Integration Form Cms 1500 with Sharepoint 2013

I need to create Health record system and submit the form through Sharepoint. I need to be able to generate electronic claims(CMS1500 Form) for billing purposes and all the data required to generate the claim would be saved as a database.

Main point of this project:

1.Create a database of the people that will have their information inserted on the form.
2.Create a database for each form created.
3.Submit electronically the form. (Signature is required on the form)
4.Print the form

Details about the CMS 1500 Form:
http://nucc.org/index.php?option=com_content&view=article&id=12&Itemid=112