I am writing a script to auto-fill the attached PDF. However, groups of check boxes all have the same field name and therefore I cannot select just one individual checkbox - it's all or nothing.
For example, the same "insurance_type" field name is used on the Medicare, Medicaid, Champus, etc. checkboxes. I would need to rename those to "insurance_type_medicare", "insurance_type_medicaid", etc. and each should have options for either Yes or Off.
Ideally, all of the checkbox groups on this form could have unique names. But if it is easier, I only need the "insurance_type" mentioned above, Sex, Relationship to Insured, Patient Status, Employment, Auto Accident, Other Accident, Outside Lab, and Accept Assignment.
The deliverable will be a PDF that looks and functions exactly the same as the attached but has unique, clearly named field names.
Thanks for your help!
Hi there,
I am professional Graphics Designer and I have more than 10 years experience.
I gone through your requirements and I am confident to design your pdf form in adove illustrator first and then add fillable function.
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Thank you.
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Hello ,
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Om.P.
Hello ,
This is Sushma (Graphic-Illustrator Artist)
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Thank you!
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Best Regards,
Aastha
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