Create a web form to be used with tablets and mobile phones

This project is to create a form that is easy to fill out for mobile sales who use Android and Iphones as well as Tablets such as the Samsung Note 10 and Applies mini and regular tablet versions. The form has 31 fields. I need someone to be very creative and try to put yourself in the shoes of someone going from door to door and entering data. I want it to be extremely fast but keep in mind that the user may be using very slow internet. Please see the attached html. It will look ugly since you won't see pictures . . . etc.