Pop-up dialog box with buttons and timestamp?

Hello everyone. I'm by no means a developer and have been assigned some light development work regardless. I can usually take pre-existing code and manipulate it to suite my needs but after googling around quite a bit I can't really get going on what I would like to accomplish.

For the background of my assignment. I've created a custom form on a SharePoint page. The form submits user input information and a workflow I created runs for a simple document approval. W

What I would like to accomplish (per customer requirements) is a form of validation. The customer request a popup box with two checkboxes, however I think buttons will work just as well and may be easier.
The pop-up will have the following display message in addition to the two clickable event buttons :"I have verified through the use of this standard work that the information is accurate and current"

If the user selects yes then a timestamp of the document submittal is collected in a report
If the user selects no then a second pop-up box will replace the first so the user can add notes, with a submit button in that pop-up box
An email is sent to the author of the word document with the notes that were submitted
Flag the template as needing a change. The flag will remain on the template until the template is opened in EDIT format and saves and closes with a "Yes? to the popup asking "I have verified through the use of the standard work that the information is accurate and current".