I create an excel spreadsheet and fill in the info for these columns:
tOrder - Table order (in case you need to sort back and forth, you can get to the order that makes sense for the db structure you are outlining)
sOrder - Field order within the table.
sTable - Table name
sField - field name
DataType - SQL valid data type (including length if needed)
IsIdentity - Y if identity column
Max Length - A Note to identify length while outlining tables and fields - length should go in data type as e.g. VARCHAR(300)
Script - Once everything is filled in the 2nd row (providing you have the field labels above, in the same order on row 1, and table is sorted by A then B) you can put this formula:
="CREATE TABLE "&C2& " (" &D2 &" "&E2&" primary key IDENTITY(1,1) NOT NULL,"
For every table field, but the last field, you can put this script formula:
=D3&" "&E3&","
For the last field of each table, put this (adjusting the row number to the right row):
=D16&" "&E16&")"
You can drag down the 2nd formula for a table, and just change the comma in the last field's formula to a close parens.
Now copy that whole column, except the header row, and paste it in a new query, in a new empty SQL database, in SSMS. Run it and your database is created.
Now you can create a new SQL schema, add in all the tables, and simply drag relationships between tables. You can also use Visio tools to connect to the DB, but I found the SSMS diagram to be sufficient. HTH.