Database for a website based on information from contact form

I need a back-end database (MySQL or whatever the coder thinks is best) ? for a website for a popular dentist.? The database needs to contain the people who filled out the contact form on his website.? The contact form contains fields such as: name, address, area of interest, best way to contact, how did you hear of us, medical history, etc. The database should show up on a page that's accessible to the client with a login password (like an administration page). There needs to be a search function so that the client can pull up, for example, all people who are on the contac list who need teeth whitening and who live in New Jersey -- so he can direct special offers or market to them. Ideally -- not sure if this feasiable -- it would have a feature where the email addresses of the people collected after a search would, upon a click of a button, appear in his email in the TO field, so he can send an email to those people. ## Deliverables Flexibility is very important to this client.? So I would like to know also additional costs if the clients wants to change some of the fields in the contact form, or add an extra feature.? Thank you!