diff --git a/awx/ui_next/src/components/FormField/PasswordField.jsx b/awx/ui_next/src/components/FormField/PasswordField.jsx
index 34823cf8a0..d865a8b70c 100644
--- a/awx/ui_next/src/components/FormField/PasswordField.jsx
+++ b/awx/ui_next/src/components/FormField/PasswordField.jsx
@@ -14,7 +14,7 @@ import {
 import { EyeIcon, EyeSlashIcon } from '@patternfly/react-icons';
 
 function PasswordField(props) {
-  const { id, name, label, validate, isRequired, i18n } = props;
+  const { id, name, label, validate, isRequired, isDisabled, i18n } = props;
   const [inputType, setInputType] = useState('password');
   const [field, meta] = useField({ name, validate });
 
@@ -40,6 +40,7 @@ function PasswordField(props) {
             variant={ButtonVariant.control}
             aria-label={i18n._(t`Toggle Password`)}
             onClick={handlePasswordToggle}
+            isDisabled={isDisabled}
           >
             {inputType === 'password' && <EyeSlashIcon />}
             {inputType === 'text' && <EyeIcon />}
@@ -50,6 +51,7 @@ function PasswordField(props) {
           placeholder={field.value === '$encrypted$' ? 'ENCRYPTED' : undefined}
           {...field}
           value={field.value === '$encrypted$' ? '' : field.value}
+          isDisabled={isDisabled}
           isRequired={isRequired}
           isValid={isValid}
           type={inputType}
@@ -68,11 +70,13 @@ PasswordField.propTypes = {
   label: PropTypes.string.isRequired,
   validate: PropTypes.func,
   isRequired: PropTypes.bool,
+  isDisabled: PropTypes.bool,
 };
 
 PasswordField.defaultProps = {
   validate: () => {},
   isRequired: false,
+  isDisabled: false,
 };
 
 export default withI18n()(PasswordField);
diff --git a/awx/ui_next/src/screens/Template/Survey/SurveyList.jsx b/awx/ui_next/src/screens/Template/Survey/SurveyList.jsx
index 5c8a53f0bd..8f859af943 100644
--- a/awx/ui_next/src/screens/Template/Survey/SurveyList.jsx
+++ b/awx/ui_next/src/screens/Template/Survey/SurveyList.jsx
@@ -1,12 +1,19 @@
 import React, { useState } from 'react';
 import { withI18n } from '@lingui/react';
 import { t } from '@lingui/macro';
-import { DataList, Button } from '@patternfly/react-core';
+import { DataList, Button as _Button } from '@patternfly/react-core';
 import ContentLoading from '@components/ContentLoading';
 import ContentEmpty from '@components/ContentEmpty';
 import AlertModal from '@components/AlertModal';
+import styled from 'styled-components';
+
 import SurveyListItem from './SurveyListItem';
 import SurveyToolbar from './SurveyToolbar';
+import SurveyPreviewModal from './SurveyPreviewModal';
+
+const Button = styled(_Button)`
+  margin: 20px;
+`;
 
 function SurveyList({
   isLoading,
@@ -20,7 +27,7 @@ function SurveyList({
   const questions = survey?.spec || [];
   const [selected, setSelected] = useState([]);
   const [isDeleteModalOpen, setIsDeleteModalOpen] = useState(false);
-
+  const [isPreviewModalOpen, setIsPreviewModalOpen] = useState(false);
   const isAllSelected =
     selected.length === questions?.length && selected.length > 0;
 
@@ -92,6 +99,21 @@ function SurveyList({
             onMoveDown={moveDown}
           />
         ))}
+        {isPreviewModalOpen && (
+          <SurveyPreviewModal
+            isPreviewModalOpen={isPreviewModalOpen}
+            onToggleModalOpen={() => setIsPreviewModalOpen(false)}
+            questions={questions}
+          />
+        )}
+
+        <Button
+          onClick={() => setIsPreviewModalOpen(true)}
+          variant="primary"
+          aria-label={i18n._(t`Preview`)}
+        >
+          Preview
+        </Button>
       </DataList>
     );
   }
diff --git a/awx/ui_next/src/screens/Template/Survey/SurveyList.test.jsx b/awx/ui_next/src/screens/Template/Survey/SurveyList.test.jsx
index acce909fd7..9621886314 100644
--- a/awx/ui_next/src/screens/Template/Survey/SurveyList.test.jsx
+++ b/awx/ui_next/src/screens/Template/Survey/SurveyList.test.jsx
@@ -88,6 +88,42 @@ describe('<SurveyList />', () => {
     );
     expect(deleteSurvey).toHaveBeenCalled();
   });
+  test('should render Preview button ', async () => {
+    let wrapper;
+
+    await act(async () => {
+      wrapper = mountWithContexts(<SurveyList survey={surveyData} />);
+    });
+
+    expect(wrapper.find('Button[aria-label="Preview"]').length).toBe(1);
+  });
+  test('Preview button should render Modal', async () => {
+    let wrapper;
+
+    await act(async () => {
+      wrapper = mountWithContexts(<SurveyList survey={surveyData} />);
+    });
+    act(() => wrapper.find('Button[aria-label="Preview"]').prop('onClick')());
+    wrapper.update();
+
+    expect(wrapper.find('SurveyPreviewModal').length).toBe(1);
+  });
+  test('Modal close button should close modal', async () => {
+    let wrapper;
+
+    await act(async () => {
+      wrapper = mountWithContexts(<SurveyList survey={surveyData} />);
+    });
+    act(() => wrapper.find('Button[aria-label="Preview"]').prop('onClick')());
+    wrapper.update();
+
+    expect(wrapper.find('SurveyPreviewModal').length).toBe(1);
+
+    wrapper.find('Modal').prop('onClose')();
+    wrapper.update();
+
+    expect(wrapper.find('SurveyPreviewModal').length).toBe(0);
+  });
 });
 
