diff --git a/app/models/medical_release.rb b/app/models/medical_release.rb
index 62f08b9..49ca937 100644
--- a/app/models/medical_release.rb
+++ b/app/models/medical_release.rb
@@ -32,6 +32,7 @@ class MedicalRelease < ApplicationRecord
   # These validations apply to all releases
   validates :person_first_name, :person_last_name, presence: true
   validates :person_email, email: true, allow_blank: true
+  validate :valid_answers
 
   acts_as_taggable_on :internal_tags, :tags
 
@@ -76,4 +77,15 @@ class MedicalRelease < ApplicationRecord
   def contract_file_name
     "#{project.name.parameterize}_#{contract_template.release_type}_#{(signed_at || created_at).strftime("%Y.%m.%d")}_#{release_number}_#{filename_suffix.parameterize}"
   end
+
+  private
+
+  def valid_answers
+    (1..ContractTemplate::NUMBER_OF_CUSTOM_FIELDS).each do |index|
+      if contract_template && contract_template["question_#{index}_text"].present? &&
+         public_send("question_#{index}_answer").blank?
+        errors.add("question_#{index}", I18n.t('medical_releases.custom_validation_errors.question_answer_is_required'))
+      end
+    end
+  end
 end
diff --git a/app/views/public/medical_releases/new.html.erb b/app/views/public/medical_releases/new.html.erb
index 7f4dd2f..0ae2d9d 100644
--- a/app/views/public/medical_releases/new.html.erb
+++ b/app/views/public/medical_releases/new.html.erb
@@ -30,7 +30,7 @@
           <% (1..MedicalRelease::NUMBER_OF_CUSTOM_FIELDS).each do |n| %>
             <% if @contract_template.public_send("question_#{n}_text").present? %>
               <div class="form-row">
-                <%= form.text_area "question_#{n}_answer", wrapper_class: "col-sm-12", label: @contract_template.public_send("question_#{n}_text") %>
+                <%= form.text_area "question_#{n}_answer", required: true, wrapper_class: "col-sm-12", label: @contract_template.public_send("question_#{n}_text") %>
               </div>
             <% end %>
           <% end %>
diff --git a/config/locales/en.yml b/config/locales/en.yml
index 7734d89..ef8b351 100644
--- a/config/locales/en.yml
+++ b/config/locales/en.yml
@@ -772,6 +772,8 @@ en:
     update:
       notice: The material release has been updated
   medical_releases:
+    custom_validation_errors:
+      question_answer_is_required: answer is required
     destroy:
       alert: The medical release has been deleted
     index:
diff --git a/config/locales/es.yml b/config/locales/es.yml
index 91e271f..636e5f2 100644
--- a/config/locales/es.yml
+++ b/config/locales/es.yml
@@ -282,6 +282,9 @@ es:
     form:
       photos:
         dropzone_label: Tap to take a photo of Licensed Material (optional) (ES)
+  medical_releases:
+    custom_validation_errors:
+      question_answer_is_required: answer is required (ES)
   public:
     appearance_releases:
       create:
diff --git a/spec/controllers/public/medical_releases_controller_spec.rb b/spec/controllers/public/medical_releases_controller_spec.rb
index 794bdb2..d80325e 100644
--- a/spec/controllers/public/medical_releases_controller_spec.rb
+++ b/spec/controllers/public/medical_releases_controller_spec.rb
@@ -19,14 +19,29 @@ RSpec.describe Public::MedicalReleasesController, type: :controller do
     end
 
     it "displays validation errors" do
-      contract_template = create(:contract_template, project: project)
+      contract_template = create(:contract_template,
+                                 project: project,
+                                 question_1_text: "Question 1",
+                                 question_2_text: "Question 2"
+      )
       sign_in(user)
 
