Intake Form PDF QR Code

I have an intake form that is currently a paper copy. In an attempt to move towards a paperless intake solution, I am going to begin to print a QR code on our intake forms. I need a script that will print out a QR code using Google Chart API QR Code system and read the code back using a QR web service API that I document further in the project details.

The current intake form in word document format is located here

[url removed, login to view]

This project requires two pages/scripts. The technologies used will be PHP/MYSQL/ImageMagick

One of the pages would be what the user uses on a daily basis to create intake forms. It should be an electronic form that looks similar to the word document form, but it is HTML. Each field on the word document should be a field that allows input on the HTML page. The input fields will then be used to post to a print function that will create the PDF using FPDF. [url removed, login to view]

The second page/script would be a PHP script that would run without any user interaction. It would take the filled out intake form, upload it to the QR reader API, and insert the returned data to MySQL.

There is very detailed documentation available once awarded that gives more detailed instructions.

Evner: MySQL, PHP

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Om arbejdsgiveren:
( 5 bedømmelser ) Dublin, United States

Projekt ID: #956408

Tildelt til:


You have a PMB.

$200 USD in 7 dage
(17 bedømmelser)

2 freelancers are bidding on average $225 for this job


We're ready to start and deliver the job. We're group of programmers, web developer having expertise in php, asp.net etc. Appreciate to get more information. Thanks

$250 USD in 5 dage
(4 bedømmelser)