Design a Flyer (Medical Health History Patient Intake form Project)

  • Status: Closed
  • Prize: $30
  • Entries Received: 6
  • Winner: anantomamun90

Contest Brief

We have a medical history form that new patients must fill out when coming to our clinics. We need somebody to create a new design of this form with small changes:

1) Check boxes should be YES / NO (circle one) where possible.
2) Couple more diseases to be added.
3) Need English and Spanish Versions
4) Would like to consolidate the signatures to just ONE signature for the Spanish version (which has 3 signatures right now)
Need the heade file to bear our logo and address, and file should be able to switch logos for different clinic names easily.

Can use PSD or illustrator to edit.
Design is up to you, as we need most of the space for text

Recommended Skills

Top entries from this contest

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Public Clarification Board

  • mynagor
    mynagor
    • 6 years ago

    well done Abdullah All M.

    • 6 years ago
  • adripoveda
    adripoveda
    • 6 years ago

    Please check #5 send the full color version and the one color version. Thank you

    • 6 years ago
  • Pandiaraja8197
    Pandiaraja8197
    • 6 years ago

    Can i design this form in Indesign? I can produce interactive Indesign with Interactive PDF? Shall I?

    • 6 years ago
  • smileless33
    smileless33
    • 6 years ago

    working on it , inbox me . Need to discuss some topics very badly. I hope you will like this and I am looking forward for your feedback. Your feedback will help me to make it more appropriate.

    Thank you very much for being with me

    • 6 years ago

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