P3 Step-Based online support referral form

A responsive multi-page online referral form for a leading not-for profit provider of housing and mental health support.

online referral web form Responsive version of multi-step form

The project

We were tasked with producing a simple to use, multi-step web form which could be used as a standalone webpage, or embedded within another site. The site needed to securely submit information to a database and redirect site visitors based on options chosen at different steps.

The design needed to break down the complicated steps of an existing paper based referral form, into easy to follow chunks, and be suitable for use on a range of common devices.

We came up with a custom solution using a mix of PHP and javascript, and condensed the steps down into a maximum of 11 short blocks. The project included creating a back end system for processing of information and is secured with a SSL certificate.

HTML • CSS • SQL • PHP • Javascript