inputSchema:
  type: object
  properties:
    title: Client Health Questionnaire
    pages:
    - id: 1
      name: patient_first_name
      label: First Name
      hint: Your legal first name
      type: text
      options: []
      required: true
    - id: 2
      name: patient_last_name
      label: Last Name
      hint: Your legal last name
      type: text
      options: []
      required: true
    - id: 3
      name: patient_email
      label: Email Address
      hint: Primary contact email
      type: email
      options: []
      required: true
    - id: 4
      name: patient_phone
      label: Phone Number
      hint: Best contact number
      type: text
      options: []
      required: true
    - id: 5
      name: date_of_birth
      label: Date of Birth
      hint: MM/DD/YYYY
      type: date
      options: []
      required: true
    - id: 6
      name: gender
      label: Gender
      hint: For medical records
      type: select_one
      options:
      - Male
      - Female
      - Non-Binary
      - Prefer Not to Say
      - Other
      required: true
    - id: 7
      name: height
      label: Height
      hint: In feet and inches or cm
      type: text
      options: []
      required: true
    - id: 8
      name: weight
      label: Weight
      hint: In pounds or kg
      type: text
      options: []
      required: true
    - id: 9
      name: chief_complaint
      label: Chief Complaint
      hint: Main reason for visit
      type: text
      options: []
      required: true
    - id: 10
      name: current_symptoms
      label: Current Symptoms
      hint: What are you experiencing?
      type: text
      options: []
      required: true
    - id: 11
      name: symptom_onset
      label: When Did Symptoms Start?
      hint: Symptom beginning
      type: date
      options: []
      required: false
    - id: 12
      name: symptom_frequency
      label: How Often Do Symptoms Occur?
      hint: Frequency
      type: select_one
      options:
      - Constant
      - Daily
      - Weekly
      - Monthly
      - Rarely
      required: true
    - id: 13
      name: symptom_triggers
      label: What Triggers Your Symptoms?
      hint: If known
      type: text
      options: []
      required: false
    - id: 14
      name: symptom_relief
      label: What Relieves Your Symptoms?
      hint: If anything helps
      type: text
      options: []
      required: false
    - id: 15
      name: pain_level
      label: Current Pain Level
      hint: Scale of 1-10
      type: select_one
      options:
      - No Pain (0)
      - Mild (1-3)
      - Moderate (4-6)
      - Severe (7-8)
      - Very Severe (9-10)
      required: true
    - id: 16
      name: pain_location
      label: Where Is the Pain Located?
      hint: Body area
      type: text
      options: []
      required: false
    - id: 17
      name: medical_conditions
      label: Current Medical Conditions
      hint: Diagnosed conditions
      type: text
      options: []
      required: true
    - id: 18
      name: chronic_conditions
      label: Chronic Conditions
      hint: Long-term conditions
      type: select_multiple
      options:
      - Diabetes
      - Hypertension
      - Heart Disease
      - Asthma
      - Arthritis
      - Depression
      - Anxiety
      - Thyroid Disorder
      - None
      - Other
      required: true
    - id: 19
      name: current_medications
      label: Current Medications
      hint: Include dosages
      type: text
      options: []
      required: true
    - id: 20
      name: medication_adherence
      label: Do You Take Medications as Prescribed?
      hint: Compliance
      type: select_one
      options:
      - Always
      - Usually
      - Sometimes
      - Rarely
      - Never
      required: false
    - id: 21
      name: drug_allergies
      label: Drug Allergies
      hint: Medication allergies
      type: text
      options: []
      required: false
    - id: 22
      name: food_allergies
      label: Food Allergies
      hint: Food allergies
      type: text
      options: []
      required: false
    - id: 23
      name: previous_surgeries
      label: Previous Surgeries
      hint: List with dates if possible
      type: text
      options: []
      required: false
    - id: 24
      name: hospitalizations
      label: Previous Hospitalizations
      hint: List with dates and reasons
      type: text
      options: []
      required: false
    - id: 25
      name: family_history
      label: Family Medical History
      hint: Parents, siblings, children
      type: text
      options: []
      required: true
    - id: 26
      name: immunization_status
      label: Immunization Status
      hint: Up to date?
      type: select_one
      options:
      - Up to Date
      - Not Up to Date
      - Not Sure
      required: true
    - id: 27
      name: smoking_status
      label: Smoking Status
      hint: Tobacco use
      type: select_one
      options:
      - Never
      - Former
      - Current
      required: true
    - id: 28
      name: alcohol_use
      label: Alcohol Use
      hint: Frequency
      type: select_one
      options:
      - Never
      - Rarely
      - Moderately
      - Regularly
      - Heavily
      required: true
    - id: 29
      name: recreational_drug_use
      label: Recreational Drug Use
      hint: Current or past
      type: select_one
      options:
      - Never
      - Past Use
      - Current Use
      - Prefer Not to Answer
      required: true
    - id: 30
      name: exercise_habits
      label: Exercise Habits
      hint: Frequency and type
      type: text
      options: []
      required: false
    - id: 31
      name: diet_description
      label: Typical Diet
      hint: Describe your eating habits
      type: text
      options: []
      required: false
    - id: 32
      name: sleep_patterns
      label: Sleep Patterns
      hint: Hours and quality
      type: text
      options: []
      required: false
    - id: 33
      name: mental_health_concerns
      label: Mental Health Concerns
      hint: Depression, anxiety, etc.
      type: text
      options: []
      required: false
    - id: 34
      name: women_health
      label: For Women - Are You Pregnant or Breastfeeding?
      hint: If applicable
      type: select_one
      options:
      - Not Applicable
      - 'False'
      - Yes, Pregnant
      - Yes, Breastfeeding
      required: false
    - id: 35
      name: additional_health_info
      label: Additional Health Information
      hint: Anything else relevant
      type: text
      options: []
      required: false
    - id: 36
      name: information_accuracy
      label: I Confirm All Information Is Accurate
      hint: Truthfulness confirmation
      type: select_one
      options:
      - I Confirm
      - I Do Not Confirm
      required: true
    - id: 37
      name: questionnaire_date
      label: Questionnaire Date
      hint: null
      type: date
      options: []
      required: true