on MSN/Skype No Last Login 3/17/2006 Peers Rating 100.00% 
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|---|---|
| Budget: | Less than 250 |
| Created: | 3/10/2006 3:28:44 PM EST |
| Bidding Ends: | 3/13/2006 3:28:44 PM EST ( Expired ) |
| Development Cycle: | 3 Days |
| Bid Count: | 7
|
| Average Bid: | 100.00 |
| Project Description:
One of my clients has this claim form that they want to convert into HTML format. Please go to http://www.sanctuarysoftwareonline.com/hcfa.jpg for a look at the form itself. I have started the conversion. Please go to http://www.sanctuarysoftwareonline.com/hcfa1500_new1.html for what I have got so far. If you like to, please feel free to continue where I left off. What my client needs is, the HTML form will print on a 8.5" x 11" paper with 0.4" margins all around. The whole form should fit in one page. When you print the HTML form out, it should look exactly like the actual form itself. My client will dynamically populate this HTML form using ColdFusion. And then their clients will print the form out and they will send in for their claims. While I am not being picky, the print-out has to match the actual form. If not, the claims may be denied. Unfortunately, I have something else to take care off and I won't be able to finish the HTML form. Considering what I have so far, it should not take you that much longer to finish the form. My budget is at a max. of $100. If you have any questions, please don't hesitate to ask. I have to deliver the form to the client no later than March 17. If the client does not like the output, you may need to make more modifications. |
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| Job Type | |
| Attached Files: | N/A |
