Developing a professional intake form

We need someone that is very precise and experienced in creating an intake form. This intake form needs a professional look and feel (layout/design) and most of all needs to be easy to fill in for a client. So needs to be send as document (pdf or else) by mail. We need it ready by Sunday 31 around 17:00 CET. We have made all teh questions and text so it's more about the technical side and design/layout.