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