{
	"fillkite": 1,
	"exported": "2026-10-07T00:00:00+00:00",
	"forms": [
		{
			"title": "Emergency dental request",
			"status": "published",
			"schema": {
				"schemaVersion": 1,
				"fields": [
					{
						"id": "f_your_name",
						"type": "name",
						"label": "Your name",
						"placeholder": "",
						"helpText": "",
						"required": true,
						"width": "full"
					},
					{
						"id": "f_phone",
						"type": "phone",
						"label": "Phone",
						"placeholder": "",
						"helpText": "",
						"required": true,
						"width": "full"
					},
					{
						"id": "f_em",
						"type": "select",
						"label": "What has happened?",
						"placeholder": "",
						"helpText": "",
						"required": true,
						"width": "full",
						"options": [
							{
								"label": "A broken or chipped tooth",
								"value": "A broken or chipped tooth"
							},
							{
								"label": "A lost filling",
								"value": "A lost filling"
							},
							{
								"label": "Swelling",
								"value": "Swelling"
							},
							{
								"label": "Bleeding that will not stop",
								"value": "Bleeding that will not stop"
							},
							{
								"label": "A knocked-out tooth",
								"value": "A knocked-out tooth"
							}
						]
					},
					{
						"id": "f_notice_189099580",
						"type": "html",
						"label": "Notice",
						"placeholder": "",
						"helpText": "",
						"required": false,
						"width": "full",
						"content": "<p><strong>If your face or neck is swelling or you find it hard to breathe, go to an emergency room now.</strong></p>",
						"logic": {
							"action": "show",
							"match": "all",
							"rules": [
								{
									"field": "f_em",
									"operator": "is",
									"value": "Swelling"
								}
							]
						}
					},
					{
						"id": "f_notice_1961610150",
						"type": "html",
						"label": "Notice",
						"placeholder": "",
						"helpText": "",
						"required": false,
						"width": "full",
						"content": "<p><strong>Keep the tooth in milk and come in within 30 minutes if you can.</strong></p>",
						"logic": {
							"action": "show",
							"match": "all",
							"rules": [
								{
									"field": "f_em",
									"operator": "is",
									"value": "A knocked-out tooth"
								}
							]
						}
					},
					{
						"id": "f_today",
						"type": "radio",
						"label": "Did it happen today?",
						"placeholder": "",
						"helpText": "",
						"required": true,
						"width": "full",
						"options": [
							{
								"label": "Yes",
								"value": "Yes"
							},
							{
								"label": "No",
								"value": "No"
							}
						]
					},
					{
						"id": "f_when_did_it_happen",
						"type": "date",
						"label": "When did it happen?",
						"placeholder": "",
						"helpText": "",
						"required": true,
						"width": "full",
						"logic": {
							"action": "show",
							"match": "all",
							"rules": [
								{
									"field": "f_today",
									"operator": "is",
									"value": "No"
								}
							]
						}
					},
					{
						"id": "f_pr",
						"type": "radio",
						"label": "Are you taking pain relief?",
						"placeholder": "",
						"helpText": "",
						"required": false,
						"width": "full",
						"options": [
							{
								"label": "Yes",
								"value": "Yes"
							},
							{
								"label": "No",
								"value": "No"
							}
						]
					},
					{
						"id": "f_which_one",
						"type": "text",
						"label": "Which one?",
						"placeholder": "",
						"helpText": "",
						"required": false,
						"width": "full",
						"logic": {
							"action": "show",
							"match": "all",
							"rules": [
								{
									"field": "f_pr",
									"operator": "is",
									"value": "Yes"
								}
							]
						}
					}
				],
				"submit": {
					"label": "Ask for an emergency slot",
					"align": "left"
				}
			},
			"settings": {
				"confirmation": {
					"type": "message",
					"message": "Thanks! We will call you within the hour.",
					"redirectUrl": "",
					"downloadUrl": "",
					"downloadLabel": ""
				}
			}
		}
	]
}