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        "code": "self_describe",
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        "code": "grad_degree",
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     "nullable": true,
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     "alias": "What brand of tobacco do you normally use?",
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        "code": "5_to_30",
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        "code": "31_to_60",
        "name": "31\u201360 minutes"
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     "nullable": true,
     "editable": true,
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     "nullable": true,
     "editable": true,
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     "editable": true,
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     "alias": "When do you crave tobacco the most? (Select all that apply)",
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     "nullable": true,
     "editable": true,
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     "length": 255,
     "alias": "What time of day do you typically crave tobacco while driving?",
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     "nullable": true,
     "editable": true,
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     "alias": "What time of day do you crave during work breaks?",
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     "nullable": true,
     "editable": true,
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        "code": "already_stopped",
        "name": "Yes \u2014 I have already stopped"
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       {
        "code": "at_this_appointment",
        "name": "Yes \u2014 at this appointment"
       },
       {
        "code": "within_30_days",
        "name": "Yes \u2014 in the next 30 days"
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       {
        "code": "within_6_months",
        "name": "Yes \u2014 in the next 6 months"
       },
       {
        "code": "undecided",
        "name": "I have not decided"
       },
       {
        "code": "not_planning",
        "name": "I am not planning to stop in the next 6 months"
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     "name": "quit_intent",
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     "alias": "Are you planning to stop using all tobacco?",
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     "nullable": true,
     "editable": true,
     "defaultValue": null,
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     "alias": "Date you last used tobacco",
     "type": "esriFieldTypeDate"
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     "nullable": true,
     "editable": true,
     "defaultValue": null,
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     "alias": "On a scale of 1\u201310, how ready are you to quit in the next 6 months?",
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     "nullable": true,
     "editable": true,
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     "nullable": true,
     "editable": true,
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     "nullable": true,
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        "code": "0",
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        "code": "1",
        "name": "1"
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       {
        "code": "2",
        "name": "2"
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       {
        "code": "3",
        "name": "3"
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        "code": "4",
        "name": "4"
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        "code": "5_or_more",
        "name": "5 or more"
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      ]
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     "name": "quit_attempts",
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     "alias": "How many serious quit attempts have you made?",
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     "nullable": true,
     "editable": true,
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     "length": 255,
     "alias": "What is the longest you have stayed quit?",
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    {
     "nullable": true,
     "editable": true,
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     "nullable": true,
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     "name": "past_quit_methods",
     "length": 255,
     "alias": "What did you use to help you quit in the past? (medicine, counseling, etc.)",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": null,
     "name": "relapse_reason",
     "length": 255,
     "alias": "Why did you relapse?",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": null,
     "name": "nrt_past",
     "length": 255,
     "alias": "What medications/NRT did you use in past quit attempts?",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": null,
     "name": "nrt_past_helpful",
     "length": 255,
     "alias": "What worked well or helped most? Describe any side effects.",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": null,
     "name": "nrt_current",
     "length": 255,
     "alias": "What nicotine replacement therapy or medications are you considering now?",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": null,
     "name": "nrt_other_specify",
     "length": 255,
     "alias": "Please specify other medication/therapy",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": null,
     "name": "household_smokers",
     "length": 255,
     "alias": "Who else in your household smokes or uses tobacco? (Select all that apply)",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": null,
     "name": "household_smokers_other",
     "length": 255,
     "alias": "Please specify other household members who smoke",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_social_smokers",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "none",
        "name": "None"
       },
       {
        "code": "few",
        "name": "A few"
       },
       {
        "code": "many",
        "name": "Many"
       },
       {
        "code": "most",
        "name": "Most"
       }
      ]
     },
     "name": "social_smokers",
     "length": 255,
     "alias": "How many of your family/friends (not living with you) smoke or use tobacco?",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_smoking_in_home",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "smoking_in_home",
     "length": 255,
     "alias": "Is smoking or tobacco use allowed inside your home?",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_smoking_in_car",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "smoking_in_car",
     "length": 255,
     "alias": "Is smoking or tobacco use allowed inside your vehicle?",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_work_smoking_policy",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "inside_outside",
        "name": "Yes \u2014 inside and outside"
       },
       {
        "code": "outside_only",
        "name": "Yes \u2014 outside only"
       },
       {
        "code": "no",
        "name": "No"
       },
       {
        "code": "na",
        "name": "N/A \u2014 Does not apply"
       }
      ]
     },
     "name": "work_smoking_policy",
     "length": 255,
     "alias": "Is smoking allowed where you work?",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_smokes_at_work",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "smokes_at_work",
     "length": 255,
     "alias": "Do you smoke during the workday?",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": null,
     "name": "note_medical",
     "length": 255,
     "alias": "Please answer YES or NO for current or past diagnoses.",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_dx_depression",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "dx_depression",
     "length": 255,
     "alias": "Depression",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_dx_anxiety",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "dx_anxiety",
     "length": 255,
