Migraine journal app for iPad and iPhone

I want to create a very simple app for the iPad or iPhone that will allow the user to access basic information about headaches, especially migraines, as well as keep a journal of the headaches that they have: Date, severity, type of headache, possible causes, what type of treatment was used. It will need to be very professional looking (I will provide graphics), and it needs the capability to save and export the data from the app as a CSV file. There is more detail in the attached Word document.