Set up 1 form page in Apple's OS X Pages Program

I need 1 pages set up in Apples OS X Pages program. Either you have it or you don't but here is what the program is: [login to view URL] I believe it's part of the iWork package. I have attached the pages. They need to be set up and laid out like my other forms. So MATCH THE CURRENT DESIGN of Greystone New Patient Form. I will pay though freelancer and only award w someone having a good rating. Prior experience isn't necessary, but you have to own the program yourself. This is a relatively small project..