{
  "version": 1,
  "title": "Community Health Visit",
  "fields": [
    {
      "id": "location",
      "type": "geopoint",
      "label": "Household Location",
      "required": true
    },
    {
      "id": "household_members",
      "type": "number",
      "label": "Total Household Members",
      "required": true
    },
    {
      "id": "children_under5",
      "type": "number",
      "label": "Children Under 5"
    },
    {
      "id": "adults_60plus",
      "type": "number",
      "label": "Adults 60 or Older"
    },
    {
      "id": "dwelling_type",
      "type": "select_one",
      "label": "Dwelling Type",
      "options": [
        {"value": "house", "label": "House"},
        {"value": "apartment", "label": "Apartment"},
        {"value": "informal", "label": "Informal / Makeshift"},
        {"value": "shared", "label": "Shared Housing"}
      ]
    },
    {
      "id": "basic_services",
      "type": "select_multiple",
      "label": "Basic Services Available",
      "options": [
        {"value": "piped_water", "label": "Piped Water"},
        {"value": "electricity", "label": "Electricity"},
        {"value": "sewage", "label": "Sewage / Sanitation"},
        {"value": "trash_collection", "label": "Trash Collection"},
        {"value": "internet", "label": "Internet Access"}
      ]
    },
    {
      "id": "health_insurance",
      "type": "select_one",
      "label": "Health Insurance Coverage",
      "options": [
        {"value": "public", "label": "Public / Government"},
        {"value": "private", "label": "Private"},
        {"value": "none", "label": "No Coverage"}
      ]
    },
    {
      "id": "chronic_conditions",
      "type": "select_multiple",
      "label": "Reported Chronic Conditions",
      "options": [
        {"value": "diabetes", "label": "Diabetes"},
        {"value": "hypertension", "label": "Hypertension"},
        {"value": "respiratory", "label": "Respiratory Disease"},
        {"value": "malnutrition", "label": "Malnutrition"},
        {"value": "none", "label": "None Reported"}
      ]
    },
    {
      "id": "photo",
      "type": "photo",
      "label": "Household Photo (optional)"
    },
    {
      "id": "notes",
      "type": "textarea",
      "label": "Notes"
    }
  ]
}