702 lines
15 KiB
JavaScript
702 lines
15 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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'digestive_health',
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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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'symptoms',
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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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'gastrointestinal_conditions',
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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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'diet_description',
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],
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},
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page4: {
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elements: [
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'h2_4',
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'h4_4',
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'dietary_restrictions',
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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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'bowel_movements',
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],
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},
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page6: {
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elements: [
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'h2_6',
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'h4_6',
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'stool_consistency',
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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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'gut_health_therapies',
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],
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},
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page8: {
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elements: [
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'h2_8',
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'h4_8',
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'prescription_medications',
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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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'current_medications',
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],
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},
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page10: {
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elements: [
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'h2_10',
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'h4_10',
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'other_conditions',
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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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'chronic_constipation_diarrhea',
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],
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},
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page12: {
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elements: [
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'h2_12',
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'h4_12',
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'consumption_habits',
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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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'lactose_intolerance',
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],
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},
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page14: {
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elements: [
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'h4_14',
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'pregnant',
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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: 'Digestive Health',
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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: 'How would you describe your overall digestive health?',
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},
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digestive_health: {
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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: 'Excellent',
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label: 'Excellent',
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},
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{
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value: 'Good',
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label: 'Good',
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},
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{
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value: 'Fair',
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label: 'Fair',
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},
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{
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value: 'Poor',
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label: 'Poor',
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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: 'Symptoms',
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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: 'Do you experience any of the following symptoms regularly?',
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},
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symptoms: {
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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: 'Bloating',
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label: 'Bloating',
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},
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{
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value: 'Gas',
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label: 'Gas',
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},
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{
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value: 'Abdominal pain or cramping',
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label: 'Abdominal pain or cramping',
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},
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{
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value: 'Constipation',
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label: 'Constipation',
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},
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{
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value: 'Diarrhea',
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label: 'Diarrhea',
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},
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{
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value: 'Heartburn or acid reflux',
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label: 'Heartburn or acid reflux',
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},
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{
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value: 'Nausea',
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label: 'Nausea',
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},
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{
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value: 'Food sensitivities',
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label: 'Food sensitivities',
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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: {
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type: 'static',
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tag: 'h2',
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content: 'Gastrointestinal Conditions',
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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: 'Have you been diagnosed with any gastrointestinal conditions?',
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},
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gastrointestinal_conditions: {
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type: 'radiogroup',
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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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rules: [
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'required',
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],
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},
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gastrointestinal_conditions_reason: {
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type: 'text',
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label: 'If yes, please specify the condition.',
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rules: [
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'required',
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],
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conditions: [
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[
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'gastrointestinal_conditions',
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'in',
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[
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'Yes',
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],
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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: 'How would you describe your current diet?',
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},
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diet_description: {
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type: 'radiogroup',
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view: 'blocks',
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items: [
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{
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value: 'Balanced',
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label: 'Balanced',
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},
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{
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value: 'High-carb',
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label: 'High-carb',
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},
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{
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value: 'Low-carb',
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label: 'Low-carb',
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},
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{
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value: 'High-fiber',
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label: 'High-fiber',
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},
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{
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value: 'Low-fiber',
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label: 'Low-fiber',
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},
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{
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value: 'Gluten-free',
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label: 'Gluten-free',
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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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rules: [
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'required',
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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: 'Dietary Restrictions',
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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 follow any specific dietary plans or restrictions?',
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},
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dietary_restrictions: {
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type: 'radiogroup',
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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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rules: [
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'required',
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],
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},
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dietary_restrictions_description: {
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type: 'text',
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label: 'If yes, please describe.',
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rules: [
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'required',
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],
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conditions: [
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[
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'dietary_restrictions',
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'in',
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[
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'Yes',
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],
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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: 'How regular are your bowel movements?',
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},
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bowel_movements: {
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type: 'radiogroup',
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view: 'blocks',
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items: [
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{
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value: 'Daily',
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label: 'Daily',
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},
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{
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value: 'Every other day',
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label: 'Every other day',
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},
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{
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value: 'Once a week',
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label: 'Once a week',
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},
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{
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value: 'Less than once a week',
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label: 'Less than once a week',
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},
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],
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rules: [
