Update EMR Lab Form

I have an existing laboratory request form inside my Electronic Medical Record that needs to be revised. The current layout no longer captures everything our clinicians want, and a few fields are now obsolete.
Cost needs to be under $50USD as this is a one page document to revise

I will supply:
• A 1 page PDF export of the form as it appears today
• A marked-up version showing the fields to add, remove and reorder
• Access to a staging copy of the EMR (web-based) so you can develop and test without touching production data

Your task is to implement those changes directly in the form builder/templates used by the EMR, verify that the new form stores data correctly, and ensure it prints cleanly to PDF. Once finished, I need a short note of what was modified so I can keep our internal documentation up to date.

Experience working with medical-record platforms, HL7/FHIR field mapping or similar web form engines will help you move quickly, but it’s not mandatory as long as you are comfortable digging into existing template code (HTML, Liquid, or proprietary tags).

Turnaround is flexible for the right person, but ideally I’d like a testable update within a week. Let me know if you have relevant examples or need clarification on the environment and I’ll get those details to you.