<fieldset>
<h4 class="fs-title">Нужен ли модуль?</h4>
<div class="form-group">
<input type="checkbox" id="yes" name="yes" value="Да"/>
<label for="yes">Да</label>
</div>
<div class="form-group">
<input type="checkbox" id="not" name="not" value="Нет"/>
<label for="not">Нет</label>
</div>
<div class="form-group">
<input type="checkbox" id="consultation" name="consultation" value="Нужна консультация"/>
<label for="consultation">Нужна консультация</label>
</div>
<input type="button" name="previous" class="previous action-button" value="НАЗАД" />
<input type="button" name="next" class="next action-button" value="ВПЕРЁД" />
</fieldset>