Dynamic Mobile Dentistry

The task required patients/clients to fill out an application form on the website and sign it with a pointing device(mouse) or finger(mobile). After the form is completed it would take the submitted data and print it on an official digital application(PDF) form together with a signed signature. The patient/client would then receive an email with the attached pdf application, signed and filled out. – “I want users to be able to submit/sign an online application with out having to download and print it.”

08/2015 & 01/2017

Work performed for this task.:

  • Coding of 3x digital templates that replicated the 3x official paper versions with 100% precision. Every single field, word, text line and box(s) was coded by hand. To accommodate the data, from the form that was filled out, every box and font size needed to be measured and adjusted countlessly times until the perfect fit was found.
  • + CCS coding to get the HTML version to display and render 100% exactly as the paper version.
  • Custom Development.
    • All the data filled in on the form including the signatures are captured and stored in the database.
    • After the data is submitted an even hook is fired to insert the captured data into HTML templates via a series of loops, row for row.
    • The HTML templates are then converted to PDF versions.
    • The patient\client is emailed with a digital copy plus an attached PDF version to be printed. A copy of this email is also sent to admin.



I created an exact digital version of a paper application paper form. Think government forms. Every single field, checkbox, an item that needs to circled or ticked that was present on each form were digitally recreated. In the end, the printed pdf version match the original paper document 100%.

Click on the images to enlarge.

Summer Sterling Grisamore

dynamicmobiledentistry.com Very professional, fast, and knowledgeable. Very satisfied with the final product.

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