Clinical Prehabilitation Protocol for Breast Cancer (Ca Breast) Patients

from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.units import cm, mm
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.enums import TA_LEFT, TA_CENTER, TA_JUSTIFY
from reportlab.platypus import (
    SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle,
    HRFlowable, KeepTogether, PageBreak
)
from reportlab.platypus.flowables import Flowable
import os

OUTPUT = "/home/daytona/workspace/breast-ca-prehab/Breast_Cancer_Prehabilitation_Checklist.pdf"

# ── Colour palette ────────────────────────────────────────────────────────────
PINK_DARK   = colors.HexColor("#C0185A")   # header / title
PINK_MID    = colors.HexColor("#E85D8A")   # section headings
PINK_LIGHT  = colors.HexColor("#FCE4EC")   # section header bg
PINK_PALE   = colors.HexColor("#FFF0F5")   # alternating row bg
TEAL        = colors.HexColor("#00838F")   # accent (tips / notes)
TEAL_LIGHT  = colors.HexColor("#E0F7FA")   # tip box bg
GREY_DARK   = colors.HexColor("#37474F")   # body text
GREY_MID    = colors.HexColor("#78909C")   # secondary text
GREY_LINE   = colors.HexColor("#CFD8DC")   # rule / border
WHITE       = colors.white
BLACK       = colors.black

# ── Checkbox flowable ─────────────────────────────────────────────────────────
class Checkbox(Flowable):
    def __init__(self, size=10):
        Flowable.__init__(self)
        self.size = size
        self.width  = size
        self.height = size

    def draw(self):
        self.canv.setStrokeColor(PINK_MID)
        self.canv.setLineWidth(1.2)
        r = 2
        s = self.size
        self.canv.roundRect(0, 0, s, s, r, stroke=1, fill=0)

# ── Page template with header/footer ─────────────────────────────────────────
def on_page(canvas, doc):
    canvas.saveState()
    w, h = A4

    # ── Top pink banner ──────────────────────────────────────────────────────
    canvas.setFillColor(PINK_DARK)
    canvas.rect(0, h - 2.2*cm, w, 2.2*cm, stroke=0, fill=1)

    # Ribbon accent stripe
    canvas.setFillColor(PINK_MID)
    canvas.rect(0, h - 2.35*cm, w, 0.18*cm, stroke=0, fill=1)

    # Title text
    canvas.setFillColor(WHITE)
    canvas.setFont("Helvetica-Bold", 14)
    canvas.drawString(1.5*cm, h - 1.35*cm, "Breast Cancer Prehabilitation – Patient Checklist")
    canvas.setFont("Helvetica", 9)
    canvas.drawRightString(w - 1.5*cm, h - 1.35*cm, "Oncology Rehabilitation Unit")

    # Subtitle bar
    canvas.setFillColor(PINK_LIGHT)
    canvas.rect(0, h - 2.55*cm, w, 0.38*cm, stroke=0, fill=1)
    canvas.setFillColor(PINK_DARK)
    canvas.setFont("Helvetica-Oblique", 8)
    canvas.drawString(1.5*cm, h - 2.42*cm,
        "Preparing Your Body & Mind Before Surgery or Chemotherapy")

    # ── Bottom footer ─────────────────────────────────────────────────────────
    canvas.setFillColor(GREY_LINE)
    canvas.rect(0, 0, w, 1.1*cm, stroke=0, fill=1)
    canvas.setFillColor(GREY_DARK)
    canvas.setFont("Helvetica", 7.5)
    canvas.drawString(1.5*cm, 0.42*cm,
        "This checklist is for educational purposes. Follow your care team's specific instructions.")
    canvas.setFont("Helvetica", 7.5)
    canvas.drawRightString(w - 1.5*cm, 0.42*cm, f"Page {doc.page}")

    canvas.restoreState()

# ── Document setup ────────────────────────────────────────────────────────────
doc = SimpleDocTemplate(
    OUTPUT,
    pagesize=A4,
    topMargin=3.0*cm,
    bottomMargin=1.8*cm,
    leftMargin=1.5*cm,
    rightMargin=1.5*cm,
    title="Breast Cancer Prehabilitation Patient Checklist",
    author="Oncology Rehabilitation Unit",
)

styles = getSampleStyleSheet()

