inputSchema:
  type: object
  properties:
    title: Aesthetics Supplementary Assessment
    pages:
    - id: 1
      name: client_basic_information_section
      label: Client Basic Information
      hint: null
      type: note
      options: []
      required: false
    - id: 2
      name: client_full_name
      label: Full Name
      hint: Enter your complete legal name
      type: text
      options: []
      required: true
    - id: 3
      name: client_dob
      label: Date of Birth
      hint: Your date of birth
      type: date
      options: []
      required: true
    - id: 4
      name: client_gender
      label: Gender
      hint: Your gender identity
      type: select_one
      options:
      - Female
      - Male
      - Non-binary
      - Prefer not to say
      required: true
    - id: 5
      name: client_phone
      label: Phone Number
      hint: Your primary phone number
      type: text
      options: []
      required: true
    - id: 6
      name: client_email
      label: Email Address
      hint: Your email for appointment confirmations
      type: email
      options: []
      required: true
    - id: 7
      name: medical_history_section
      label: Medical History
      hint: null
      type: note
      options: []
      required: false
    - id: 8
      name: current_health_conditions
      label: Current Health Conditions
      hint: Do you have any ongoing health conditions?
      type: select_multiple
      options:
      - Diabetes
      - Heart Disease
      - Hypertension
      - Autoimmune Disorders
      - Skin Conditions
      - Cancer
      - Blood Clotting Disorders
      - Pregnancy
      - None of the Above
      - Prefer not to disclose
      required: true
    - id: 9
      name: current_medications
      label: Current Medications
      hint: List any medications you are currently taking
      type: text
      options: []
      required: false
    - id: 10
      name: medication_details
      label: Medication Details
      hint: For each medication, please include dosage and frequency
      type: text
      options: []
      required: false
    - id: 11
      name: previous_aesthetic_treatments
      label: Previous Aesthetic Treatments
      hint: Have you had any previous aesthetic treatments?
      type: select_one
      options:
      - 'True'
      - 'False'
      required: true
    - id: 12
      name: previous_treatments_details
      label: Details of Previous Treatments
      hint: If yes, please list the treatments and approximate dates
      type: text
      options: []
      required: false
    - id: 13
      name: allergy_information_section
      label: Allergy Information
      hint: null
      type: note
      options: []
      required: false
    - id: 14
      name: medication_allergies
      label: Medication Allergies
      hint: Are you allergic to any medications?
      type: select_one
      options:
      - 'True'
      - 'False'
      - Unknown
      required: true
    - id: 15
      name: medication_allergies_details
      label: Details of Medication Allergies
      hint: If yes, please specify which medications and reactions experienced
      type: text
      options: []
      required: false
    - id: 16
      name: cosmetic_product_allergies
      label: Cosmetic Product Allergies
      hint: Are you allergic to any cosmetic products or ingredients?
      type: select_one
      options:
      - 'True'
      - 'False'
      - Unknown
      required: true
    - id: 17
      name: cosmetic_allergies_details
      label: Details of Cosmetic Product Allergies
      hint: If yes, please specify which products or ingredients and reactions experienced
      type: text
      options: []
      required: false
    - id: 18
      name: skin_sensitivity_section
      label: Skin Sensitivity
      hint: null
      type: note
      options: []
      required: false
    - id: 19
      name: skin_sensitivity_level
      label: Skin Sensitivity Level
      hint: How would you describe your skin sensitivity?
      type: select_one
      options:
      - Very Sensitive
      - Sensitive
      - Normal
      - Resistant
      required: true
    - id: 20
      name: previous_skin_reactions
      label: Previous Skin Reactions
      hint: Have you had any adverse skin reactions to treatments or products?
      type: select_one
      options:
      - 'True'
      - 'False'
      required: true
    - id: 21
      name: skin_reaction_details
      label: Details of Skin Reactions
      hint: If yes, please describe the reactions and what caused them
      type: text
      options: []
      required: false
    - id: 22
      name: sun_exposure_habits
      label: Sun Exposure Habits
      hint: What are your typical sun exposure habits?
      type: select_one
      options:
      - Minimal sun exposure
      - Moderate sun exposure
      - Extensive sun exposure
      - Regular tanning bed use
      required: true
    - id: 23
      name: treatment_goals_section
      label: Treatment Goals
      hint: null
      type: note
      options: []
      required: false
    - id: 24
      name: primary_treatment_goal
      label: Primary Treatment Goal
      hint: What is your primary goal for aesthetic treatment?
      type: select_one
      options:
      - Reduce signs of aging
      - Improve skin texture
      - Address acne/scars
      - Enhance facial features
      - Body contouring
      - Hair removal
      - Other
      required: true
    - id: 25
      name: specific_concerns
      label: Specific Concerns
      hint: What specific skin or aesthetic concerns do you have?
      type: text
      options: []
      required: true
    - id: 26
      name: desired_outcomes
      label: Desired Outcomes
      hint: What outcomes are you hoping to achieve?
      type: text
      options: []
      required: true
    - id: 27
      name: expectations_realisticness
      label: Expectations Realisticness
      hint: Do you have realistic expectations about treatment outcomes?
      type: select_one
      options:
      - 'True'
      - 'False'
      - Unsure
      required: true
    - id: 28
      name: lifestyle_factors_section
      label: Lifestyle Factors
      hint: null
      type: note
      options: []
      required: false
    - id: 29
      name: smoking_status
      label: Smoking Status
      hint: Do you smoke tobacco products?
      type: select_one
      options:
      - Never smoked
      - Former smoker
      - Current smoker
      - Occasional smoker
      required: true
    - id: 30
      name: alcohol_consumption
      label: Alcohol Consumption
      hint: How often do you consume alcohol?
      type: select_one
      options:
      - Never
      - Rarely
      - Socially
      - Regularly
      required: true
    - id: 31
      name: skincare_routine
      label: Current Skincare Routine
      hint: Describe your current daily skincare routine
      type: text
      options: []
      required: false
    - id: 32
      name: consent_section
      label: Consent
      hint: null
      type: note
      options: []
      required: false
    - id: 33
      name: information_accuracy_confirmation
      label: Information Accuracy Confirmation
      hint: I confirm that the information provided is accurate and complete to the
        best of my knowledge
      type: select_one
      options:
      - 'True'
      - 'False'
      required: true
    - id: 34
      name: treatment_consent
      label: Treatment Consent
      hint: I consent to the aesthetic treatments recommended by the practitioner
        based on this assessment
      type: select_one
      options:
      - 'True'
      - 'False'
      required: true
    - id: 35
      name: signature
      label: Signature
      hint: Electronic signature to confirm consent
      type: text
      options: []
      required: true