inputSchema:
  type: object
  properties:
    title: Circumcision Consent Form
    pages:
    - id: 1
      name: section_header_patient_info
      label: -- Patient Information --
      hint: null
      type: note
      options: []
      required: false
    - id: 2
      name: patient_name
      label: Patient Name or Guardian Name (if minor)
      hint: null
      type: text
      options: []
      required: true
    - id: 3
      name: date_of_birth
      label: Patient Date of Birth
      hint: null
      type: date
      options: []
      required: true
    - id: 4
      name: patient_id
      label: Patient ID or Medical Record Number
      hint: null
      type: text
      options: []
      required: false
    - id: 5
      name: contact_phone
      label: Contact Phone Number
      hint: null
      type: text
      options: []
      required: true
    - id: 6
      name: contact_email
      label: Contact Email
      hint: null
      type: email
      options: []
      required: true
    - id: 7
      name: section_header_reason
      label: -- Reason for Procedure --
      hint: null
      type: note
      options: []
      required: false
    - id: 8
      name: procedure_reason
      label: Reason for Circumcision
      hint: null
      type: select_one
      options:
      - Parental or cultural choice
      - Medical necessity
      - Religious observance
      - Personal choice
      - Phimosis or other condition
      - Other
      required: true
    - id: 9
      name: medical_indication
      label: Medical Indication (if applicable)
      hint: null
      type: text
      options: []
      required: false
    - id: 10
      name: section_header_health_info
      label: -- Health Information --
      hint: null
      type: note
      options: []
      required: false
    - id: 11
      name: medical_conditions
      label: Any Current Medical Conditions
      hint: Diabetes, bleeding disorders, infections, etc
      type: text
      options: []
      required: false
    - id: 12
      name: current_medications
      label: Current Medications
      hint: null
      type: text
      options: []
      required: false
    - id: 13
      name: allergies
      label: Known Allergies
      hint: Medication allergies or material allergies
      type: text
      options: []
      required: false
    - id: 14
      name: bleeding_disorders
      label: History of Bleeding Disorders or Excessive Bleeding
      hint: null
      type: select_one
      options:
      - 'No'
      - 'Yes'
      - Unknown
      required: true
    - id: 15
      name: previous_surgeries
      label: Previous Surgeries
      hint: null
      type: text
      options: []
      required: false
    - id: 16
      name: section_header_procedure_understanding
      label: -- Understanding of Procedure --
      hint: null
      type: note
      options: []
      required: false
    - id: 17
      name: procedure_explanation
      label: The procedure has been explained to me
      hint: Circumcision involves removal of the foreskin under anesthesia
      type: select_one
      options:
      - I understand
      - I partially understand
      - I do not understand
      required: true
    - id: 18
      name: risks_discussed
      label: Risks and Possible Complications Have Been Discussed
      hint: Bleeding, infection, reaction to anesthesia, etc
      type: select_one
      options:
      - 'Yes'
      - 'No'
      required: true
    - id: 19
      name: alternatives_discussed
      label: Alternative Treatments or Options Have Been Discussed
      hint: null
      type: select_one
      options:
      - 'Yes'
      - 'No'
      - Not applicable
      required: false
    - id: 20
      name: recovery_expectations
      label: Recovery and Care Instructions Understood
      hint: null
      type: select_one
      options:
      - 'Yes'
      - 'No'
      required: true
    - id: 21
      name: section_header_risks
      label: -- Acknowledgment of Risks --
      hint: null
      type: note
      options: []
      required: false
    - id: 22
      name: bleeding_risk
      label: Acknowledge Risk of Bleeding or Hemorrhage
      hint: null
      type: select_one
      options:
      - I acknowledge
      - I do not acknowledge
      required: true
    - id: 23
      name: infection_risk
      label: Acknowledge Risk of Infection
      hint: null
      type: select_one
      options:
      - I acknowledge
      - I do not acknowledge
      required: true
    - id: 24
      name: anesthesia_risk
      label: Acknowledge Risks Associated with Anesthesia
      hint: null
      type: select_one
      options:
      - I acknowledge
      - I do not acknowledge
      required: true
    - id: 25
      name: permanent_change_risk
      label: Acknowledge This is a Permanent Cosmetic Change
      hint: null
      type: select_one
      options:
      - I acknowledge
      - I do not acknowledge
      required: true
    - id: 26
      name: section_header_consent
      label: -- Consent and Authorization --
      hint: null
      type: note
      options: []
      required: false
    - id: 27
      name: voluntary_consent
      label: I Voluntarily Consent to This Procedure
      hint: null
      type: select_one
      options:
      - I consent
      - I do not consent
      required: true
    - id: 28
      name: no_coercion
      label: I Confirm This Decision is Made Freely Without Coercion
      hint: null
      type: select_one
      options:
      - I confirm
      - I do not confirm
      required: true
    - id: 29
      name: surgeon_authority
      label: I Authorize the Surgeon to Make Any Necessary Decisions
      hint: In case of unexpected complications or findings
      type: select_one
      options:
      - I authorize
      - I do not authorize
      required: true
    - id: 30
      name: section_header_signature
      label: -- Signature and Acknowledgment --
      hint: null
      type: note
      options: []
      required: false
    - id: 31
      name: signature_date
      label: Date of Consent
      hint: null
      type: date
      options: []
      required: true