# ── Custom styles ─────────────────────────────────────────────────────────────
def S(name, **kw):
    return ParagraphStyle(name, **kw)

s_body = S("body", fontName="Helvetica", fontSize=9.5, leading=14,
           textColor=GREY_DARK, spaceAfter=3)
s_bold = S("bold", fontName="Helvetica-Bold", fontSize=9.5, leading=14,
           textColor=GREY_DARK)
s_note = S("note", fontName="Helvetica-Oblique", fontSize=8.5, leading=13,
           textColor=TEAL, leftIndent=6)
s_tip_head = S("tip_head", fontName="Helvetica-Bold", fontSize=9,
               textColor=TEAL, spaceAfter=2)
s_tip_body = S("tip_body", fontName="Helvetica", fontSize=9, leading=13,
               textColor=GREY_DARK)
s_intro = S("intro", fontName="Helvetica", fontSize=9.5, leading=15,
            textColor=GREY_DARK, spaceAfter=4, alignment=TA_JUSTIFY)

def section_header(title, subtitle=""):
    """Returns a coloured section-header table row."""
    content = f'<font name="Helvetica-Bold" size="11" color="#C0185A">{title}</font>'
    if subtitle:
        content += f'<br/><font name="Helvetica-Oblique" size="8.5" color="#78909C">{subtitle}</font>'
    t = Table([[Paragraph(content, styles["Normal"])]], colWidths=[17.0*cm])
    t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), PINK_LIGHT),
        ("TOPPADDING",    (0,0), (-1,-1), 6),
        ("BOTTOMPADDING", (0,0), (-1,-1), 6),
        ("LEFTPADDING",   (0,0), (-1,-1), 10),
        ("RIGHTPADDING",  (0,0), (-1,-1), 6),
        ("LINEBELOW",     (0,0), (-1,-1), 1.5, PINK_DARK),
    ]))
    return t

def checkbox_row(text, note="", indent=0):
    """Returns a checklist row [☐] [text] as a Table."""
    cb = Checkbox(11)
    main = Paragraph(
        f'<font name="Helvetica" size="9.5" color="#37474F">{text}</font>',
        styles["Normal"]
    )
    items = [[cb, main]]
    col_w = [0.55*cm, 16.45*cm - indent*cm]
    t = Table(items, colWidths=col_w)
    t.setStyle(TableStyle([
        ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
        ("LEFTPADDING",   (0,0), (0,-1), indent*10 + 4),
        ("RIGHTPADDING",  (0,0), (-1,-1), 4),
        ("TOPPADDING",    (0,0), (-1,-1), 3),
        ("BOTTOMPADDING", (0,0), (-1,-1), 3),
    ]))
    rows = [t]
    if note:
        note_t = Table(
            [[Spacer(0.6*cm, 0), Paragraph(
                f'<font name="Helvetica-Oblique" size="8.5" color="#00838F">{note}</font>',
                styles["Normal"]
            )]],
            colWidths=[0.55*cm, 16.45*cm - indent*cm]
        )
        note_t.setStyle(TableStyle([
            ("TOPPADDING",    (0,0), (-1,-1), 0),
            ("BOTTOMPADDING", (0,0), (-1,-1), 3),
            ("LEFTPADDING",   (1,0), (1,0), 4),
        ]))
        rows.append(note_t)
    return rows

def tip_box(heading, body_text):
    """A teal tip / reminder box."""
    content = [
        [Paragraph(f"💡 {heading}", s_tip_head)],
        [Paragraph(body_text, s_tip_body)],
    ]
    t = Table(content, colWidths=[17.0*cm])
    t.setStyle(TableStyle([
        ("BACKGROUND",    (0,0), (-1,-1), TEAL_LIGHT),
        ("LINEABOVE",     (0,0), (-1,0),  1.5, TEAL),
        ("LINEBELOW",     (0,-1), (-1,-1), 1.5, TEAL),
        ("LEFTPADDING",   (0,0), (-1,-1), 10),
        ("RIGHTPADDING",  (0,0), (-1,-1), 10),
        ("TOPPADDING",    (0,0), (-1,-1), 6),
        ("BOTTOMPADDING", (0,0), (-1,-1), 6),
    ]))
    return t

def sub_heading(text):
    return Paragraph(
        f'<font name="Helvetica-Bold" size="10" color="#E85D8A">{text}</font>',
        styles["Normal"]
    )

# ── Build content ─────────────────────────────────────────────────────────────
story = []

# ── Patient info banner ───────────────────────────────────────────────────────
info_data = [
    [
        Paragraph('<font name="Helvetica" size="9" color="#78909C">Patient Name</font>', styles["Normal"]),
        Paragraph('<font name="Helvetica" size="9" color="#78909C">Date of Birth</font>', styles["Normal"]),
        Paragraph('<font name="Helvetica" size="9" color="#78909C">MRN / Hospital No.</font>', styles["Normal"]),
    ],
    [
        Paragraph('________________________________', styles["Normal"]),
        Paragraph('_______ / _______ / _______', styles["Normal"]),
        Paragraph('________________________________', styles["Normal"]),
    ],
    [
        Paragraph('<font name="Helvetica" size="9" color="#78909C">Planned Procedure</font>', styles["Normal"]),
        Paragraph('<font name="Helvetica" size="9" color="#78909C">Surgery / Treatment Date</font>', styles["Normal"]),
        Paragraph('<font name="Helvetica" size="9" color="#78909C">Oncology Team</font>', styles["Normal"]),
    ],
    [
        Paragraph('________________________________', styles["Normal"]),
        Paragraph('_______ / _______ / _______', styles["Normal"]),
        Paragraph('________________________________', styles["Normal"]),
    ],
]
info_table = Table(info_data, colWidths=[5.67*cm, 5.67*cm, 5.66*cm])
info_table.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,-1), PINK_PALE),
    ("BOX",        (0,0), (-1,-1), 0.8, GREY_LINE),
    ("INNERGRID",  (0,0), (-1,-1), 0.5, GREY_LINE),
    ("TOPPADDING",    (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING",   (0,0), (-1,-1), 8),
]))
story.append(info_table)
story.append(Spacer(1, 0.4*cm))