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'required',
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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: 'Stool Consistency',
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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: 'How would you describe the consistency of your stools?',
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},
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stool_consistency: {
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type: 'radiogroup',
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view: 'blocks',
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items: [
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{
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value: 'Hard',
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label: 'Hard',
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},
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{
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value: 'Loose',
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label: 'Loose',
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},
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{
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value: 'Normal',
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label: 'Normal',
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},
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{
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value: 'Mixed',
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label: 'Mixed',
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},
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],
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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 previously used gut health therapies?',
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},
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gut_health_therapies: {
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type: 'radiogroup',
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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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rules: [
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'required',
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],
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},
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gut_health_therapies_description: {
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type: 'text',
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label: 'If yes, please list the therapies and describe your experience.',
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rules: [
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'required',
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],
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conditions: [
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[
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'gut_health_therapies',
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'in',
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[
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'Yes',
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],
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],
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],
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},
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h2_8: {
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type: 'static',
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tag: 'h2',
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content: 'Prescription Medications',
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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 ever taken prescription medications for gut health?',
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},
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prescription_medications: {
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type: 'radiogroup',
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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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rules: [
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'required',
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],
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},
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prescription_medications_description: {
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type: 'text',
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label: 'If yes, please list the medications and their effectiveness.',
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rules: [
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'required',
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],
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conditions: [
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[
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'prescription_medications',
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'in',
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[
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'Yes',
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],
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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: 'Are you currently taking any medications or supplements for gut health?',
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},
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current_medications: {
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type: 'radiogroup',
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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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rules: [
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'required',
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],
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},
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current_medications_description: {
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type: 'text',
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label: 'If yes, please list the products and dosages.',
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rules: [
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'required',
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],
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conditions: [
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[
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'current_medications',
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'in',
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[
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'Yes',
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],
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],
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],
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},
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h2_10: {
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type: 'static',
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tag: 'h2',
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content: 'Other Conditions',
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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 been diagnosed with any of the following conditions?',
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},
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other_conditions: {
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type: 'checkboxgroup',
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view: 'blocks',
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items: [
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{
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value: 'Irritable Bowel Syndrome (IBS)',
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label: 'Irritable Bowel Syndrome (IBS)',
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},
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{
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value: 'Inflammatory Bowel Disease (IBD)',
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label: 'Inflammatory Bowel Disease (IBD)',
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},
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{
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value: 'Crohn’s Disease',
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label: 'Crohn’s Disease',
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},
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{
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value: 'Ulcerative Colitis',
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label: 'Ulcerative Colitis',
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},
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{
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value: 'Celiac Disease',
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label: 'Celiac Disease',
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},
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{
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value: 'Diverticulitis',
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label: 'Diverticulitis',
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},
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{
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value: 'Small Intestinal Bacterial Overgrowth (SIBO)',
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label: 'Small Intestinal Bacterial Overgrowth (SIBO)',
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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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rules: [
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'required',
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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: 'Do you suffer from chronic constipation or diarrhea?',
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},
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chronic_constipation_diarrhea: {
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type: 'radiogroup',
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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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rules: [
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'required',
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],
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},
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chronic_constipation_diarrhea_description: {
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type: 'text',
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label: 'If yes, please describe.',
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||
rules: [
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'required',
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],
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||
conditions: [
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[
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'chronic_constipation_diarrhea',
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'in',
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[
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'Yes',
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],
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],
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],
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},
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h2_12: {
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||
type: 'static',
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tag: 'h2',
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content: 'Consumption Habits',
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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 consume caffeine, nicotine, or alcohol?',
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},
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consumption_habits: {
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type: 'radiogroup',
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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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||
],
|
||
rules: [
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'required',
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],
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},
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consumption_habits_description: {
|
||
type: 'text',
|
||
label: 'If yes, please specify.',
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||
rules: [
|
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'required',
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],
|
||
conditions: [
|
||
[
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'consumption_habits',
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||
'in',
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[
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'Yes',
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],
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||
],
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||
],
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||
},
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h4_13: {
|
||
type: 'static',
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||
tag: 'h4',
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||
content: 'Do you have any history of lactose intolerance or sensitivities to sugar alcohols?',
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||
},
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||
lactose_intolerance: {
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||
type: 'radiogroup',
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||
view: 'blocks',
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||
items: [
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||
{
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||
value: 'Yes',
|
||
label: 'Yes',
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||
},
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||
{
|
||
value: 'No',
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label: 'No',
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||
},
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||
],
|
||
rules: [
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||
'required',
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],
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||
},
|
||
lactose_intolerance_description: {
|
||
type: 'text',
|
||
label: 'If yes, please describe.',
|
||
rules: [
|
||
'required',
|
||
],
|
||
conditions: [
|
||
[
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'lactose_intolerance',
|
||
'in',
|
||
[
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||
'Yes',
|
||
],
|
||
],
|
||
],
|
||
},
|
||
h4_14: {
|
||
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',
|
||
],
|
||
},
|
||
},
|
||
}; |