Form Requirements

Before an ANS Challenge test can be considered valid, patients must complete required questionnaires. The SDK allows you to determine when these forms are presented (before test, after test, or separately), but test results will not be released until all required forms are completed.

Required Forms

Form Completion is Mandatory

A test cannot be reviewed by a physician until all required forms are complete. The SDK enforces this by marking tests as pending_forms if forms are incomplete. Configure your app to prompt users to complete forms before or immediately after testing.

28-Symptom Autonomic Questionnaire

The 28-Symptom Autonomic Questionnaire is a proprietary, clinically-validated instrument that assesses autonomic dysfunction across multiple body systems. This questionnaire is required for all diagnostic ANS testing.

What It Measures:

• Cardiovascular symptoms (palpitations, chest pain, dizziness, syncope)
• Orthostatic intolerance (lightheadedness upon standing, vision changes)
• Gastrointestinal symptoms (nausea, bloating, constipation, diarrhea)
• Thermoregulation (excessive sweating, heat/cold intolerance)
• Urogenital symptoms (bladder control, sexual dysfunction)
• Cognitive/neurological (brain fog, concentration issues, sleep disturbances)
• Exercise intolerance and fatigue

Question Format:

• Each symptom rated on a 0-4 scale:
  • 0 = Never/Not present
  • 1 = Mild/Occasional
  • 2 = Moderate/Frequent
  • 3 = Severe/Very frequent
  • 4 = Extreme/Constant

Clinical Use:

• Baseline symptom burden assessment
• Correlate symptoms with ANS testing results (e.g., high orthostatic symptom score + standing challenge abnormalities = POTS diagnosis)
• Track symptom changes over time during treatment
• Identify specific autonomic branches affected (parasympathetic vs sympathetic)

Trademark Notice

The "28-Symptom Autonomic Questionnaire" and its scoring methodology are proprietary and trademarked by Autonomic Health. Unauthorized reproduction or modification of the questionnaire is prohibited.

Medical History Form

Required Information:

• Past medical diagnoses (autoimmune diseases, neurological conditions, cardiovascular disease)
• Surgeries and hospitalizations
• Family history of autonomic disorders, POTS, dysautonomia, autoimmune diseases
• Allergies and adverse reactions
• History of fainting, seizures, or unexplained falls

Why This Matters:

• Conditions like Ehlers-Danlos Syndrome, Sjögren's syndrome, and lupus are strongly associated with autonomic dysfunction
• Family history helps identify genetic predispositions
• Certain medications or surgeries can cause autonomic side effects

Current Medications Form

Required Information:

• All prescription medications (name, dosage, frequency)
• Over-the-counter medications and supplements
• Recent medication changes (added/removed in past 3 months)
• Compliance/adherence notes

Why This Matters:

• Beta-blockers, alpha agonists, and other autonomic medications directly affect test results
• SSRIs, SNRIs, and other psychotropic drugs influence ANS function
• Stimulants (ADHD medications, caffeine supplements) alter sympathetic activity
• Physicians must know current medications to interpret test results and avoid drug interactions in treatment plans

Medication Conflicts

Failure to disclose medications can lead to:

• Misinterpretation of test results (e.g., beta-blockers artificially lower sympathetic activity)
• Dangerous drug interactions if physician prescribes conflicting medications
• Invalid test results if stimulants were taken before testing

Lifestyle Factors Form

Required Information:

• Exercise habits (frequency, intensity, type)
• Sleep patterns (hours per night, sleep disorders, insomnia)
• Diet and hydration (caffeine intake, alcohol use, salt intake)
• Stress levels and mental health
• Occupational factors (physical demands, standing/sitting duration)

Why This Matters:

• Athletes have different ANS baselines than sedentary individuals
• Sleep deprivation affects autonomic function
• Dehydration and low salt intake can mimic POTS symptoms
• High stress occupations may show elevated sympathetic tone

When to Present Forms

You have flexibility in when to present forms to users, but they must be completed before physician review can begin:

