purityselect/resources/js/views/pages/questionere/anti-aging-form.js
2024-10-25 01:05:27 +05:00

618 lines
11 KiB
JavaScript

export default {
steps: {
page0: {
elements: [
'h3',
'h4',
'anti_aging_goals',
],
buttons: {
previous: false,
},
},
page1: {
elements: [
'h2_1',
'h4_1',
'skin_changes',
'skin_changes_reason',
],
},
page2: {
elements: [
'h2',
'h4_2',
'aging_concerns',
'aging_concerns_reason',
],
},
page3: {
elements: [
'h4_3',
'skin_condition',
],
},
page4: {
elements: [
'h4_4',
'anti_aging_products',
'anti_aging_products_list',
],
},
page5: {
elements: [
'h4_5',
'skin_conditions',
'skin_conditions_reason',
],
},
page6: {
elements: [
'h4_6',
'sensitivities',
'sensitivities_reason',
],
},
page7: {
elements: [
'h4_7',
'hormonal_imbalances',
'hormonal_imbalances_reason',
],
},
page8: {
elements: [
'h4_8',
'hormone_replacement_therapies',
'hormone_replacement_therapies_reason',
],
},
page9: {
elements: [
'h4_9',
'supplements',
'supplements_list',
],
},
page10: {
elements: [
'h4_10',
'caffeine_nicotine_alcohol',
],
},
page11: {
elements: [
'h4_11',
'gastrointestinal_conditions',
'gastrointestinal_conditions_reason',
],
},
page12: {
elements: [
'h4_12',
'prescription_skincare',
'prescription_skincare_reason',
],
},
page13: {
elements: [
'h4_13',
'pregnant',
],
},
},
schema: {
h3: {
type: 'static',
tag: 'h2',
content: 'Anti-Aging Survey',
align: 'left',
},
h4: {
type: 'static',
tag: 'h4',
content: 'Please answer the following questions:',
},
anti_aging_goals: {
type: 'checkboxgroup',
rules: [
'required',
],
view: 'blocks',
items: [
{
value: 'Improve skin elasticity and texture',
label: 'Improve skin elasticity and texture',
},
{
value: 'Reduce wrinkles and fine lines',
label: 'Reduce wrinkles and fine lines',
},
{
value: 'Boost energy levels',
label: 'Boost energy levels',
},
{
value: 'Enhance hair and nail health',
label: 'Enhance hair and nail health',
},
{
value: 'Improve overall vitality',
label: 'Improve overall vitality',
},
{
value: 'Other',
label: 'Other',
},
],
},
h2_1: {
type: 'static',
tag: 'h2',
content: 'Recent Changes',
},
h4_1: {
type: 'static',
tag: 'h4',
content: 'Have you noticed any significant changes in your skin, hair, or nails in the past 6 months?',
},
skin_changes: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Yes',
label: 'Yes',
},
{
value: 'No',
label: 'No',
},
],
rules: [
'required',
],
},
skin_changes_reason: {
type: 'text',
label: 'If yes, please describe:',
rules: [
'required',
],
conditions: [
[
'skin_changes',
'in',
[
'Yes',
],
],
],
},
h2: {
type: 'static',
tag: 'h2',
content: 'Aging Concerns',
},
h4_2: {
type: 'static',
tag: 'h4',
content: 'Do you have concerns related to aging?',
},
aging_concerns: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Yes',
label: 'Yes',
},
{
value: 'No',
label: 'No',
},
],
rules: [
'required',
],
},
aging_concerns_reason: {
type: 'text',
label: 'If yes, please specify:',
rules: [
'required',
],
conditions: [
[
'aging_concerns',
'in',
[
'Yes',
],
],
],
},
h4_3: {
type: 'static',
tag: 'h4',
content: 'How would you describe your current skin condition?',
},
skin_condition: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Dry',
label: 'Dry',
},
{
value: 'Oily',
label: 'Oily',
},
{
value: 'Combination',
label: 'Combination',
},
{
value: 'Sensitive',
label: 'Sensitive',
},
{
value: 'Normal',
label: 'Normal',
},
],
rules: [
'required',
],
},
h4_4: {
type: 'static',
tag: 'h4',
content: 'Do you currently use any anti-aging skincare products or treatments?',
},
anti_aging_products: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Yes',
