Build an Application - 21/12/2016 10:50 EST

We are looking to host a PDF form behind simple HTML fields for easy medical data entry (can be a few web-pages, looking to make a form more simple and turn key to navigate and complete). This pdf in question is the DOT medical PDF attached below. This web-based application would also have secure Login access and all necessary security features for encryption (Https and SSL + any best practices known) as this is very confidential information. Beyond this, we will need this web-app connected to a DB that can hold all completed forms, with a back-end that can manage logins. In addition, we would want basic reporting and exporting tools for the DB. MS Power BI connectivity (most DBs are freely compatible) would be great for the reporting, but is not required for the project (if not possible, we would want a simple billing solution with CC processing). Once completed, we wish to be able to build an IOS application around this web-app, with (temporary) offline storage incase of internet disconnection to the server/db listed above. Project ID: 12324451