Enhance Power Outage Notification Form

I need a skilled consultant to modify my existing Power Outage Notification Form, currently in Microsoft Word. The modifications should enable the form to accommodate multiple outages and incorporate both text and image inputs. Furthermore, an automatic email template for Outlook needs to be generated with these inputs.

Ideal Skills and Experience:
- Proficient in Microsoft Word
- Experience with form design and modification
- Understanding of email template creation
- Ability to incorporate multimedia inputs into forms
- Knowledge of power outage notification processes will be a plus