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Health Plan Simulator

I need a simple Health Plan simulator. If you know Javascript It should not take more than 1hour to do.

Here is what I need: [url removed, login to view] (of course this form is totally messed up, I want something better)

When people fills that form and click the button, a value will be showed, so the user will know exactly how much he/she will have to pay.

I'll provide the values.

Doing a admin area (so values can be easily change) will be awesome, but is not needed (you'll just need to tell me how can I do that)

As Simple As That to be done As Soon As Possible

Compétences : HTML, Javascript

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Concernant l'employeur :
( 5 commentaires ) Campinas, Brazil

N° du projet : #1078926

Décerné à :

danieloraca

PMB first please.

50 $ USD en 0 jours
(32 Commentaires)
4.7

11 freelance ont fait une offre moyenne de 56 $ pour ce travail

lsweb

Hello. Please check your PM. Thanks.

35 $ USD en 1 jour
(80 Commentaires)
6.8
tonykim100

Hello sir! Please check PMB.

30 $ USD en 0 jours
(100 Commentaires)
6.0
php4world

Hello! Please check your PMB.

35 $ USD en 0 jours
(51 Commentaires)
5.9
sriraj1233

PLEASE CHECK PMB

30 $ USD en 0 jours
(72 Commentaires)
5.4
a4ren

I am really interested to do this [url removed, login to view] check your PM.

100 $ USD en 2 jours
(2 Commentaires)
3.2
Artistontheroll

i will deliver on time if u give the chance....

200 $ USD en 3 jours
(0 Commentaires)
0.0
Algotrade

Please see the PM for more details.

30 $ USD en 0 jours
(1 Commentaire)
0.0
andleigh007

I know java script well so please give me this project.. I will give my best

50 $ USD en 2 jours
(0 Commentaires)
0.0
nitrup

looks simple, just tell where you actually want to show values.

30 $ USD en 1 jour
(0 Commentaires)
0.0
dotnetguruvn

Check your PMB please

30 $ USD en 0 jours
(0 Commentaires)
0.0
webdeon

Hello, I can do it quickly. See PMB please.

30 $ USD en 1 jour
(0 Commentaires)
0.0