Can an Internal form be included in a notes template

Can an Internal form be included in a notes template;
Tryin to include an optional list of serviced preformed, by our tech , for a customer, by using an internal form in a notes template that would go into the contact record

In internal form getting submitted can trigger a campaign goal and then a sequence can have the create a note action which you can include the same custom fields (using merge fields) in the note.