MS Access DB and entry form

I am looking for someone to create a Microsoft Access Database and Entry Form for me. The purpose of this database is to store and manage data entries, which I expect to be less than 1000. My goal is for the entry form to have between 5 and 8 fields that will be entered by a user. One field will be an open field with two fields being date selected. If the combination of open field and date are already entered a message should be displayed and allow user to add a suffix to the open field. The open field will be a unique key such that the date field attached to the open field remains the same.

Once an entry is completed the form will allow for an xml file to be exported to a configurable folder. It will only be possible to export the entry once. It shall be possible to make an additional export with a concatenation of the open field and suffix