243 lines
9.1 KiB
TypeScript
243 lines
9.1 KiB
TypeScript
import { FormControl, FormControlLabel, FormLabel, Grid, Radio, RadioGroup, TextField } from "@mui/material";
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import React from "react";
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interface FormValues {
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hobbies: string;
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educationLevel: string;
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excercise: string;
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excerciseExplanation: string;
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tobacco: string;
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tobaccoExplanation: string;
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alcohol: string;
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alcoholExplanation: string;
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healthyDiet: string;
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healthyDietExplanation: string;
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sleep: string;
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sleepExplanation: string;
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workSchool: string;
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workSchoolExplanation: string;
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familyLife: string;
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familyLifeExplanation: string;
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drugs: string;
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drugsExplanation:string;
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}
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export default function RecreationalHobbiesSection7(){
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return(
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<>
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<Grid container direction="row">
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<Grid item xs={12} className='collapsable-form-style-multiline'>
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<FormLabel>Recreational Activities/Hobbies:</FormLabel><br></br>
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<TextField
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multiline
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variant="outlined"
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label=""
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name='explanation'
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value=''
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disabled
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/>
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</Grid>
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<Grid item xs={12} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormLabel>Your education level:</FormLabel>
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<RadioGroup
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sx={{display:'flex', flexDirection:'row'}}
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>
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<FormControlLabel value="High School" control={<Radio />} label="High School" />
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<FormControlLabel value="Some college" control={<Radio />} label="Some college" />
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<FormControlLabel value="College Graduate" control={<Radio />} label="College Graduate" />
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<FormControlLabel value="Post college" control={<Radio />} label="Post college" />
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<FormControlLabel value="Other" control={<Radio />} label="Other" />
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</RadioGroup>
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</FormControl>
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</Grid>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormLabel>Do you excercise?</FormLabel>
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<RadioGroup
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name="painDuration"
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sx={{display:'flex', flexDirection:'row'}}
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>
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<FormControlLabel value="Yes" control={<Radio />} label="Yes" />
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<FormControlLabel value="No" control={<Radio />} label="No" />
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</RadioGroup>
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</FormControl>
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</Grid>
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<Grid item xs={6} className='collapsable-form-style-form7'>
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<TextField
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disabled
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variant="outlined"
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label="Times per week?"
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name='treatmentGoal'
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value=''
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/>
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</Grid>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormLabel>Use tobacco?</FormLabel>
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<RadioGroup
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name="painDuration"
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sx={{display:'flex', flexDirection:'row'}}
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>
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<FormControlLabel value="Yes" control={<Radio />} label="Yes" />
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<FormControlLabel value="No" control={<Radio />} label="No" />
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</RadioGroup>
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</FormControl>
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</Grid>
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<Grid item xs={6} className='collapsable-form-style-form7'>
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<TextField
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disabled
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variant="outlined"
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label="Packs/Cans per day(If you have quit, when did you quit?)"
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name='treatmentGoal'
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value=''
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/>
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</Grid>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormLabel>Consume alcohol?</FormLabel>
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<RadioGroup
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name="painDuration"
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sx={{display:'flex', flexDirection:'row'}}
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>
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<FormControlLabel value="Yes" control={<Radio />} label="Yes" />
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<FormControlLabel value="No" control={<Radio />} label="No" />
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</RadioGroup>
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</FormControl>
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</Grid>
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<Grid item xs={6} className='collapsable-form-style-form7'>
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<TextField
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disabled
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variant="outlined"
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label="How many drinks per week?"
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name='treatmentGoal'
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value=''
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/>
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</Grid>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormLabel>Have a healthy diet?</FormLabel>
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<RadioGroup
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name="painDuration"
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sx={{display:'flex', flexDirection:'row'}}
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>
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<FormControlLabel value="Yes" control={<Radio />} label="Yes" />
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<FormControlLabel value="No" control={<Radio />} label="No" />
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</RadioGroup>
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</FormControl>
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</Grid>
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<Grid item xs={6} className='collapsable-form-style-form7'>
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<TextField
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disabled
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variant="outlined"
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label="If no, explain"
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name='treatmentGoal'
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value=''
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/>
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</Grid>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormLabel>Get adequate sleep?</FormLabel>
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<RadioGroup
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name="painDuration"
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sx={{display:'flex', flexDirection:'row'}}
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>
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<FormControlLabel value="Yes" control={<Radio />} label="Yes" />
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<FormControlLabel value="No" control={<Radio />} label="No" />
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</RadioGroup>
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</FormControl>
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</Grid>
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<Grid item xs={6} className='collapsable-form-style-form7'>
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<TextField
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disabled
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variant="outlined"
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label="If no, explain"
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name='treatmentGoal'
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value=''
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/>
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</Grid>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormLabel>Is Work/School stressful to you?</FormLabel>
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<RadioGroup
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name="painDuration"
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sx={{display:'flex', flexDirection:'row'}}
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>
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<FormControlLabel value="Yes" control={<Radio />} label="Yes" />
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<FormControlLabel value="No" control={<Radio />} label="No" />
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</RadioGroup>
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</FormControl>
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</Grid>
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<Grid item xs={6} className='collapsable-form-style-form7'>
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<TextField
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variant="outlined"
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label="If yes, explain"
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name='treatmentGoal'
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value=''
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disabled
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/>
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</Grid>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormLabel>Family life stressful to you?</FormLabel>
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<RadioGroup
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name="painDuration"
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sx={{display:'flex', flexDirection:'row'}}
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>
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<FormControlLabel value="Yes" control={<Radio />} label="Yes" />
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<FormControlLabel value="No" control={<Radio />} label="No" />
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</RadioGroup>
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</FormControl>
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</Grid>
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<Grid item xs={6} className='collapsable-form-style-form7'>
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<TextField
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disabled
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variant="outlined"
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label="If yes, explain"
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name='treatmentGoal'
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value=''
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/>
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</Grid>
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<Grid item xs={6} className='collapsable-form-style-radioButtons'>
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<FormControl>
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<FormLabel>Use recreational drugs?</FormLabel>
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<RadioGroup
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name="painDuration"
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sx={{display:'flex', flexDirection:'row'}}
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>
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<FormControlLabel value="Yes" control={<Radio />} label="Yes" />
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<FormControlLabel value="No" control={<Radio />} label="No" />
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</RadioGroup>
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</FormControl>
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</Grid>
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<Grid item xs={6} className='collapsable-form-style-form7'>
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<TextField
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disabled
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variant="outlined"
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label="If yes, explain"
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name='treatmentGoal'
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value=''
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/>
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</Grid>
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</Grid>
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</>
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)
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} |