The WEB Team in IT can help you build a custom survey and store the data results on servers housed on campus. If you need more information about their services please contact them directly.
Another alternative is to use Survey Monkey. SurveyMonkey.com is a online service that specializes in making surveys easy to create. You can demo survey monkey and even send out surveys free of charge. This service is tiered, and also has a pay for service aspect. A paid account provides you with many more features such as the ability to download your data in a .csv format and build reports for your data. Survey Monkey is one of many online services that offer survey functionality.
NOTE: This is not a UofL created or supported site, and you should make sure you understand surveymonkey completely before endeavoring to use it for any academic research etc.