You can use standard javaScript “date picker”.
You really need only add this line in the embed code widget inside the form: <input class="w-input some-class-name" type="date" name="some-name" min="2000-01-02">
Anything else - pretty standard fields from Webflow forms. If you mean the structure of the form, you can use divs and rows for creating the structure which you need. All you have to do is add them inside the FORM (not a FORM WRAPPER).