Website for business system

I need a website that people can use to analyse the value of their business. 1 page
It needs to be business related and professionally focused.
I will direct people to it from my main site and through marketing campaigns.
It will have a series of questions and fields. Some of which will store the information someone is entering and some of it will be used to give pre determined answers at the end.
Approx. 20 questions
When the customer has pressed submit the website will display the results and email the results to them and me.
e.g How many employees does your company have 1-5 or 5-20 or 20-80 or 80-150 there will be 4 available answers at the end depending on which box they tick.
At the end they get a summary, some pre written guidance and i will have captured their data with consent and can contact them.