export default { "steps": { "page0": { "elements": [ "h3", "h4", "menopause_symptoms" ], "buttons": { "previous": false } }, "page1": { "elements": [ "h2_1", "h4_1", "menopause_diagnosis" ] }, "page2": { "elements": [ "h2", "h4_2", "menopause_goals" ] }, "page3": { "elements": [ "h4_3", "last_menstrual_period" ] }, "page4": { "elements": [ "h2_2", "h4_4", "irregular_periods" ] }, "page5": { "elements": [ "h4_5", "menopause_symptoms_list" ] }, "page6": { "elements": [ "h2_3", "h4_6", "most_bothersome_symptom" ] }, "page7": { "elements": [ "h4_7", "hrt_experience" ] }, "page8": { "elements": [ "h2_4", "h4_8", "bioidentical_hormone_treatment" ] }, "page9": { "elements": [ "h4_9", "hormone_imbalances" ] }, "page10": { "elements": [ "h2_5", "h4_10", "bone_loss" ] }, "page11": { "elements": [ "h4_11", "current_medications" ] }, "page12": { "elements": [ "h2_6", "h4_12", "dietary_plans" ] }, "page13": { "elements": [ "h4_13", "hormone_sensitive_conditions" ] }, "page14": { "elements": [ "h2_7", "h4_14", "peptide_sensitivities" ] } }, "schema": { "h3": { "type": "static", "tag": "h2", "content": "Menopause", "align": "left" }, "h4": { "type": "static", "tag": "h4", "content": "Are you currently experiencing symptoms of menopause?" }, "menopause_symptoms": { "type": "radiogroup", "rules": [ "required" ], "view": "blocks", "items": [ { "value": "Yes", "label": "Yes" }, { "value": "No", "label": "No" } ] }, "h2_1": { "type": "static", "tag": "h2", "content": "Menopause Diagnosis" }, "h4_1": { "type": "static", "tag": "h4", "content": "Have you been officially diagnosed as being in menopause or perimenopause by a healthcare provider?" }, "menopause_diagnosis": { "type": "radiogroup", "rules": [ "required" ], "view": "blocks", "items": [ { "value": "Yes", "label": "Yes" }, { "value": "No", "label": "No" } ] }, "h2": { "type": "static", "tag": "h2", "content": "Menopause Goals" }, "h4_2": { "type": "static", "tag": "h4", "content": "What is your primary goal for menopause therapy?" }, "menopause_goals": { "type": "checkboxgroup", "rules": [ "required" ], "view": "blocks", "items": [ { "value": "Manage hot flashes", "label": "Manage hot flashes" }, { "value": "Improve mood and emotional well-being", "label": "Improve mood and emotional well-being" }, { "value": "Boost energy levels", "label": "Boost energy levels" }, { "value": "Reduce menopause-related weight gain", "label": "Reduce menopause-related weight gain" }, { "value": "Improve skin elasticity and collagen production", "label": "Improve skin elasticity and collagen production" }, { "value": "Other", "label": "Other" } ] }, "h4_3": { "type": "static", "tag": "h4", "content": "When was your last menstrual period?" }, "last_menstrual_period": { "type": "text", "inputType": "text", "rules": [ "required" ] }, "h2_2": { "type": "static", "tag": "h2", "content": "Menstrual Cycle" }, "h4_4": { "type": "static", "tag": "h4", "content": "Do you experience irregular periods or spotting?" }, "irregular_periods": { "type": "radiogroup", "rules": [ "required" ], "view": "blocks", "items": [ { "value": "Yes", "label": "Yes" }, { "value": "No", "label": "No" } ] }, "h4_5": { "type": "static", "tag": "h4", "content": "Which menopause symptoms are you currently experiencing?" }, "menopause_symptoms_list": { "type": "checkboxgroup", "rules": [ "required" ], "view": "blocks", "items": [ { "value": "Hot flashes", "label": "Hot flashes" }, { "value": "Night sweats", "label": "Night sweats" }, { "value": "Mood swings or irritability", "label": "Mood swings or irritability" }, { "value": "Fatigue", "label": "Fatigue" }, { "value": "Insomnia", "label": "Insomnia" }, { "value": "Vaginal