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SurveyJS
Open-Source JSON Form Builder to Create Dynamic Forms Right in Your App. With SurveyJS form UI libraries, you can build and style forms in a fully-integrated drag & drop form builder, render them in your JS app, and store form submission data in any backend, inc. PHP, ASP.NET Core, and Node.js.
Personally in my donk brain, basing this off what I already know, I would start with a pajbot clone, then build a module for what you're trying to do within that. It's a great chat moderation mod already, and it's fairly simple to build modules for it. Plus you'd have a lot more features with this bot. You could even program the module so that only users with a certain level could do the command, to prevent griefing/trolling. https://github.com/pajbot/pajbot/