label: 'Yes',
},
{
value: 'No',
label: 'No',
},
],
rules: [
'required',
],
},
anti_aging_products_list: {
type: 'text',
label: 'If yes, please list the products or treatments:',
rules: [
'required',
],
conditions: [
[
'anti_aging_products',
'in',
[
'Yes',
],
],
],
},
h4_5: {
type: 'static',
tag: 'h4',
content: 'Do you have a history of skin conditions?',
},
skin_conditions: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Yes',
label: 'Yes',
},
{
value: 'No',
label: 'No',
},
],
rules: [
'required',
],
},
skin_conditions_reason: {
type: 'text',
label: 'If yes, please specify:',
rules: [
'required',
],
conditions: [
[
'skin_conditions',
'in',
[
'Yes',
],
],
],
},
h4_6: {
type: 'static',
tag: 'h4',
content: 'Do you have any known sensitivities or allergies?',
},
sensitivities: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Yes',
label: 'Yes',
},
{
value: 'No',
label: 'No',
},
],
rules: [
'required',
],
},
sensitivities_reason: {
type: 'text',
label: 'If yes, please specify:',
rules: [
'required',
],
conditions: [
[
'sensitivities',
'in',
[
'Yes',
],
],
],
},
h4_7: {
type: 'static',
tag: 'h4',
content: 'Have you been diagnosed with any hormonal imbalances or endocrine disorders?',
},
hormonal_imbalances: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Yes',
label: 'Yes',
},
{
value: 'No',
label: 'No',
},
],
rules: [
'required',
],
},
hormonal_imbalances_reason: {
type: 'text',
label: 'If yes, please describe:',
rules: [
'required',
],
conditions: [
[
'hormonal_imbalances',
'in',
[
'Yes',
],
],
],
},
h4_8: {
type: 'static',
tag: 'h4',
content: 'Are you currently taking any hormone replacement therapies?',
},
hormone_replacement_therapies: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Yes',
label: 'Yes',
},
{
value: 'No',
label: 'No',
},
],
rules: [
'required',
],
},
hormone_replacement_therapies_reason: {
type: 'text',
label: 'If yes, please specify:',
rules: [
'required',
],
conditions: [
[
'hormone_replacement_therapies',
'in',
[
'Yes',
],
],
],
},
h4_9: {
type: 'static',
tag: 'h4',
content: 'Are you currently taking any medications or supplements to support anti-aging, skin health, or general wellness?',
},
supplements: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Yes',
label: 'Yes',
},
{
value: 'No',
label: 'No',
},
],
rules: [
'required',
],
},
supplements_list: {
type: 'text',
label: 'If yes, please list the products and dosages:',
rules: [
'required',
],
conditions: [
[
'supplements',
'in',
[
'Yes',
],
],
],
},
h4_10: {
type: 'static',
tag: 'h4',
content: 'Do you consume caffeine, nicotine, or alcohol?',
},
caffeine_nicotine_alcohol: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Yes',
label: 'Yes',
},
{
value: 'No',
label: 'No',
},
],
rules: [
'required',
],
},
h4_11: {
type: 'static',
tag: 'h4',
content: 'Do you have 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 describe:',
rules: [
'required',
],
conditions: [
[
'gastrointestinal_conditions',
'in',
[
'Yes',
],
],
],
},
h4_12: {
type: 'static',
tag: 'h4',
content: 'Do you currently use any prescription-strength skincare products?',
},
prescription_skincare: {
type: 'radiogroup',
view: 'blocks',
items: [
{
value: 'Yes',
label: 'Yes',
},
{
value: 'No',
label: 'No',
},
],
rules: [
'required',
],
},
prescription_skincare_reason: {
type: 'text',
label: 'If yes, please specify:',
rules: [
'required',
],
conditions: [
[
'prescription_skincare',
'in',
[
'Yes',
],
],
],
},
h4_13: {
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',
],
},
},
};