Yes, I would take this as definately being possible...
You would first need to create your form to handle the right amount of inputs, where you can use typical form features (text input, dropdown lists (you use a lookup file (via inputlookup command) or search results for this)... Don't worry about the search for now. (Documentation here)
Then you will need to create a script (something in python would be ideal), this should be created to handle sys.argv inputs, which will basically be the user's input. You could then have this data formatted to your needs via your script. Have this script write to a file somewhere on the Splunk installation. Once you have set up your script, you will then need to add this to a custom command via the "commmands.conf" file. (Documentation here)
Now, back to the form, you will need a search for the form using your custom command. I typically use a search starting with |inputlookup OR |metadata as these usually have little search overhead. Then pipe to your custom command. You will then assign the user inputs to the custom command as arguments. For example: