Build Two Elementor Contact Forms
Budget: $10 – $20 USD
I need two new contact forms created with Elementor on my WordPress site.
1. Fix the one I have, not receiving notifications at the moment.
2. Create a New One with the next fields:
1. Practice Legal Name
2. d.b.a (If applicable)
3. Practice Address
4. Practice Phone Number
5. Practice EIN #
6. Practice Group NPI
7. Individual Owner NPI
8. Provider Name
9. Provider Credentials:
10. MD, DO, DC, DPM, NP, PA
11. Provider Specialty: Family Medicine, Internal Medicine, Pediatrics, Cardiologist, Neurologist, Surgeon, Orthopedics,
12 Owner Mobile Number & Email
13. Practice Manager’s Name
14. Practice Manager Mobile Number & Email
15. Signature Field
16. Date
1. Fix the one I have, not receiving notifications at the moment.
2. Create a New One with the next fields:
1. Practice Legal Name
2. d.b.a (If applicable)
3. Practice Address
4. Practice Phone Number
5. Practice EIN #
6. Practice Group NPI
7. Individual Owner NPI
8. Provider Name
9. Provider Credentials:
10. MD, DO, DC, DPM, NP, PA
11. Provider Specialty: Family Medicine, Internal Medicine, Pediatrics, Cardiologist, Neurologist, Surgeon, Orthopedics,
12 Owner Mobile Number & Email
13. Practice Manager’s Name
14. Practice Manager Mobile Number & Email
15. Signature Field
16. Date