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Inshal
2024-10-25 01:05:27 +05:00
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export default {
steps: {
page0: {
elements: [
'h3',
'h4',
'digestive_health',
],
buttons: {
previous: false,
},
},
page1: {
elements: [
'h2_1',
'h4_1',
'symptoms',
],
},
page2: {
elements: [
'h2',
'h4_2',
'gastrointestinal_conditions',
],
},
page3: {
elements: [
'h4_3',
'diet_description',
],
},
page4: {
elements: [
'h2_4',
'h4_4',
'dietary_restrictions',
],
},
page5: {
elements: [
'h4_5',
'bowel_movements',
],
},
page6: {
elements: [
'h2_6',
'h4_6',
'stool_consistency',
],
},
page7: {
elements: [
'h4_7',
'gut_health_therapies',
],
},
page8: {
elements: [
'h2_8',
'h4_8',
'prescription_medications',
],
},
page9: {
elements: [
'h4_9',
'current_medications',
],
},
page10: {
elements: [
'h2_10',
'h4_10',
'other_conditions',
],
},
page11: {
elements: [
'h4_11',
'chronic_constipation_diarrhea',
],
},
page12: {
elements: [
'h2_12',
'h4_12',
'consumption_habits',
],
},
page13: {
elements: [
'h4_13',
'lactose_intolerance',
],
},
page14: {
elements: [
'h4_14',
'pregnant',
],
},
},
schema: {
h3: {
type: 'static',
tag: 'h2',
content: 'Digestive Health',
align: 'left',
},
h4: {
type: 'static',
tag: 'h4',
content: 'How would you describe your overall digestive health?',
},
digestive_health: {
type: 'radiogroup',
rules: [
'required',
],
view: 'blocks',
items: [
{
value: 'Excellent',
label: 'Excellent',
},
{
value: 'Good',
label: 'Good',
},
{
value: 'Fair',
label: 'Fair',
},
{
value: 'Poor',
label: 'Poor',
},
],
},
h2_1: {
type: 'static',
tag: 'h2',
content: 'Symptoms',
},
h4_1: {
type: 'static',
tag: 'h4',
content: 'Do you experience any of the following symptoms regularly?',
},
symptoms: {
type: 'checkboxgroup',
rules: [
'required',
],
view: 'blocks',
items: [
{
value: 'Bloating',
label: 'Bloating',
},
{
value: 'Gas',
label: 'Gas',
},
{
value: 'Abdominal pain or cramping',
label: 'Abdominal pain or cramping',
},
{
value: 'Constipation',
label: 'Constipation',
},
{
value: 'Diarrhea',
label: 'Diarrhea',
},
{
value: 'Heartburn or acid reflux',
label: 'Heartburn or acid reflux',
},
{
value: 'Nausea',
label: 'Nausea',
},
{
value: 'Food sensitivities',
label: 'Food sensitivities',
},
{
value: 'Other',
label: 'Other',
},
],
},
h2: {
type: 'static',
tag: 'h2',
content: 'Gastrointestinal Conditions',
},
h4_2: {
type: 'static',
tag: 'h4',
content: 'Have you been diagnosed with any gastrointestinal conditions?',
},
gastrointestinal_conditions: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Yes',
label: 'Yes',
},
{
value: 'No',
label: 'No',
},
],
rules: [
'required',
],
},
gastrointestinal_conditions_reason: {
type: 'text',
label: 'If yes, please specify the condition.',
rules: [
'required',
],
conditions: [
[
'gastrointestinal_conditions',
'in',
[
'Yes',
],
],
],
},
h4_3: {
type: 'static',
tag: 'h4',
content: 'How would you describe your current diet?',
},
diet_description: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Balanced',
label: 'Balanced',
},
{
value: 'High-carb',
label: 'High-carb',
},
{
value: 'Low-carb',
label: 'Low-carb',
},
{
value: 'High-fiber',
label: 'High-fiber',
},
{
value: 'Low-fiber',
label: 'Low-fiber',
},
{
value: 'Gluten-free',
label: 'Gluten-free',
},
{
value: 'Other',
label: 'Other',
},
],
rules: [
'required',
],
},
h2_4: {
type: 'static',
tag: 'h2',
content: 'Dietary Restrictions',
},
h4_4: {
type: 'static',
tag: 'h4',
content: 'Do you follow any specific dietary plans or restrictions?',
},
dietary_restrictions: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Yes',
label: 'Yes',
},
{
value: 'No',
label: 'No',
},
],
rules: [
'required',
],
},
dietary_restrictions_description: {
type: 'text',
label: 'If yes, please describe.',
rules: [
'required',
],
conditions: [
[
'dietary_restrictions',
'in',
[
'Yes',
],
],
],
},
h4_5: {
type: 'static',
tag: 'h4',
content: 'How regular are your bowel movements?',
},
bowel_movements: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Daily',
label: 'Daily',
},
{
value: 'Every other day',
label: 'Every other day',
},
{
value: 'Once a week',
label: 'Once a week',
},
{
value: 'Less than once a week',
label: 'Less than once a week',
},
],
rules: [
'required',
],
},
h2_6: {
type: 'static',
tag: 'h2',
content: 'Stool Consistency',
},
h4_6: {
type: 'static',