dryness or discomfort", "label": "Vaginal dryness or discomfort" }, { "value": "Decreased libido", "label": "Decreased libido" }, { "value": "Weight gain (especially around the abdomen)", "label": "Weight gain (especially around the abdomen)" }, { "value": "Hair thinning or loss", "label": "Hair thinning or loss" }, { "value": "Skin dryness or reduced elasticity", "label": "Skin dryness or reduced elasticity" }, { "value": "Other", "label": "Other" } ] }, "h2_3": { "type": "static", "tag": "h2", "content": "Most Bothersome Symptom" }, "h4_6": { "type": "static", "tag": "h4", "content": "Which of these symptoms is the most bothersome to you?" }, "most_bothersome_symptom": { "type": "text", "inputType": "text", "rules": [ "required" ] }, "h4_7": { "type": "static", "tag": "h4", "content": "Have you been on hormone replacement therapy (HRT) before?" }, "hrt_experience": { "type": "radiogroup", "rules": [ "required" ], "view": "blocks", "items": [ { "value": "Yes", "label": "Yes" }, { "value": "No", "label": "No" } ] }, "h2_4": { "type": "static", "tag": "h2", "content": "Bioidentical Hormone Treatment" }, "h4_8": { "type": "static", "tag": "h4", "content": "Have you used any bioidentical hormone treatments, including estrogen/progesterone-collagen therapy?" }, "bioidentical_hormone_treatment": { "type": "radiogroup", "rules": [ "required" ], "view": "blocks", "items": [ { "value": "Yes", "label": "Yes" }, { "value": "No", "label": "No" } ] }, "h4_9": { "type": "static", "tag": "h4", "content": "Do you have a history of irregular periods, heavy menstrual bleeding, or hormone imbalances (e.g., PCOS)?" }, "hormone_imbalances": { "type": "radiogroup", "rules": [ "required" ], "view": "blocks", "items": [ { "value": "Yes", "label": "Yes" }, { "value": "No", "label": "No" } ] }, "h2_5": { "type": "static", "tag": "h2", "content": "Bone Loss" }, "h4_10": { "type": "static", "tag": "h4", "content": "Have you experienced any bone loss, osteoporosis, or frequent fractures?" }, "bone_loss": { "type": "radiogroup", "rules": [ "required" ], "view": "blocks", "items": [ { "value": "Yes", "label": "Yes" }, { "value": "No", "label": "No" } ] }, "h4_11": { "type": "static", "tag": "h4", "content": "Are you currently taking any medications or supplements for menopause symptoms or hormone balance?" }, "current_medications": { "type": "radiogroup", "rules": [ "required" ], "view": "blocks", "items": [ { "value": "Yes", "label": "Yes" }, { "value": "No", "label": "No" } ] }, "h2_6": { "type": "static", "tag": "h2", "content": "Dietary Plans" }, "h4_12": { "type": "static", "tag": "h4", "content": "Do you follow any specific dietary plans or restrictions?" }, "dietary_plans": { "type": "radiogroup", "rules": [ "required" ], "view": "blocks", "items": [ { "value": "Yes", "label": "Yes" }, { "value": "No", "label": "No" } ] }, "h4_13": { "type": "static", "tag": "h4", "content": "Do you have any history of hormone-sensitive conditions (e.g., breast cancer, endometriosis)?" }, "hormone_sensitive_conditions": { "type": "radiogroup", "rules": [ "required" ], "view": "blocks", "items": [ { "value": "Yes", "label": "Yes" }, { "value": "No", "label": "No" } ] }, "h2_7": { "type": "static", "tag": "h2", "content": "Peptide Sensitivities" }, "h4_14": { "type": "static", "tag": "h4", "content": "Do you have any known sensitivities to peptide-based therapies?" }, "peptide_sensitivities": { "type": "radiogroup", "rules": [ "required" ], "view": "blocks", "items": [ { "value": "Yes", "label": "Yes" }, { "value": "No", "label": "No" } ] } } }