This demonstrates a UX called Narrow Focus. The idea is that the user is presented with a very small amount of information and a single input at a time. The focus is narrow rather than having to broaden the focus to a busy screen.

Click the button to begin. Narrow Focus will ask a few questions. after you've answered a question, you can hit enter or tab. That will move you on to the next question. Repeat till you get to the end. you can also move back and forth with the left and right arrow buttons. Shift+Tab will move backward.

You could ask as many quesitons as you want with different types of answers: numbers, dates, text, a choice like a dropdown or radio buttons.

There's lots of other stuff you could do with this. Show a progress bar, have clickable UI to move back and forth through the questions, show a summary at the end, etc.