PHP Contact form with e-mail confirmation and page redirect & CSS styling

I am mid-way through developing a web-page for use in primary care. I have got to the stage where I need to develop the contact form but this has always been my weak point.

The form must be conditional (ie. when one option is selected, a new option box is presented) and on submit, the user must receive an e-mail confirming that their message has been sent, the submission will be e-mailed to me, and the page will then refresh with a Thank you message (using the if post script in PHP).


See brief attached.

Once the form is developed, tested and all is working, I just want the labels, inputs and submit button styled a tiny bit to fit in with the theme of the page.

The .php file and .css file will be sent to the successful candidate and they must continue the css to my style (across the page, not down.)

Thanks
Any questions let me know.

P.s. no huge quotes please as I know this would only take an experienced PHP developer no more than an hour or 2 to do this.