How do I convert my PDF in chart format with graphics into an online form?

I've included a screen shot. I need to the overall format of this form to stay the same since it is standardized but would like the checkboxes to be fillable, so I can send it to people to be filled out. Is there any way to do this with your platform?

You can use an Input table field on the online form with checkboxes and map that to the original PDF on the right side:

This will make your form look similar to the original PDF and make it fillable.

Please try this and let us know if this helps.