diff --git a/awx/ui/static/js/forms/SurveyTaker.js b/awx/ui/static/js/forms/SurveyTaker.js
new file mode 100644
index 0000000000..aef71c8214
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+++ b/awx/ui/static/js/forms/SurveyTaker.js
@@ -0,0 +1,65 @@
+/*********************************************
+ *  Copyright (c) 2014 AnsibleWorks, Inc.
+ *
+ *  SurveyMaker.js
+ *  Form definition for survey maker model
+ *
+ *
+ */
+ /**
+ * @ngdoc function
+ * @name forms.function:SurveyMaker
+ * @description This form is for adding/editing a survey
+*/
+angular.module('SurveyTakerFormDefinition', [])
+    .value('SurveyTakerForm', {
+
+        // addTitle: 'Add Survey', //Title in add mode
+        // editTitle: 'Edit Survey', //Title in edit mode
+        name: 'survey_taker', //entity or model name in singular form
+        // // well: true,
+        breadCrumbs: false,
+        // twoColumns: true,
+        // // collapse: true,
+        // collapseTitle: "Properties",
+        // collapseMode: 'edit',
+        // collapseOpen: true,
+
+        // actions: {
+        //     stream: {
+        //         'class': "btn-primary btn-xs activity-btn",
+        //         ngClick: "showActivity()",
+        //         awToolTip: "View Activity Stream",
+        //         dataPlacement: "top",
+        //         icon: "icon-comments-alt",
+        //         mode: 'edit',
+        //         iconSize: 'large'
+        //     }
+        // },
+
+        fields: {
+            survey_name: {
+                type: 'custom',
+                control: '<div class="row">'+
+                    '<div class="col-sm-12">'+//<label for="survey"><span class="label-text prepend-asterisk">Questions</span></label>'+
+                    '<div id="survey_taker_description"></div>' +
+                    '<div id="survey_maker_question_area"></div><div id="survey_taker_finalized_questions"></div>'+
+                    //'<button style="display:none" type="button" class="btn btn-sm btn-primary" id="add_question_btn" ng-click="addNewQuestion()" aw-tool-tip="Create a new question" data-placement="top" data-original-title="" title="" disabled><i class="fa fa-plus fa-lg"></i>  Add Question</button>'+
+                    '<div id="new_question"></div></div></div>'
+
+            },
+
+        },
+
+        buttons: { //for now always generates <button> tags
+            // save: {
+            //     ngClick: 'formSave()', //$scope.function to call on click, optional
+            //     ngDisabled: true //Disable when $pristine or $invalid, optional
+            // }
+            // reset: {
+            //     ngClick: 'formReset()',
+            //     ngDisabled: true //Disabled when $pristine
+            // }
+        }
+
+    });
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