Readiness Assessment Plugin

Does anyone know of a plugin that will accomplish the following behavior:

1. Visitor of my website can complete a readiness assessment which is a series of questions where they are evaluating their readiness to do a certain task.

2. The assessment can be rendered directly inside of a WordPress page or externally to the site.

3. Once the visitor completes the assessment, they provide the email and will receive an email with a personalized copy of their results.

4. The plugin needs to tally the results of their results and provide customized feedback (which will be preset based on score levels) for each visitor taking the readiness assessment.

Thanks in advance