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121 lines (121 loc) · 2.79 KB
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{
"id": "0d8931a1-3d0f-4d75-9b26-4c5be62fc8fb",
"slug": "ncd-risk-assessment-v1",
"version": "",
"title": "NCD Risk Assessment Form",
"description": "Screening adults (30 y+) for common NCD risk factors.",
"status": "active",
"subject_type": "patient",
"styling_metadata": {
"classes": "grid-2-col"
},
"questions": [
{
"id": "156a8cb0-7e72-45f6-9e26-75f45ffb4ed1",
"text": "Full Name",
"type": "string",
"link_id": "1.1",
"required": true
},
{
"id": "9d738c56-35f0-4c66-9d9a-ef9d1ae2717c",
"text": "Age (years)",
"type": "integer",
"link_id": "1.2",
"required": true
},
{
"id": "f74e0a1c-8844-45bd-9a7e-8f40f5662524",
"text": "Sex",
"type": "choice",
"link_id": "1.3",
"required": true,
"answer_option": [
{
"value": "MALE"
},
{
"value": "FEMALE"
},
{
"value": "OTHER"
}
]
},
{
"id": "5d38d035-9c70-46b7-8a7a-45ef6d682a72",
"text": "Contact Number",
"type": "string",
"link_id": "1.4"
},
{
"id": "4a03f436-8a63-4b68-bc32-74aa5e0a5e34",
"text": "Date of Assessment",
"type": "date",
"link_id": "1.5",
"required": true
},
{
"id": "5694138f-f83a-42cf-845f-0fa3b95db65e",
"text": "Previously diagnosed hypertension?",
"type": "boolean",
"link_id": "2.1"
},
{
"id": "e78e5e2e-1d68-465a-bfa3-5c7ce3bf5474",
"text": "Previously diagnosed diabetes?",
"type": "boolean",
"link_id": "2.2"
},
{
"id": "1a2ee9b5-fb92-48e0-b415-298f39b63df5",
"text": "Family history of heart disease or stroke?",
"type": "boolean",
"link_id": "2.3"
},
{
"id": "7cf1eb24-d798-49a3-8672-27391619e26d",
"text": "Currently on medication for any chronic illness?",
"type": "boolean",
"link_id": "2.4"
},
{
"id": "9f956eb4-83c1-46c5-bf55-16bb9cb77f04",
"text": "List current medications",
"type": "string",
"link_id": "2.5",
"enable_when": [
{
"question": "2.4",
"operator": "equals",
"answerBoolean": true
}
]
}
],
"created_by": {
"meta": {},
"id": "00000000-0000-0000-0000-000000000000",
"first_name": "System",
"last_name": "",
"phone_number": "",
"username": "system",
"deleted": false
},
"updated_by": {
"meta": {},
"id": "00000000-0000-0000-0000-000000000000",
"first_name": "System",
"last_name": "",
"phone_number": "",
"username": "system",
"deleted": false
},
"tags": [
{
"id": "b4f115c8-0af4-4481-aa42-df6ba85f843d",
"name": "NCD Screening",
"slug": "ncd_screening"
}
]
}