Create A PDF Doument, that I can edit.

Hi, I have a document that looks like a questionnaire, I wll scan the document it needs to be re created and editted (add a few things and subtact few things) then save in pdf format. I would like that when I open the document I can still write on it and and select boxes created, that an X will appear and write on lines as seen below. The docment that needs to be recreated is about 9 -10 pages you will need to have some graphic ability to create this task. Name:_________ Do you like this document: (box) Yes (box) No