comfortdentalrockypoint.com

{
  "type": "object",
  "properties": {
    "first_name": {
      "type": "string",
      "description": "Patient's first name."
    },
    "last_name": {
      "type": "string",
      "description": "Patient's last name."
    },
    "phone": {
      "type": "string",
      "description": "Best phone number to reach the patient, e.g. (631) 555-0000."
    },
    "email": {
      "type": "string",
      "description": "Optional email address."
    },
    "reason_for_visit": {
      "type": "string",
      "enum": [
        "Tooth Pain or Sensitivity",
        "Broken or Chipped Tooth",
        "Crown or Restoration",
        "Professional Teeth Whitening",
        "Advanced Dental Work",
        "Gum Concerns",
        "Emergency",
        "Other"
      ],
      "description": "Reason for visit. Must be one of the listed values exactly. Needed before the form can be sent."
    },
    "preferred_contact_method": {
      "type": "string",
      "enum": [
        "Call me",
        "Text me",
        "Email me",
        "Either is fine"
      ],
      "description": "How the office should follow up. Must be one of the listed values exactly."
    },
    "preferred_time_window": {
      "type": "string",
      "description": "Optional preferred time. Free text (e.g. \"weekday mornings\") or one of the time windows shown on the form, written like \"Monday, November 9 · 10:00 AM – 12:00 PM\". An exact match is selected on the form; otherwise it is added to the message. This is a preference, not a confirmed time."
    },
    "message": {
      "type": "string",
      "description": "Optional short note for the office (for example, \"nervous about dental visits\"). Never ask for or pass along medical history, insurance member/ID numbers, date of birth, or payment information."
    },
    "patient_age": {
      "type": "number",
      "description": "Optional patient age in years. If under 10 the request is declined (the office sees ages 10+). Do not ask for date of birth; this is not sent to the office."
    }
  },
  "required": [
    "first_name",
    "last_name",
    "phone"
  ]
}