 describe('Survey with no questions', () => {
diff --git a/awx/ui_next/src/screens/Template/Survey/SurveyPreviewModal.jsx b/awx/ui_next/src/screens/Template/Survey/SurveyPreviewModal.jsx
new file mode 100644
index 0000000000..3d9919dca9
--- /dev/null
+++ b/awx/ui_next/src/screens/Template/Survey/SurveyPreviewModal.jsx
@@ -0,0 +1,115 @@
+import React from 'react';
+import { withI18n } from '@lingui/react';
+import { t } from '@lingui/macro';
+import { PasswordField } from '@components/FormField';
+import { Formik } from 'formik';
+
+import {
+  Form,
+  FormGroup,
+  Modal,
+  TextInput,
+  TextArea,
+  Select,
+  SelectVariant,
+} from '@patternfly/react-core';
+
+function SurveyPreviewModal({
+  questions,
+  isPreviewModalOpen,
+  onToggleModalOpen,
+  i18n,
+}) {
+  const initialValues = {};
+  questions.forEach(q => {
+    initialValues[q.variable] = q.default;
+    return initialValues;
+  });
+
+  return (
+    <Modal
+      title={i18n._(t`Survey Preview`)}
+      isOpen={isPreviewModalOpen}
+      onClose={() => onToggleModalOpen(false)}
+      isSmall
+    >
+      <Formik initialValues={initialValues}>
+        {() => (
+          <Form>
+            {questions.map(q => (
+              <div key={q.variable}>
+                {['text', 'integer', 'float'].includes(q.type) && (
+                  <FormGroup
+                    fieldId={`survey-preview-text-${q.variable}`}
+                    label={q.question_name}
+                  >
+                    <TextInput
+                      id={`survey-preview-text-${q.variable}`}
+                      value={q.default}
+                      isDisabled
+                      aria-label={i18n._(t`Text`)}
+                    />
+                  </FormGroup>
+                )}
+                {['textarea'].includes(q.type) && (
+                  <FormGroup
+                    fieldId={`survey-preview-textArea-${q.variable}`}
+                    label={q.question_name}
+                  >
+                    <TextArea
+                      id={`survey-preview-textArea-${q.variable}`}
+                      type={`survey-preview-textArea-${q.variable}`}
+                      value={q.default}
+                      aria-label={i18n._(t`Text Area`)}
+                      disabled
+                    />
+                  </FormGroup>
+                )}
+                {['password'].includes(q.type) && (
+                  <PasswordField
+                    id={`survey-preview-password-${q.variable}`}
+                    label={q.question_name}
+                    name={q.variable}
+                    isDisabled
+                  />
+                )}
+                {['multiplechoice'].includes(q.type) && (
+                  <FormGroup
+                    fieldId={`survey-preview-multipleChoice-${q.variable}`}
+                    label={q.question_name}
+                  >
+                    <Select
+                      id={`survey-preview-multipleChoice-${q.variable}`}
+                      isDisabled
+                      aria-label={i18n._(t`Multiple Choice`)}
+                      placeholderText={q.default}
+                      onToggle={() => {}}
+                    />
+                  </FormGroup>
+                )}
+                {['multiselect'].includes(q.type) && (
+                  <FormGroup
+                    fieldId={`survey-preview-multiSelect-${q.variable}`}
+                    label={q.question_name}
+                  >
+                    <Select
+                      isDisabled
+                      isReadOnly
+                      variant={SelectVariant.typeaheadMulti}
+                      isExpanded={false}
+                      selections={q.default.length > 0 && q.default.split('\n')}
+                      onToggle={() => {}}
+                      aria-label={i18n._(t`Multi-Select`)}
+                      id={`survey-preview-multiSelect-${q.variable}`}
+                    />
+                  </FormGroup>
+                )}
+              </div>
+            ))}
+          </Form>
+        )}
+      </Formik>
+    </Modal>
+  );
+}
+export default withI18n()(SurveyPreviewModal);
diff --git a/awx/ui_next/src/screens/Template/Survey/SurveyPreviewModal.test.jsx b/awx/ui_next/src/screens/Template/Survey/SurveyPreviewModal.test.jsx
new file mode 100644
index 0000000000..89dfe57ccb