Option 1: Before Testing (Recommended)

• Present forms during onboarding or account creation
• Ensures test can be reviewed immediately after upload
• Reduces friction in the test flow
• Best for diagnostic use cases where time-to-results matters

Option 2: After Testing

• Users complete ANS Challenge first
• Forms presented immediately after test dismissal
• Capitalizes on user engagement after completing test
• Risk: Users may abandon forms, delaying review

Option 3: Separate Flow

• Forms accessible from profile/settings
• Users can complete at their convenience
• Must gate test initiation until required forms are complete
• Good for research studies with extensive questionnaires

Best Practice

For diagnostic testing, require the 28-Symptom Autonomic Questionnaire and Current Medications form before allowing test initiation. Medical History and Lifestyle Factors can be collected after testing if needed to reduce upfront friction.

Checking Form Completion Status

Before initiating a test, check which forms are required and which are completed:

iOS

Task {
    // Get all form templates to see what's required
    let templates = try await sdk.apiService.forms.listFormTemplates()
    let requiredForms = templates.filter { $0.required }

    // Get user's form submissions
    let submissions = try await sdk.apiService.forms.listMyFormSubmissions(
        patientId: patientId,
        status: .completed
    )

    let completedFormIds = Set(submissions.map { $0.formId })
    let requiredFormIds = Set(requiredForms.map { $0.formId })

    let missingForms = requiredFormIds.subtracting(completedFormIds)

    if missingForms.isEmpty {
        // All required forms complete, can proceed with test
        sdk.presentANSChallenge(from: self, animated: true)
    } else {
        // Prompt user to complete missing forms
        promptUserToCompleteForms(missingForms)
    }
}

Android

lifecycleScope.launch {
    // Get all form templates to see what's required
    val templates = sdk.apiService.forms.listFormTemplates()
    val requiredForms = templates.filter { it.required }

    // Get user's form submissions
    val submissions = sdk.apiService.forms.listMyFormSubmissions(
        patientId = patientId,
        status = FormStatus.COMPLETED
    )

    val completedFormIds = submissions.map { it.formId }.toSet()
    val requiredFormIds = requiredForms.map { it.formId }.toSet()

    val missingForms = requiredFormIds - completedFormIds

    if (missingForms.isEmpty()) {
        // All required forms complete, can proceed with test
        sdk.presentANSChallenge(activity = this, animated = true)
    } else {
        // Prompt user to complete missing forms
        promptUserToCompleteForms(missingForms)
    }
}

Fetching Form Templates

iOS

Task {
    let templates = try await apiService.forms.listFormTemplates()
    let autonomicForm = try await apiService.forms.getFormTemplate(
        formId: "28-symptom-autonomic"
    )
}

Android

lifecycleScope.launch {
    val templates = apiService.forms.listFormTemplates()
    val autonomicForm = apiService.forms.getFormTemplate(
        formId = "28-symptom-autonomic"
    )
}

Form Input Types

Type	Description
checkbox	Multiple selection
radio	Single selection
dropdown	Single from list
text	Short text input
textarea	Long text input

Submitting Responses

iOS

let responses: [String: AnyCodable] = [
    "q1_dizziness": AnyCodable("3"),
    "q2_medications": AnyCodable("Metoprolol 25mg daily")
]

let submission = FormSubmissionIn(
    patientId: patientId,
    responses: responses
)

let result = try await apiService.forms.submitFormResponse(
    formId: "28-symptom-autonomic",
    submission: submission
)

Android

val responses = mapOf(
    "q1_dizziness" to "3",
    "q2_medications" to "Metoprolol 25mg daily"
)

val submission = FormSubmissionIn(
    patientId = patientId,
    responses = responses
)

val result = apiService.forms.submitFormResponse(
    formId = "28-symptom-autonomic",
    submission = submission
)

Form Status

Status	Description
pending	Not started
in_progress	Partial completion
completed	All questions answered
cancelled	Abandoned

Next Steps

Continue to API Reference for complete endpoint documentation.