Disease risk

I need a website that will permit users to key in details, and have a summary score to be benchmarked against an average: 1. Initial entry page - choose a problem of choice to be risk screened for - breast cancer/ lung cancer / colon cancer (radio button). 2. Subsequent pages key in details : age (years - free entry with limits) gender (Male/Female - radio button) height (cm) (free entry with limits) weight (kg) (free entry with limits) alcohol drinking (Yes/No) (radio button) smoking habits (Never / Past / Current) - drop down). Gender/Age/Height/Weight and Alcohol Drinking/Smoking should be on separate pages. A check to be included - if gender = Male and problem to be screened is Breast Cancer, message to be shown to terminate, and to be returned to front page. 3. Following user keying in of details, a simple calculation to be made against a range of coefficients - i.e. e.g. Male = 1, Female = 0; alcohol Yes = 1, No = 0, Smoking = 0 / 1 / 2 (Never/Past/Current). These figures should be multiplied against a standard list of coefficients to be stored in MySQL and not accessible by users. Hypothetically, if the coefficients for lung cancer are Gender = 0.3, Alcohol = 0.8, Smoking = 3.3, a Male Non-Drinker who is a Past Smoker should be 1 * 0.3 + 0 * 0.8 + 1 * 3.3 = 3.6. Each cancer type should have its own "standard list of coefficients". For each cancers, there are a specific additional list of questions.e.g. for colon cancer, there is a list of questions pertaining to bowel habits, for breast cancer, a list of questions pertaining to screening mammograms. These can be divided into multiple pages. 4. In a final page, This figure to be reported as a simple bar graph, with the user graph (i.e. 3.6), against a predetermined bar (hypothetically 3.0). Non-Zero variables (i.e. in the above example "Male" and "Past Smoker", but NOT alcohol) should be highlighted as examples of factors that can be altered to reduce risk, and a third bar of similar magnitude as the user's graph should have a proportion color-coded to show what would happen to the user's risk if he modifies the behavior. If some factors such as Gender (Male/Female), which are non-correctable, these should be color-coded on the same 3rd bar. 6. Should the user choose a second cancer to be screened for, the previous user-keyed in details for common entry should be available, rather than requiring the user to key in all details all over again. i.e. Age / Gender for example, but not the cancer-specific list of questions. All files / scripts should be available for review by myself.