Create look and feel for existing Web Page

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Resumen de Diseño Web
Update Web Page
We have a website at http://www.getplano.com/index-web.html. It is a single page html site, with a custom signup form. We also have a zen desk plugin at the bottom of the page. We'd like to redesign the look and feel of the entire site. We sell software to eye doctors. Also called optometrists, our software tool makes it easy for doctors to manage patients, bill, and document patient encounters. I have included our logos below.
We are looking for a new design preferably in HTML 5, CSS etc. The fields on the form on this page: http://www.getplano.com/index-web.html
You can get screen shots of our software application at this site: http://staging.getplano.com
username: test@example.com
password: password
Codificación
Codificado: se requiere diseño y codificación