Form self naming on button click

Hello everyone,

I'm using Adobe Pro and I have a form that I added a button to it from Tools > Interactive Objects. On the button properties, on the "actions" tab, under the drop down menu "select action" I selected execute a menu item File > Save as...

When the button is clicked I need the form to save itself as "filename_patient name_date" in the same folder. Thus leaving the blank template and the new file named "Progress Notes John Doe 04/01/2014". So everytime John Doe comes into the office  a new file with the visit date with be saved.

Any and all help with be highly appreciated.

Thanks.