I need a custom FAX cover sheet for my medical clinic that meets my specifications.

I'm using the software RingCentral. This software lets you set a custom cover sheet for your e-Fax, and lets you use variables that will be automatically filled in as long as they're written correctly. -This FAX sheet needs to be designed, but ultimately saved as a .DOCX format ONLY, for it to work. So you will need to import your designs into word. -I have saved an attachment of the sample custom cover sheet they provide, with all the possible variables. I need my final FAX cover sheet to have all these variables as well. -I need my logo on the FAX cover sheet -I need a second fax cover sheet made, with EVERYTHING the same except for a different logo. (Both included in the files) -I need the following written at the bottom of the cover sheet, in accordance with HIPAA laws: Confidential Health Information Enclosed. Health care information is personal and sensitive. It is being faxed to you after appropriate authorization from the Individual or under circumstances that do not require Individual authorization. You, the recipient, are obligated to maintain this information in a safe, secure and confidential manner. Re-disclosure without additional consent or authorization of the Individual or as permitted by law is prohibited. Unauthorized re-disclosure or failure to maintain the confidentiality of this information could subject you to penalties under Federal and/or State law. -I need a PDF417 Barcode put at the top left or top right of the FAX cover sheet. I need a professional, elegant design that is appropriate for a doctor's office to be sending to pharmacies and insurance companies. I need a designer who is willing to make revisions if I don't like something. I need this done immediately. If you are not able to start immediately, please don't bid.