Using a table in a SharePoint survey

My colleague wants a question in a SharePoint survey to look like this:

Picture a table with two columns and five rows. In each table cell is some text. Beside each table cell is a checkbox, either to the left or to the right. The user checks off one or more checkbox.

Can anyone suggest a way to accomplish this? I know it is easy with just one column, how can I do this with two columns?

Thanks,

– Thom