Firstly if it is just a web form only, you can do the following.
Going by the theme is for medical instution,
Firstly: Add a suitable background to the page instead of the plain green, make the background transparency around 50% for more soothing feel.
Secondary: Add a border to your main survey form, thin border of black should be fine
Third: You will need a suitable banner,try to not to make it black in background as it does not goes well with the black border.
Fourth: Suggest the top part of the form for selecting nurse to be white. The main survey to alternate between light yellow and light green
