Urgent question!

I could really use some help here!
The medical practice I'm working with has been using Portfolios, of which I know very little.
I'll start over...they've gone ahead and converted all their medical charts to digital images (PDFs). Each chart is divided into sections, such as Patient Info, Progress Notes, Benefits, Treatment Plan and so forth. Every time a patient comes into the office for an appointment, a new page is added to certain parts of the chart (such as Progress Notes) detailing their last visit. Now that all the charts are electronic, this can be done on a computer. So, for a section like, say, Progress Notes, there's all the old charts organized with the most recent one on top. However, that's not the very first page-the very first page is a blank progress note, ready for the patient's next visit.
All they want to be able to do when they fill out a chart is, after it's saved, have it go on top of the chart (as it's now the most recent page) and have a new blank page appear, ready for the next visit. It's like inserting a blank page, but they don't want to do that-they simply want a new blank page to appear and move to the front on top of the most recent page.
Does this make sense? Help!

Typically PDF documents are not used for updating a document. The editing is done in the original document, then it is converted to PDF.

There are only two ways I know to do this in Acrobat. One is to code a program to do it each time the file is opened. This would require someone with programming experience.

The other is to manually insert it by, either going to "Insert Page" command off the Document menu, you will need to choose a file or clipboard object to Insert. (You can choose a previously created 'blank page' PDF file, or you can insert clipboard. If it is empty, it will create a blank page)

You can also manually insert this way: open Pages tab to the left of the document, right-click on the last page, and click insert page.

Dj