adobe acrobat fillable calendar conversion for rabies

I need a calendar for use in Adobe on our laptops when visiting 3rd world countries by public health volunteers. When we encounter a person with rabies, we need to identify the date of the infection and print out a calendar with the vaccination dose schedule. the vaccination dose will include 5 shots over 4 weeks. We need to print the calendar and give it to the patient so they know when to come back to the clinic. Here is a copy of the broken form that was given to us by someone in another country. this form uses mm/dd/yy. we need dd/mm/yy. i do not want all the options that this form uses. i just need the dates. no colors or additional fluff. (that may be an upgrade project for later). we will need 2 months displayed to show all the weeks. (there can be spill over on the second month for the case of someone coming in on Feb 27/28 and the 30th day running into the 3rd month. I can explain this more later) I will convert all of the 1st tab into adobe acrobat. I just need the second tab converted into Adobe Acrobat so that it (the calendar) is fillable based on a given date. The calendar already exists out there in javascript.. i just need someone to convert it into adobe and make it fillable.