Adding CHAT Questionnaire

Hi All,

Need to add a question in to CHAT, So that customers select the service that they want to discuss so that have start to route chats by skill and show location.

We need to add:
State(drop down choices)
other(drop down choices)

This two questions are added in to Chat. Have to do bit coding. It Would be great if i get help on this.

Thanks in Advance,
Pavithra.