--- /dev/null
+++ b/awx/ui_next/src/screens/Template/Survey/SurveyPreviewModal.test.jsx
@@ -0,0 +1,125 @@
+import React from 'react';
+import { act } from 'react-dom/test-utils';
+import { waitForElement, mountWithContexts } from '@testUtils/enzymeHelpers';
+
+import SurveyPreviewModal from './SurveyPreviewModal';
+
+const questions = [
+  {
+    question_name: 'Text Question',
+    question_description: '',
+    required: true,
+    type: 'text',
+    variable: 'dfgh',
+    min: 0,
+    max: 1024,
+    default: 'Text Question Value',
+    choices: '',
+  },
+  {
+    question_name: 'Select Question',
+    question_description: '',
+    required: true,
+    type: 'multiplechoice',
+    variable: 'sdf',
+    min: null,
+    max: null,
+    default: 'Select Question Value',
+    choices: 'a\nd\nc',
+  },
+  {
+    question_name: 'Text Area Question',
+    question_description: '',
+    required: true,
+    type: 'textarea',
+    variable: 'b',
+    min: 0,
+    max: 4096,
+    default: 'Text Area Question Value',
+    choices: '',
+  },
+  {
+    question_name: 'Password Question',
+    question_description: '',
+    required: true,
+    type: 'password',
+    variable: 'c',
+    min: 0,
+    max: 32,
+    default: '$encrypted$',
+    choices: '',
+  },
+  {
+    question_name: 'Multiple select Question',
+    question_description: '',
+    required: true,
+    type: 'multiselect',
+    variable: 'a',
+    min: null,
+    max: null,
+    default: 'a\nc\nd\nb',
+    choices: 'a\nc\nd\nb',
+  },
+];
+
+describe('<SurveyPreviewModal />', () => {
+  let wrapper;
+  beforeEach(async () => {
+    await act(async () => {
+      wrapper = mountWithContexts(
+        <SurveyPreviewModal questions={questions} isPreviewModalOpen />
+      );
+    });
+    waitForElement(wrapper, 'Form');
+  });
+  test('renders successfully', async () => {
+    expect(wrapper.find('SurveyPreviewModal').length).toBe(1);
+  });
+
+  test('Renders proper fields', async () => {
+    const question1 = wrapper.find('FormGroup[label="Text Question"]');
+    const question1Value = wrapper.find('TextInputBase').at(0);
+
+    const question2 = wrapper
+      .find('FormGroup[label="Select Question"]')
+      .find('label');
+    const question2Value = wrapper.find('Select[aria-label="Multiple Choice"]');
+
+    const question3 = wrapper
+      .find('FormGroup[label="Text Area Question"]')
+      .find('label');
+    const question3Value = wrapper.find('TextArea');
+
+    const question4 = wrapper.find('FormGroup[label="Password Question"]');
+    const question4Value = wrapper.find('TextInputBase[type="password"]');
+
+    const question5 = wrapper
+      .find('FormGroup[label="Multiple select Question"]')
+      .find('label');
+    const question5Value = wrapper
+      .find('Select[aria-label="Multi-Select"]')
+      .find('Chip');
+
+    expect(question1.text()).toBe('Text Question');
+    expect(question1Value.prop('value')).toBe('Text Question Value');
+    expect(question1Value.prop('isDisabled')).toBe(true);
+
+    expect(question2.text()).toBe('Select Question');
+    expect(question2Value.find('span').text()).toBe('Select Question Value');
+    expect(question2Value.prop('isDisabled')).toBe(true);
+
+    expect(question3.text()).toBe('Text Area Question');
+    expect(question3Value.prop('value')).toBe('Text Area Question Value');
+    expect(question3Value.prop('disabled')).toBe(true);
+
+    expect(question4.text()).toBe('Password Question');
+    expect(question4Value.prop('placeholder')).toBe('ENCRYPTED');
+    expect(question4Value.prop('isDisabled')).toBe(true);
+
+    expect(question5.text()).toBe('Multiple select Question');
+    expect(question5Value.length).toBe(4);
+    expect(
+      wrapper.find('Select[aria-label="Multi-Select"]').prop('isDisabled')
+    ).toBe(true);
+  });
+});
diff --git a/awx/ui_next/src/screens/Template/Survey/index.js b/awx/ui_next/src/screens/Template/Survey/index.js
index eaa4f40fae..a7a5cd9fe7 100644
--- a/awx/ui_next/src/screens/Template/Survey/index.js
+++ b/awx/ui_next/src/screens/Template/Survey/index.js
@@ -1,3 +1,4 @@
 export { default as SurveyList } from './SurveyList';
 export { default as SurveyQuestionAdd } from './SurveyQuestionAdd';
 export { default as SurveyQuestionEdit } from './SurveyQuestionEdit';
+export { default as SurveyPreviewModal } from './SurveyPreviewModal';