tag: 'h4',
content: 'How would you describe the consistency of your stools?',
},
stool_consistency: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Hard',
label: 'Hard',
},
{
value: 'Loose',
label: 'Loose',
},
{
value: 'Normal',
label: 'Normal',
},
{
value: 'Mixed',
label: 'Mixed',
},
],
rules: [
'required',
],
},
h4_7: {
type: 'static',
tag: 'h4',
content: 'Have you previously used gut health therapies?',
},
gut_health_therapies: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Yes',
label: 'Yes',
},
{
value: 'No',
label: 'No',
},
],
rules: [
'required',
],
},
gut_health_therapies_description: {
type: 'text',
label: 'If yes, please list the therapies and describe your experience.',
rules: [
'required',
],
conditions: [
[
'gut_health_therapies',
'in',
[
'Yes',
],
],
],
},
h2_8: {
type: 'static',
tag: 'h2',
content: 'Prescription Medications',
},
h4_8: {
type: 'static',
tag: 'h4',
content: 'Have you ever taken prescription medications for gut health?',
},
prescription_medications: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Yes',
label: 'Yes',
},
{
value: 'No',
label: 'No',
},
],
rules: [
'required',
],
},
prescription_medications_description: {
type: 'text',
label: 'If yes, please list the medications and their effectiveness.',
rules: [
'required',
],
conditions: [
[
'prescription_medications',
'in',
[
'Yes',
],
],
],
},
h4_9: {
type: 'static',
tag: 'h4',
content: 'Are you currently taking any medications or supplements for gut health?',
},
current_medications: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Yes',
label: 'Yes',
},
{
value: 'No',
label: 'No',
},
],
rules: [
'required',
],
},
current_medications_description: {
type: 'text',
label: 'If yes, please list the products and dosages.',
rules: [
'required',
],
conditions: [
[
'current_medications',
'in',
[
'Yes',
],
],
],
},
h2_10: {
type: 'static',
tag: 'h2',
content: 'Other Conditions',
},
h4_10: {
type: 'static',
tag: 'h4',
content: 'Have you been diagnosed with any of the following conditions?',
},
other_conditions: {
type: 'checkboxgroup',
view: 'blocks',
items: [
{
value: 'Irritable Bowel Syndrome (IBS)',
label: 'Irritable Bowel Syndrome (IBS)',
},
{
value: 'Inflammatory Bowel Disease (IBD)',
label: 'Inflammatory Bowel Disease (IBD)',
},
{
value: 'Crohns Disease',
label: 'Crohns Disease',
},
{
value: 'Ulcerative Colitis',
label: 'Ulcerative Colitis',
},
{
value: 'Celiac Disease',
label: 'Celiac Disease',
},
{
value: 'Diverticulitis',
label: 'Diverticulitis',
},
{
value: 'Small Intestinal Bacterial Overgrowth (SIBO)',
label: 'Small Intestinal Bacterial Overgrowth (SIBO)',
},
{
value: 'Other',
label: 'Other',
},
],
rules: [
'required',
],
},
h4_11: {
type: 'static',
tag: 'h4',
content: 'Do you suffer from chronic constipation or diarrhea?',
},
chronic_constipation_diarrhea: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Yes',
label: 'Yes',
},
{
value: 'No',
label: 'No',
},
],
rules: [
'required',
],
},
chronic_constipation_diarrhea_description: {
type: 'text',
label: 'If yes, please describe.',
rules: [
'required',
],
conditions: [
[
'chronic_constipation_diarrhea',
'in',
[
'Yes',
],
],
],
},
h2_12: {
type: 'static',
tag: 'h2',
content: 'Consumption Habits',
},
h4_12: {
type: 'static',
tag: 'h4',
content: 'Do you consume caffeine, nicotine, or alcohol?',
},
consumption_habits: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Yes',
label: 'Yes',
},
{
value: 'No',
label: 'No',
},
],
rules: [
'required',
],
},
consumption_habits_description: {
type: 'text',
label: 'If yes, please specify.',
rules: [
'required',
],
conditions: [
[
'consumption_habits',
'in',
[
'Yes',
],
],
],
},
h4_13: {
type: 'static',
tag: 'h4',
content: 'Do you have any history of lactose intolerance or sensitivities to sugar alcohols?',
},
lactose_intolerance: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Yes',
label: 'Yes',
},
{
value: 'No',
label: 'No',
},
],
rules: [
'required',
],
},
lactose_intolerance_description: {
type: 'text',
label: 'If yes, please describe.',
rules: [
'required',
],
conditions: [
[
'lactose_intolerance',
'in',
[
'Yes',
],
],
],
},
h4_14: {
type: 'static',
tag: 'h4',
content: 'Are you pregnant? (Female Specific)',
},
pregnant: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Yes',
label: 'Yes',
},
{
value: 'No',
label: 'No',
},
],
rules: [
'required',
],
},
},
};