Checkout Form / Checkout Page

I need checkout page with similar features like this one - checkout page.

I need to set up a bar that users could drag to a necessary number, dropdowns, and the field where user can type text.

Ideally, after submitting all the info user would be redirected to a payment page and his provided info would be sent to me and/or added to the PayPal order/invoice.

Is there any plugin or service where I can build a similar checkout form?

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I found some online forms, but that is still not 100% what I am looking for.. .