These are the 3 fields I'd like displayed on the page to have data inputted into. any suggestions on how i can do it?
2 answers
Robert,
For you to be able to have it all on one single page will require some Javascript or Apex & Visualforce programming skills (as far as my knowledge of the Salesforce CRM tells me). However, if you are OK with the user first inputting the Account Name on one screen , then showing the user another screen to input values into the two custom fields, you can use Flows to accomplish this. The Flow can be launched from a Visualforce tab.
It will take some practice to be fully familiar with Flows but it will be worth it as Flows offer the flexibility and versatility to accomplish tasks that otherwise needed custom programmatic development in the past. Here's a great guide to help you understand flows:
https://resources.docs.salesforce.com/sfdc/pdf/workbook_flow.pdf
I highly highly recommen spending some time to go through the above and then trying to implement your requirement. It will teach you a lot and make your life easier in the long run (believe me on that). And if you come across any issues while implementing the flow , you can obviously come back and seek help on the forum and we will be glad to help you out.