Custom Form Build With Zapier Integration

Concluído Postado há 3 anos Pago na entrega
Concluído Pago na entrega

I am looking to replace a current lead generation form on my current website.

For an example of what I am looking to replace, please see - https://hairtransplantdallastx.com.

Click on any one of the "consultation" buttons to get an idea of the function of what I am looking for.

**Three VERY IMPORTANT features and functions:**

- Form MUST have popup function/capability.

- Form MUST integrate with Zapier

- Form MUST be compatible with WordPress

- Form MUST come with a basic CRM to track all form submissions

Rather than the simple 4 questions I am asking now, I would like a multi-step form that displays the same way.

Here are the steps I would like to include:

1. Norwood classification (image selection)

- User will choose from 10 images of what their hair loss looks like

2. Are you on any hair loss medication or have you had a procedure in the past? (multiple selection)

- User will choose between a drop down menu and radio box options

3. Hair loss photo upload (optional for users)

4. How would you like to meet Dr. Smith? (single answer option)

- User will choose Virtual, In-Person or Phone consultation

5. Contact Information (three input fields)

- User will input Name, Phone and Email Address

6. Contact Preference (dropdown options)

- User will choose the best way to contact and the best time to contact

PHP WordPress HTML JavaScript CSS

ID do Projeto: #29080583

Sobre o projeto

17 propostas Projeto remoto Ativo em há 3 anos

Concedido a:

rukshanlancer

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$250 USD em 2 dias
(47 Comentários)
6.1

17 freelancers estão ofertando em média $477 nesse trabalho

AwaisChaudhry

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$750 USD in 28 dias
(89 Comentários)
8.0
einnovention

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$500 USD in 7 dias
(197 Comentários)
7.5
kishanlalyadav

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$600 USD in 7 dias
(423 Comentários)
7.3
stepanbohanov

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$650 USD in 7 dias
(45 Comentários)
6.0
nizamfarhas

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$300 USD in 2 dias
(26 Comentários)
5.5
WebThunder0

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$700 USD in 3 dias
(10 Comentários)
4.6
HopeYourSuccess

HI there. I have read your description very carefully and I am sure I can make it perfectly as I specialize in wordpress for over 8 years. I am ready to get to it . Thanks, Donald.

$500 USD in 7 dias
(17 Comentários)
4.7
Ridafarhat5

Hello, Wordpress is fine to build your landing page? What do you prefer WordPress or PHP to build your website? I have reviewed your project description and understood your project scope, would love to discuss your p Mais

$500 USD in 7 dias
(5 Comentários)
4.4
vibhutitech

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$555 USD in 69 dias
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4.3
margoleena

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$250 USD in 7 dias
(7 Comentários)
3.8
wpdeveloper01

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$555 USD in 12 dias
(1 Comentário)
0.0
Hamza2288

Hello there! Expert Developer here. I have read your needs and i can help you with your website with 100% quality results. I can start working on it right now. Kindly, send me a message in the inbox so we can discus Mais

$300 USD em 1 dia
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0.0