-      post :create, params: { account_id: user.primary_account.to_param, project_id: project, contract_template_id: contract_template, medical_release: { person_address_city: "Albuquerque" } }
+      post :create, params: {
+        account_id: user.primary_account.to_param,
+        project_id: project,
+        contract_template_id: contract_template,
+        medical_release: {
+          person_address_city: "Albuquerque",
+          question_2_answer: "Answer 2"
+        }
+      }
+
       body = CGI.unescape_html(response.body)
       expect(body).to match /Person first name can't be blank/
       expect(body).to match /Person last name can't be blank/
       expect(body).to match />can't be blank</
+      expect(body).to match /Question 1 #{question_answer_validation_error}/
+      expect(body).not_to match /Question 2 #{question_answer_validation_error}/
     end
 
     it "responds with success " do
@@ -68,4 +83,8 @@ RSpec.describe Public::MedicalReleasesController, type: :controller do
 
     { signature_base64: data_uri }
   end
+
+  def question_answer_validation_error
+    t 'medical_releases.custom_validation_errors.question_answer_is_required'
+  end
 end
diff --git a/spec/features/user_managing_medical_releases_spec.rb b/spec/features/user_managing_medical_releases_spec.rb
index 59510fb..fd619c5 100644
--- a/spec/features/user_managing_medical_releases_spec.rb
+++ b/spec/features/user_managing_medical_releases_spec.rb
@@ -121,6 +121,43 @@ feature "User managing medical releases" do
       expect(page).to have_content(successful_submission_message)
       expect(MedicalRelease.last.guardian_2_first_name).to eq 'Second'
     end
+
+    scenario 'when signing release, question answers are required', js: true do
+      project = create(:project, members: current_user, account: current_user.primary_account)
+      contract_template = create(:contract_template,
+                                 project: project,
+                                 question_1_text: 'Question 1',
+                                 question_2_text: 'Question 2'
+      )
+
+      visit new_account_project_contract_template_medical_release_path(project.account, project, contract_template)
+
+      fill_in person_first_name_field, with: 'Jane'
+      fill_in person_last_name_field, with: 'Doe'
+      draw_signature file_fixture("signature.png"), "medical_release_signature_base64"
+
+      expect do
+        click_button submit_release_button
+      end.to change(MedicalRelease, :count).by(0)
+      expect(page).not_to have_content(successful_submission_message)
+
+      fill_in answer_field_for_question(1), with: 'Answer 1'
+      draw_signature file_fixture("signature.png"), "medical_release_signature_base64"
+
+      expect do
+        click_button submit_release_button
+      end.to change(MedicalRelease, :count).by(0)
+      expect(page).not_to have_content(successful_submission_message)
+
+      fill_in answer_field_for_question(2), with: 'Answer 2'
+      draw_signature file_fixture("signature.png"), "medical_release_signature_base64"
+
+      expect do
+        click_button submit_release_button
+      end.to change(MedicalRelease, :count).by(1)
+      expect(page).to have_content(successful_submission_message)
+
+    end
   end
 
   context "when signed in as account manager" do
@@ -396,4 +433,8 @@ feature "User managing medical releases" do
   def guardian_2_information_heading
     t 'public.medical_releases.new.guardian_2_info.heading'
   end
+
+  def answer_field_for_question(number)
+    "medical_release[question_#{number}_answer]"
+  end
 end
diff --git a/spec/models/medical_release_spec.rb b/spec/models/medical_release_spec.rb
index 917c3ef..53860fb 100644
--- a/spec/models/medical_release_spec.rb
+++ b/spec/models/medical_release_spec.rb
@@ -22,6 +22,23 @@ RSpec.describe MedicalRelease do
     context "for non-native releases" do
       it { is_expected.to validate_attachment_of(:contract).on(:non_native) }
     end
+
+    context "question answers" do
+      let(:project) { create(:project) }
+      let(:contract_template) { create(:contract_template, project: project, question_1_text: 'Question 1') }
+
+      it "returns validation errors if answers are missing" do
+        expect do
+          create(:medical_release, contract_template: contract_template)
+        end.to raise_exception ActiveRecord::RecordInvalid
+      end
+
+      it "creates release if answers are present" do
+        expect do
+          create(:medical_release, contract_template: contract_template, question_1_answer: 'Answer 1')
+        end.to change(MedicalRelease, :count).by(1)
+      end
+    end
   end
 
   describe "attachments" do