customized form

when we accept a provider on our company we send and excel form (attached image) to provider and he need to fill it and send it back to us for enter it on another software for process information. We are looking for bring this form online for provide an link to provider and fill the form online and send it to us. We are implementing an website for do this but we are looking for a experience person to do the form. The form will need 1. required fields 2. some optios are drop down list 3. At the beggining of the form (below title) are four checkbox option (PALC, PAEX, PADI, PAIN) depending of the seleccion will appear the section A and B only or all sections. So the form must ask first to check this area and depending of user selection will appears all sections or only some sections. [login to view URL] system must send an email like the form of the image with entered information [login to view URL] the bottom before click send will be 3 checkbox option linking some legal terms that user must check before send form. I need a quote for 2 scenarios SCENARIO 1. Do the form with all steps above. the form must be easyly edit in case that any word is need to be modified later. or if is needed to add/edit options, etc. SCENARIO 2. The same as scenario 1 but all data will be stored in a database that will keep all forms information. All the form must be later reviewed and there exist and option for serach forms by date, month, etc the system must generate reports or look into the database depending of some terms . Example 1. We want to know how many form was filled from X country 2. How many form was filled last month 3. quote 7-10 search criteria on the database . i still dont have all the search criteria. * remember that the form must be easyly edit , etc....We are thinking in joomla for make the site and may be the work can be perform modifying some existing component for make form.... but if are offered another option another than joomla for this... only tell me Remember i need the quote for 2 scenarios.,,, thank you guys