Database based on Contact Form

I need a database for a website for a dentist which? I am putting up with the following features (all very important!) 1) It should take the fields from a contact form and put these into the fields in the database. 2) The database should have a search function and be searchable by any field - for example, all patients in New Jersey who need porcelain fillings. 3) The database should be accessible by a login and password by the client or by? me. ? 4) The database should first display each contact's full name and the date the contact form was filled out and sent (I have an automatic date stamp on my contact form).? Upon clicking on the name, you can then see the other fields. 5) There should be a delete button next to each contact so the client can delete that contact if they so choose -- or there can be another means for deleting a contact. 6) If we need to add an additional field to the contact form, the database should be able to take this information as well. The current website is HTML and CSS (and will contain some flash), and I'm putting it up on GoDaddy hosting, so coding should be done in a compatible language! Thank you very much!