Create a Database Sales Lead Form

I need to create a form similar to that which you can find here: [login to view URL] I do not need the website designed, just the form and the related coding. The form is essentially a price comparison for professional services that emails out details of 5-8 professionals to the site visitor who completes the form, and generates a sales lead for the professionals registered to the site. When the visitor completes the form it has to do the following: 1. Automatically select 5-8 registered professionals from an SQL database (or similar) based on their location and proximity to the person who has completed the form by postcode or town. 2. Email those 5-8 selected professionals' details from the database to the email address entered by the site visitor. 3. Email each of the 5-8 professionals notifying them that someone is seeking their services and include the contact details entered within the form by the visitor. 4. Create a record for each of the 5-8 professionals on the system that identifies that they have been sent a lead in order to invoice them correctly on a monthly basis. If you think there is a simpler way to do this then I am open to ideas. This is just the best way I can think to make it work.