State Lookup

Needs to work on a Joomla Site. So we have page that requires someone to be able to lookup clinic information by 'state'. The other criteria is 'disorder type' which can be 'none' or any combination of 4 types (that they treat). So a person should be able to choose 1 state and get ALL clinic listings results from that state only. Or choose 'state' and lets say 'leukemia' and 'fibromas'; Then get results for that state with listings that treat those disorders Only. And if they just choose 'leukemia' they get listing in any state that treat leukemia (and whatever other disorder they check). etc.. Results should display alphabetically by state then by clinic name. In order to add listings to the database, someone should be able to fill out a web form and submit into the database. Here is an example of a listing. Hopefully contact info can be all one input but 'specialty' corresponds with the type explained above. Lucille Packard Children’s Hospital Palo Alto, CA Genetics Clinic Phone: (650) 723-XXXX Allan L Reiss, MD Specialty: Learning Disabilities Phone: (650) 498-XXXX Michael Edwards, MD Specialty: Pediatric Neurosurgery Phone: (650) 724-XXXX Specialty: leukemia I need this done ASAP so please only bid if you are familiar with doing what I am asking here. Thanks. On Unix/MySql