Create a Modern Fillable Referral Form

I need a referral form designed in both PDF and Microsoft Word formats. The design should be modern and clean, incorporating my brand colors and logo. I have attached my current referral form and I also included a sample form that has a layout that incorporates a lot of information.

Requirements:
- Include personal details, referral details, and additional comments sections
- Modern and clean design style
- Use of my brand colors and logo

Ideal Skills and Experience:
- Proficiency in Adobe Creative suite, PDF and Microsoft office suite
- Strong design skills for modern and clean layouts
- Experience with branding integration