Why did the form I created change after saving?

I have Adobe Acrobat XI Standard and was creating a form from a PDF. I didn't have permission so I made a copy of the form so that I wouldn't have any restrictions. I was able to edit the copy perfectly and it printed perfectly. I saved as a Reader Extended PDF so that the recipient could save and print, I emailed the form and then when I opened the attachment, part of it was all jumbled. Now the file is saved jumbled and I can't go back to the original. Is there a way I can fix this without redoing everything? How did this happen? See the bottom of the page under Insurance Requirements as a reference attached.

I couldn't get the image to attach.....

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