export default { steps: { page0: { elements: [ 'h3', 'h4', 'current_sleep_quality', ], buttons: { previous: false, }, }, page1: { elements: [ 'h2_1', 'h4_1', 'hours_sleep_per_night', ], }, page2: { elements: [ 'h2', 'h4_2', 'diagnosed_sleep_disorders', 'diagnosed_sleep_disorders_reason', ], }, page3: { elements: [ 'h4_3', 'prescribed_sleep_medications', ], }, page4: { elements: [ 'h4_4', 'over_the_counter_sleep_aids', 'over_the_counter_sleep_aids_reason', ], }, page5: { elements: [ 'h4_5', 'other_medications_affect_sleep', ], }, page6: { elements: [ 'h4_6', 'consume_caffeine_nicotine_alcohol', ], }, page7: { elements: [ 'h4_7', 'regular_physical_activity', ], }, page8: { elements: [ 'h4_8', 'high_stress_anxiety', ], }, page9: { elements: [ 'h4_9', 'nasal_sinus_issues', 'nasal_sinus_issues_reason', ], }, page10: { elements: [ 'h4_10', 'used_nasal_sprays', 'nasal_sprays_side_effects', ], }, page11: { elements: [ 'h4_11', 'prescribed_peptide_therapies', 'peptide_therapies_side_effects', ], }, page12: { elements: [ 'h4_12', 'using_hormone_peptide_treatments', 'hormone_peptide_treatments_reason', ], }, page13: { elements: [ 'h4_13', 'known_allergies', 'allergies_list', ], }, page14: { elements: [ 'h4_14', 'diagnosed_chronic_conditions', 'chronic_conditions_reason', ], }, page15: { elements: [ 'h4_15', 'respiratory_conditions', ], }, page16: { elements: [ 'h4_16', 'primary_goals', ], }, page17: { elements: [ 'h4_17', 'pregnant', ], }, }, schema: { h3: { type: 'static', tag: 'h2', content: 'Sleep Quality', align: 'left', }, h4: { type: 'static', tag: 'h4', content: 'How would you describe your current sleep quality?', }, current_sleep_quality: { type: 'radiogroup', rules: [ 'required', ], view: 'blocks', items: [ { value: 'Poor', label: 'Poor', }, { value: 'Fair', label: 'Fair', }, { value: 'Good', label: 'Good', }, { value: 'Excellent', label: 'Excellent', }, ], }, h2_1: { type: 'static', tag: 'h2', content: 'Sleep Quality', }, h4_1: { type: 'static', tag: 'h4', content: 'On average, how many hours do you sleep per night?', }, hours_sleep_per_night: { type: 'text', inputType: 'text', rules: [ 'required', ], }, h2: { type: 'static', tag: 'h2', content: 'Sleep Quality', }, h4_2: { type: 'static', tag: 'h4', content: 'Do you suffer from any diagnosed sleep disorders (e.g., insomnia, sleep apnea)?', }, diagnosed_sleep_disorders: { type: 'radiogroup', view: 'blocks', items: [ { value: 'Yes', label: 'Yes', description: '', }, { value: 'No', label: 'No', description: '', }, ], rules: [ 'required', ], }, diagnosed_sleep_disorders_reason: { type: 'text', label: ' \n \t\nIf yes, please specify the condition.', rules: [ 'required', ], conditions: [ [ 'diagnosed_sleep_disorders', 'in', [ 'Yes', ], ], ], }, h4_3: { type: 'static', tag: 'h4', content: 'Have you ever been prescribed any sleep medications or therapies in the past?', }, prescribed_sleep_medications: { type: 'radiogroup', view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], rules: [ 'required', ], }, h4_4: { type: 'static', tag: 'h4', content: 'Do you take any over-the-counter sleep aids, such as melatonin or herbal supplements?', }, over_the_counter_sleep_aids: { type: 'radiogroup', view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], rules: [ 'required', ], }, over_the_counter_sleep_aids_reason: { type: 'text', label: ' \n \t\nIf yes, please specify the condition.', rules: [ 'required', ], conditions: [ [ 'over_the_counter_sleep_aids', 'in', [ 'Yes', ], ], ], }, h4_5: { type: 'static', tag: 'h4', content: 'Are you currently taking any other medications or supplements that affect your sleep?', }, other_medications_affect_sleep: { type: 'radiogroup', view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], rules: [ 'required', ], }, h4_6: { type: 'static', tag: 'h4', content: 'Do you consume caffeine, nicotine, or alcohol?', }, consume_caffeine_nicotine_alcohol: { type: 'radiogroup', view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], rules: [ 'required', ], }, h4_7: { type: 'static', tag: 'h4', content: 'Do you engage in regular physical activity