I have a web page that is online. Please see www.smilebritelabs.com
What we need done is to have
1. a floating window appear when the link “Pick Up Case” link is clicked. On the floating window we need to have a contact form that asks for
A. Doctor/Office name:
B. Office phone Number:
C. Email address: (this will need to have an auto responder to send an confermation email to them stating that they have sucsefully requested a pick up.
D. Case is ready: have the options of now, or by time: then a field to place the time.
Then a submit button and clear button.
all of this data will nee to be sent to my email address.
2.I need a secound contact form created on our contact us page.
what I need in the contact form
a. Office name
b. Doctor name
c. Address
d. City
e. State
f. zip
g. Office phone number
h. Office email address
1.(check box) Please contact me about your lab.
2. Order supplies (Drop down box with, Lab slips, Boxes, Bags, Shipping labels, product infomation)
3. please send me more infomation.
4. Notes box
We would like to have the contact form be the smae look and style as our curent page.
I am looking to get this completed ASAP.
Please let me know when you will be able to complete this project.
Thanks
