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neck-question.html
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<!DOCTYPE html>
<html>
<head>
<title>Neck Questions</title>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<!-- <link rel="stylesheet" type="text/css" href="assets/css/common.css"> -->
<link rel="stylesheet" type="text/css" href="assets/css/neck-question.css">
<link href='https://fonts.googleapis.com/css?family=Poppins' rel='stylesheet'>
</head>
<body>
<!-- header section start -->
<header>
<div class="header_top">
<img class="back" src="assets/images/back.png">
<p>Health Check Questionnaire</p>
<img class="close" src="assets/images/close.png">
</div>
<div class="header_footer">
<div class="real_or"></div>
</div>
</header>
<!-- main section -->
<main class="main container">
<div class="main_content">
<div class="question_content">
<div class="flex-1">
<div>
<p>How would you describe your pain?</p>
<p>Select all that apply.</p>
</div>
<div>
<div class="grid-1">
<div class="badge-sm q1_item">
<img src="assets/images/q11111.png">
<p>Sharp</p>
</div>
<div class="badge-sm q1_item">
<img src="assets/images/q12.png">
<p>Dull</p>
</div>
<div class="badge-sm q1_item">
<img src="assets/images/q13.png">
<p>Intense</p>
</div>
<div class="badge-sm q1_item">
<img src="assets/images/q14.png">
<p>Burning</p>
</div>
<div class="badge-sm q1_item">
<img src="assets/images/q15.png">
<p>Prickly</p>
</div>
<div class="badge-sm q1_item">
<img src="assets/images/q16.png">
<p>Stabbing</p>
</div>
<div class="badge-sm q1_item">
<img src="assets/images/q17.png">
<p>Shooting</p>
</div>
<div class="badge-sm q1_item">
<img src="assets/images/q18.png">
<p>Cramping</p>
</div>
<div class="badge-sm q1_item">
<img src="assets/images/q19.png">
<p>Gnawing</p>
</div>
<div class="badge-sm q1_item">
<img src="assets/images/q110.png">
<p>Gripping</p>
</div>
<div class="badge-sm q1_item">
<img src="assets/images/q111.png">
<p>Pressure</p>
</div>
<div class="badge-sm q1_item">
<img src="assets/images/q112.png">
<p>Heavy</p>
</div>
<div class="badge-sm q1_item">
<img src="assets/images/q113.png">
<p>Aching</p>
</div>
<div class="badge-sm q1_item">
<img src="assets/images/q114.png">
<p>Tender</p>
</div>
<div class="badge-sm q1_item">
<img src="assets/images/q115.png">
<p>Stinging</p>
</div>
</div>
</div>
</div>
</div>
<div class="question_content">
<div class="flex-1">
<div>
<p>How long have you suffered from this pain?</p>
<p>Select the one that most applies.</p>
</div>
<div>
<div class="grid-3">
<div class="badge-lg q2_item">
<img src="assets/images/q11_1.png">
<p>Just today</p>
</div>
<div class="badge-lg q2_item">
<img src="assets/images/q11_2.png">
<p>Less than <br/> a week</p>
</div>
<div class="badge-lg q2_item">
<img src="assets/images/q11_3.png">
<p>Less than <br/> a month</p>
</div>
<div class="badge-lg q2_item">
<img src="assets/images/q11_4.png">
<p>6 months <br/ >or more</p>
</div>
</div>
</div>
</div>
</div>
<div class="question_content">
<div class="flex-1">
<div>
<p>Does the pain come and go?</p>
<p>Select the one that most applies.</p>
</div>
<div>
<div class="grid-4">
<div>
<div class="badge-lg q3_item">
<img src="assets/images/q31.png">
<p>Yes</p>
</div>
</div>
<div>
<div class="badge-lg q3_item">
<img src="assets/images/q32.png">
<p>No</p>
</div>
</div>
<div>
<div class="badge-lg q3_item">
<img src="assets/images/q33.png">
<p>Not Sure</p>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="question_content">
<div class="flex-1">
<div>
<p>Is the pain localized in one spot, or does it radiate into the shoulders, arms, or fingers?</p>
<p>Select the one that most applies.</p>
</div>
<div>
<div class="grid-4">
<div>
<div class="badge-lg q4_item">
<img src="assets/images/q31.png">
<p>Yes</p>
</div>
</div>
<div>
<div class="badge-lg q4_item">
<img src="assets/images/q32.png">
<p>No</p>
</div>
</div>
<div>
<div class="badge-lg q4_item">
<img src="assets/images/q33.png">
