export default { steps: { page0: { elements: [ 'h4', 'day_time_symptoms', 'night_symptoms_copy', 'during_or_after_exersise_symptoms', 'extra_albuterol_use', ], }, page1: { elements: [ 'h4_1', 'upper_respiratory_symptoms', 'upper_respiratory_symptoms_copy', ], }, page2: { elements: [ 'h4_2', 'lung_function_test', 'container', ], }, page3: { elements: [ 'h4_3', 'alergy_symptoms_month', ], }, }, schema: { h4: { type: 'static', tag: 'h4', content: 'COUGH OR WHEEZE SYMPTOMS', }, day_time_symptoms: { type: 'checkboxgroup', items: [ { value: 'less_than_twice_weekly', label: 'Less than twice weekly', }, { value: 'more_than_twice_weekly', label: 'More than twice weekly', }, { value: 'daily', label: 'Daily', }, { value: 'continuous', label: 'Continuous', }, ], label: 'DAYTIME SYMPTOMS', }, night_symptoms_copy: { type: 'checkboxgroup', items: [ { value: 'less_than_twice_weekly', label: 'Less than twice weekly', }, { value: 'more_than_twice_weekly', label: 'More than twice weekly', }, { value: 'nightly', label: 'Nightly', }, ], label: 'NIGHT SYMPTOMS\n', }, during_or_after_exersise_symptoms: { type: 'checkboxgroup', items: [ { value: 'exercise_symptoms_may_occur', label: 'Exercise symptoms may occur', }, { value: 'less_than_once_weekly', label: 'Less than once weekly', }, { value: 'frequent_exercise_symptoms', label: 'Frequent exercise symptoms', }, { value: 'significant_limitation_activity', label: 'Significant limitation activity', }, ], label: 'DURING OR AFTER EXERCISE', }, extra_albuterol_use: { type: 'checkboxgroup', items: [ { value: 'occasional_use', label: 'Occasional use', }, { value: 'periods_of_daily_use', label: 'Periods of daily use', }, { value: 'daily_use', label: 'Daily use', }, { value: 'frequent_daily_need', label: 'Frequent daily need', }, { value: '_', label: null, }, ], label: 'EXTRA ALBUTEROL USE', }, h4_1: { type: 'static', tag: 'h4', content: 'ALLERGY - LIKE SYMPTOMS', }, upper_respiratory_symptoms: { type: 'checkboxgroup', items: [ { value: 'sneezing', label: 'Sneezing', }, { value: 'sniffing_drippy_nose', label: 'Sniffing drippy nose', }, { value: 'itchy_eyes_nose', label: 'Itchy eyes/nose', }, { value: 'dark_circles_under_eyes', label: 'Dark circles under eyes', }, { value: 'sinus_infection', label: 'Sinus infection', }, { value: 'mouth_breathing_snoring', label: 'mouth breathing/snoring', }, { value: 'congestion', label: 'Congestion', }, { value: 'dry_skin', label: 'Dry Skin', }, ], label: 'UPPER RESPIRATORY SYMPTOMS', }, upper_respiratory_symptoms_copy: { type: 'checkboxgroup', items: [ { value: 'smoke', label: 'Smoke', }, { value: 'fireplace_woodstove', label: 'Fireplace/woodstove', }, { value: 'animals', label: 'Animals', }, { value: 'feather', label: 'Feather (pillows, stuffed animals)', }, { value: 'carpeting', label: 'Carpeting', }, { value: 'bedroom_carpeting', label: 'Bedroom carpeting', }, { value: 'forced_air_heat', label: 'Forced air heat', }, { value: 'mold_in_lower level', label: 'Mold in lower level', }, ], label: 'EXPOSURES', }, h4_2: { type: 'static', tag: 'h4', content: 'Has the patient ever had a breathing/lung function test?', }, lung_function_test: { type: 'radiogroup', items: [ { value: 'yes', label: 'Yes', }, { value: 'no', label: 'No', }, ], }, container: { type: 'group', schema: { text: { type: 'text', label: 'When?', }, }, conditions: [ [ 'lung_function_test', 'in', [ 'yes', ], ], ], }, h4_3: { type: 'static', tag: 'h4', content: 'Please select symptoms month', }, alergy_symptoms_month: { type: 'checkboxgroup', items: [ { value: '1', label: 'January', }, { value: '2', label: 'February', }, { value: '3', label: 'March', }, { value: '4', label: 'April', }, { value: '5', label: 'May', }, { value: '6', label: 'June', }, { value: '7', label: 'July', }, { value: '8', label: 'August', }, { value: '9', label: 'September', }, { value: '10', label: 'October', }, { value: '11', label: 'November', }, { value: '12', label: 'December', }, ], }, }, }