Create a Skill Development Plan with Learner Input

Hello,

I would like to create a 1- or 2-page Skill Development Plan based on input received from the learner throughout the course.

For example, after presenting the 5 ways to increase your energy, I would like to ask the learner to check the 2 ways that most appeal to them.

Then in another section, do the same thing with the 5 ways to improve Focus.

Then, in another section, ask the user to check the area where they feel they need the most development and type in 2 activities they will commit to performing over the next 3 weeks.

Then I want the answers to come together in 1 document & allow the learner to choose to print or e-mail this document to themselves.

Is there a sample out there somewhere that is similar to this? I have looked up interactive job aid & printing a job aid, but the answers aren't quite what I'm looking for.

I'm in Storyline 1.

Thank you,