Hi,
you can achieve that writing code.
create a form and hide the inputs, click on the matching images will fill the hidden inputs with values (for example radio buttons, checkboxes, dropdown etc). you can also capture the on submit button click so before submitting the form you can retrieve the selections and insert them to a db collection.
Wix is currently working on more input types - time, color, slider etc which will be released in the future
Shlomi