or exercise?', }, regular_physical_activity: { type: 'radiogroup', view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], rules: [ 'required', ], }, h4_8: { type: 'static', tag: 'h4', content: 'Do you experience high levels of stress or anxiety that impact your sleep?', }, high_stress_anxiety: { type: 'radiogroup', view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], rules: [ 'required', ], }, h4_9: { type: 'static', tag: 'h4', content: 'Do you have a history of nasal or sinus issues (e.g., chronic congestion, allergies)?', }, nasal_sinus_issues: { type: 'radiogroup', view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], rules: [ 'required', ], }, nasal_sinus_issues_reason: { type: 'text', label: ' \n \t\nIf yes, please describe.', rules: [ 'required', ], conditions: [ [ 'nasal_sinus_issues', 'in', [ 'Yes', ], ], ], }, h4_10: { type: 'static', tag: 'h4', content: 'Have you used nasal sprays or inhalers before?', }, used_nasal_sprays: { type: 'radiogroup', view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], rules: [ 'required', ], }, nasal_sprays_side_effects: { type: 'text', label: ' \n \t\nIf yes, did you experience any side effects?', rules: [ 'required', ], conditions: [ [ 'used_nasal_sprays', 'in', [ 'Yes', ], ], ], }, h4_11: { type: 'static', tag: 'h4', content: 'Have you been prescribed peptide therapies (like PE 22-28 or DHHB) before?', }, prescribed_peptide_therapies: { type: 'radiogroup', view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], rules: [ 'required', ], }, peptide_therapies_side_effects: { type: 'text', label: ' \n \t\nIf yes, did you experience any side effects?', rules: [ 'required', ], conditions: [ [ 'prescribed_peptide_therapies', 'in', [ 'Yes', ], ], ], }, h4_12: { type: 'static', tag: 'h4', content: 'Are you currently using any other hormone or peptide-based treatments?', }, using_hormone_peptide_treatments: { type: 'radiogroup', view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], rules: [ 'required', ], }, hormone_peptide_treatments_reason: { type: 'text', label: ' \n \t\nIf yes, please specify.', rules: [ 'required', ], conditions: [ [ 'using_hormone_peptide_treatments', 'in', [ 'Yes', ], ], ], }, h4_13: { type: 'static', tag: 'h4', content: 'Do you have any known allergies to medications or supplements?', }, known_allergies: { type: 'radiogroup', view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], rules: [ 'required', ], }, allergies_list: { type: 'text', label: ' \n \t\nIf yes, please list the allergies.', rules: [ 'required', ], conditions: [ [ 'known_allergies', 'in', [ 'Yes', ], ], ], }, h4_14: { type: 'static', tag: 'h4', content: 'Have you been diagnosed with any chronic conditions (e.g., diabetes, hypertension, heart disease) that may affect sleep?', }, diagnosed_chronic_conditions: { type: 'radiogroup', view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], rules: [ 'required', ], }, chronic_conditions_reason: { type: 'text', label: ' \n \t\nIf yes, please specify the condition.', rules: [ 'required', ], conditions: [ [ 'diagnosed_chronic_conditions', 'in', [ 'Yes', ], ], ], }, h4_15: { type: 'static', tag: 'h4', content: 'Do you suffer from any respiratory conditions (e.g., asthma, COPD) that could interfere with nasal spray use?', }, respiratory_conditions: { type: 'radiogroup', view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], rules: [ 'required', ], }, h4_16: { type: 'static', tag: 'h4', content: 'What are your primary goals for improving sleep quality with this therapy?', }, primary_goals: { type: 'radiogroup', view: 'blocks', items: [ { value: 'Falling asleep faster', label: 'Falling asleep faster', }, { value: 'Staying asleep throughout the night', label: 'Staying asleep throughout the night', }, { value: 'Reducing nighttime awakenings', label: 'Reducing nighttime awakenings', }, { value: 'Feeling more rested upon waking', label: 'Feeling more rested upon waking', }, { value: 'Other', label: 'Other', }, ], rules: [ 'required', ], }, h4_17: { 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', ], }, }, };