Storyline Graded Question for filling in a form

I am stumped right now and could really use some input from others here! 

Trying to create a question in Storyline 360 where the learner is basically using a form. I'd like the three form questions to have independent banks that are either shapes/buttons, drop down, or pick one selections. They need to be independent because the second and third options need to be "blank." Since they have the same response, it can't be used in a matching drop down. 

Any thoughts about how I might be able to accomplish this? 

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