<p>Not Sure</p>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="question_content">
<div class="flex-1">
<div>
<p>Are there any other symptoms in addition to neck pain?</p>
<p>Select the one that most applies.</p>
</div>
<div>
<div class="grid-4">
<div>
<div class="badge-lg q5_item">
<img src="assets/images/q31.png">
<p>Yes</p>
</div>
</div>
<div>
<div class="badge-lg q5_item">
<img src="assets/images/q32.png">
<p>No</p>
</div>
</div>
<div>
<div class="badge-lg q5_item">
<img src="assets/images/q33.png">
<p>Not Sure</p>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="question_content">
<div class="flex-1">
<div>
<p>Please type additional symptoms</p>
</div>
<div>
<div><textarea id="textarea-1" class="textarea" oninput="onInput(this);" placeholder="Please type your answer here"></textarea></div>
</div>
</div>
</div>
<div class="question_content">
<div class="flex-1">
<div>
<p>What do you do for a living?</p>
</div>
<div>
<div><textarea id="textarea-2" class="textarea" oninput="onInput(this);" placeholder="Please type your answer here"></textarea></div>
</div>
</div>
</div>
<div class="question_content">
<div class="flex-1">
<div>
<p>Do you usually spend your day doing manual labour or sitting in front of a computer?</p>
<p>Select the one that most applies.</p>
</div>
<div>
<div class="grid-4">
<div>
<div class="badge-lg q8_item">
<img src="assets/images/q31.png">
<p>Yes</p>
</div>
</div>
<div>
<div class="badge-lg q8_item">
<img src="assets/images/q32.png">
<p>No</p>
</div>
</div>
<div>
<div class="badge-lg q8_item">
<img src="assets/images/q33.png">
<p>Not Sure</p>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="question_content">
<div class="flex-1">
<div>
<p>What is your commute like?</p>
</div>
<div>
<div><textarea id="textarea-3" class="textarea" oninput="onInput(this);" placeholder="Please type your answer here"></textarea></div>
</div>
</div>
</div>
<div class="question_content">
<div class="flex-1">
<div>
<p>Do you tend to be more active or sedentary?</p>
<p>Select the one that most applies.</p>
</div>
<div>
<div class="grid-2">
<div class="badge-lg q10_item">
<img src="assets/images/q12_1.png">
<p>Yes</p>
</div>
<div class="badge-lg q10_item">
<img src="assets/images/q12_3.png">
<p>No</p>
</div>
</div>
</div>
</div>
</div>
<div class="question_content">
<div class="flex-1">
<div>
<p>Do you experience numbness and/or pain in the upper limbs</p>
<p>Select the one that most applies.</p>
</div>
<div>
<div class="grid-4">
<div>
<div class="badge-lg q12_item">
<img src="assets/images/q31.png">
<p>Yes</p>
</div>
</div>
<div>
<div class="badge-lg q12_item">
<img src="assets/images/q32.png">
<p>No</p>
</div>
</div>
<div>
<div class="badge-lg q12_item">
<img src="assets/images/q33.png">
<p>Not Sure</p>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="question_content">
<div class="flex-1">
<div>
<p>Do you experience numbness and/or pain in the upper limbs</p>
<p>Select the one that most applies.</p>
</div>
<div>
<div class="grid-4">
<div>
<div class="badge-lg q11_item">
<img src="assets/images/q31.png">
<p>Yes</p>
</div>
</div>
<div>
<div class="badge-lg q11_item">
<img src="assets/images/q32.png">
<p>No</p>
</div>
</div>
<div>
<div class="badge-lg q11_item">
<img src="assets/images/q33.png">
<p>Not Sure</p>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="question_content">
<div class="flex-1">
<div>
<p>Do you feel any difference in the strength of upper limbs?</p>
<p>Select the one that most applies.</p>
</div>
<div>
<div class="grid-4">
<div>
<div class="badge-lg q12_item">
<img src="assets/images/q31.png">
<p>Yes</p>
</div>
</div>
<div>
<div class="badge-lg q12_item">
<img src="assets/images/q32.png">
<p>No</p>
</div>
</div>
<div>
<div class="badge-lg q12_item">
<img src="assets/images/q33.png">
<p>Not Sure</p>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
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