I have a small project for a physician client.
The project will need a few forms and some payment integration.
Payment Integration:
I need to set up a web page for patients to go online and pay a bill that the client has sent them
Amounts will be different since it’s their bill and not standard shopping cart type amounts.
Client’s merchant can integrate with Authorize.net. They don’t currently have a cart system.
Any thoughts on how to handle this?
Forms:
-Request appts Form:
Need a form for patients to request an appointment.
This should have:
Contact name for person submitting form
Contact phone for person submitting form
Contact email for person submitting form
Patient Name
Symptoms/Reason for visit (text area)
Requested date/time
-Request Refills
Need a form for patients to request prescription refills.
Fields:
Contact name for person submitting form
Contact phone for person submitting form
Contact email for person submitting form
Patient Name
Add Patient
Patient Name 1
Patient 1 Prescription 1 Description | Prescription 1 Number
Patient 1 Prescription 2 Description | Prescription 2 Number
Add Prescription
Patient Name 2
Patient 2 Prescription 1 Description | Prescription 1 Number
Patient 2 Prescription Description | Prescription 2 Number
Add Prescription
-Patient Questionnaire
10 field patient questionnaire (basic patient background info)