     "alias": "Anxiety",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_dx_schizophrenia",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "dx_schizophrenia",
     "length": 255,
     "alias": "Schizophrenia",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_dx_bipolar",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "dx_bipolar",
     "length": 255,
     "alias": "Bipolar Disorder",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_dx_seizure",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "dx_seizure",
     "length": 255,
     "alias": "Seizure / Convulsions / Epilepsy",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_dx_heart_attack_30d",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "dx_heart_attack_30d",
     "length": 255,
     "alias": "Heart attack within the last 30 days",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_dx_stroke_30d",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "dx_stroke_30d",
     "length": 255,
     "alias": "Stroke or TIA (Temporary Stroke) within the last 30 days",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_dx_pregnant",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "dx_pregnant",
     "length": 255,
     "alias": "Currently pregnant",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_dx_under18",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "dx_under18",
     "length": 255,
     "alias": "Under 18 years of age",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_dx_arrhythmia_6mo",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "dx_arrhythmia_6mo",
     "length": 255,
     "alias": "Diagnosed within the last 6 months with very rapid or irregular heartbeat requiring change in activities or medication",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_dx_angina_6mo",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "dx_angina_6mo",
     "length": 255,
     "alias": "Diagnosed within the last 6 months with serious or worsening angina (chest pain)",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_dx_nrt_rash",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "dx_nrt_rash",
     "length": 255,
     "alias": "Previous generalized rash over entire body related to NRT",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_dx_patch_reaction",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "dx_patch_reaction",
     "length": 255,
     "alias": "Previous adverse reaction to patch medication or adhesive tape",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_dx_jaw_dental",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "dx_jaw_dental",
     "length": 255,
     "alias": "Jaw or dental problems that limit chewing (gum only)",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_dx_bupropion_nrt",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "dx_bupropion_nrt",
     "length": 255,
     "alias": "Planning to use Zyban/Bupropion along with NRT (patch, gum, lozenges)",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_dx_uncontrolled_bp",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "dx_uncontrolled_bp",
     "length": 255,
     "alias": "Have high blood pressure not controlled by medication",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_dx_breastfeeding",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "dx_breastfeeding",
     "length": 255,
     "alias": "Currently breastfeeding (if female)",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_dx_planning_pregnancy",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "dx_planning_pregnancy",
     "length": 255,
     "alias": "Planning pregnancy within 3 months (if female)",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": null,
     "name": "medical_comments",
     "length": 255,
     "alias": "Additional comments about medical history",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": null,
     "name": "note_mh",
     "length": 255,
     "alias": "Over the past TWO WEEKS, how often have you been bothered by the following?",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_phq_little_interest",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "not_at_all",
        "name": "Not at all"
       },
       {
        "code": "several_days",
        "name": "Several days"
       },
       {
        "code": "more_than_half",
        "name": "More than half the days"
       },
       {
        "code": "nearly_every_day",
        "name": "Nearly every day"
       }
      ]
     },
     "name": "phq_little_interest",
     "length": 255,
     "alias": "Little interest or pleasure in doing things",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_phq_feeling_down",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "not_at_all",
        "name": "Not at all"
       },
       {
        "code": "several_days",
        "name": "Several days"
       },
       {
        "code": "more_than_half",
        "name": "More than half the days"
       },
       {
        "code": "nearly_every_day",
        "name": "Nearly every day"
       }
      ]
     },
     "name": "phq_feeling_down",
     "length": 255,
     "alias": "Feeling down, depressed, or hopeless",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_phq_anxious",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "not_at_all",
        "name": "Not at all"
       },
       {
        "code": "several_days",
        "name": "Several days"
       },
       {
        "code": "more_than_half",
        "name": "More than half the days"
       },
       {
        "code": "nearly_every_day",
        "name": "Nearly every day"
       }
      ]
     },
     "name": "phq_anxious",
     "length": 255,
     "alias": "Being anxious, nervous, restless, or fidgety",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_tension_physical",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "tension_physical",
     "length": 255,
     "alias": "Do you have physical signs of excess tension (headaches, difficulty sleeping, upset stomach)?",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": null,
     "name": "tension_explain",
     "length": 255,
     "alias": "Please explain your tension symptoms",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": {
      "name": "service_4a2364c8d5d04a3bbc70b8194028716c_cvd_ok_contact_provider",
      "type": "codedValue",
      "codedValues": [
       {
        "code": "yes",
        "name": "Yes"
       },
       {
        "code": "no",
        "name": "No"
       }
      ]
     },
     "name": "ok_contact_provider",
     "length": 255,
     "alias": "Is it okay for the tobacco treatment facilitator to contact your medical provider to discuss your quit plan (via fax/phone)?",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": null,
     "name": "provider_name_location",
     "length": 255,
     "alias": "Provider's Name and Location",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": true,
     "defaultValue": null,
     "domain": null,
     "name": "additional_info",
     "length": 255,
     "alias": "Please provide any additional information that may be helpful",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": false,
     "defaultValue": null,
     "domain": null,
     "name": "created_user",
     "length": 255,
     "alias": "created_user",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": false,
     "defaultValue": null,
     "domain": null,
     "precision": 1,
     "name": "created_date",
     "length": 29,
     "alias": "created_date",
     "type": "esriFieldTypeDate"
    },
    {
     "nullable": true,
     "editable": false,
     "defaultValue": null,
     "domain": null,
     "name": "last_edited_user",
     "length": 255,
     "alias": "last_edited_user",
     "type": "esriFieldTypeString"
    },
    {
     "nullable": true,
     "editable": false,
     "defaultValue": null,
     "domain": null,
     "precision": 1,
     "name": "last_edited_date",
     "length": 29,
     "alias": "last_edited_date",
     "type": "esriFieldTypeDate"
    }
   ],
   "maxRecordCountFactor": 1,
   "dateFieldsTimeReference": {
    "timeZoneIANA": "Etc/UTC",
    "respectsDaylightSaving": false,
    "timeZone": "UTC"
   },
   "supportsFieldDescriptionProperty": true,
   "hasM": false,
   "allowGeometryUpdates": true,
   "isView": true,
   "useStandardizedQueries": true,
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