So, it's all about chatbot.
Hope you are doing well. I can help you to create a chatbot which can ask for these details and than pass it via API as a parameter to the backend.
And if you want than i can handle the backend too, i can save them in a file , or .csv or in database. But it seems you don't want database.
I can develop an interactive chatbot based on Artificial Intelligence and NLP.
And if you want i can integrate it with Website or facebook messenger too.
Before startig work i can also show you my recent 5 to 6 chatbots and their implementation.
Let's have a detailed chat.
Thank you.