# ── Introduction ──────────────────────────────────────────────────────────────
story.append(Paragraph(
    "Prehabilitation means preparing your body and mind <b>before</b> your breast cancer "
    "surgery or chemotherapy. Research shows that patients who follow a prehabilitation program "
    "recover faster, have fewer complications, and feel better during and after treatment. "
    "Use this checklist every week in the weeks leading up to your procedure. "
    "Tick each item when completed and bring this sheet to every appointment.",
    s_intro
))
story.append(Spacer(1, 0.3*cm))
story.append(tip_box(
    "How to use this checklist",
    "Work through each section weekly. Tick the box once done. "
    "Bring this checklist to every clinic visit so your team can review your progress. "
    "Do not worry if you cannot do everything — do your best and tell your nurse or physiotherapist if you need help."
))
story.append(Spacer(1, 0.4*cm))

# ═══════════════════════════════════════════════════════════════════════
# SECTION 1 — FIRST APPOINTMENT
# ═══════════════════════════════════════════════════════════════════════
story.append(section_header("SECTION 1 — AT YOUR FIRST APPOINTMENT",
                             "Complete these before or at your first prehabilitation visit"))
story.append(Spacer(1, 0.2*cm))

for row in checkbox_row("Attended the prehabilitation assessment appointment"):
    story.append(row)
for row in checkbox_row("Completed the 6-Minute Walk Test (6MWT) with your physiotherapist"):
    story.append(row)
for row in checkbox_row("Had grip strength measured (both hands)",
                         "This helps track your muscle strength throughout your program."):
    story.append(row)
for row in checkbox_row("Completed nutrition screening (NRS-2002 / MUST form)"):
    story.append(row)
for row in checkbox_row("Completed anxiety and depression screening (HADS questionnaire)"):
    story.append(row)
for row in checkbox_row("Completed sleep quality questionnaire (ISI — Insomnia Severity Index)"):
    story.append(row)
for row in checkbox_row("Completed the DASH / SPADI shoulder questionnaire (upper arm function baseline)"):
    story.append(row)
for row in checkbox_row("Baseline arm circumference measured (both arms) — lymphedema prevention"):
    story.append(row)
for row in checkbox_row("Received and read the prehabilitation information booklet"):
    story.append(row)
for row in checkbox_row("Medical review completed (blood tests, ECG if needed, medications reviewed)"):
    story.append(row)
story.append(Spacer(1, 0.35*cm))

# ═══════════════════════════════════════════════════════════════════════
# SECTION 2 — EXERCISE
# ═══════════════════════════════════════════════════════════════════════
story.append(section_header("SECTION 2 — EXERCISE PROGRAM",
                             "Aim to complete weekly — tick when done each week"))
story.append(Spacer(1, 0.2*cm))

story.append(sub_heading("Aerobic (Cardio) Exercise"))
story.append(Spacer(1, 0.1*cm))
for row in checkbox_row("Completed ≥ 150 minutes of moderate-intensity aerobic activity this week",
                         "Brisk walking, cycling, or swimming. You should be able to talk but feel slightly breathless."):
    story.append(row)
for row in checkbox_row("Walked for at least 20–30 minutes on most days"):
    story.append(row)
for row in checkbox_row("Kept a log of my exercise (steps, minutes, or app tracking)"):
    story.append(row)
story.append(Spacer(1, 0.2*cm))

story.append(sub_heading("Strength Training"))
story.append(Spacer(1, 0.1*cm))
for row in checkbox_row("Completed 2–3 resistance/strength training sessions this week",
                         "Light weights, resistance bands, or bodyweight exercises. Do NOT train on consecutive days."):
    story.append(row)
for row in checkbox_row("Performed arm, shoulder, and upper body strengthening exercises as prescribed"):
    story.append(row)
for row in checkbox_row("Performed leg strengthening exercises (squats, step-ups, calf raises)"):
    story.append(row)
story.append(Spacer(1, 0.2*cm))

story.append(sub_heading("Shoulder & Arm Exercises (Breast Cancer Specific)"))
story.append(Spacer(1, 0.1*cm))
for row in checkbox_row("Performed pendulum (Codman) exercises daily — as shown by physiotherapist"):
    story.append(row)
for row in checkbox_row("Performed wall-climbing finger exercise — 2 sets × 10 reps, twice daily"):
    story.append(row)
for row in checkbox_row("Performed overhead arm raises and shoulder circles — as instructed"):
    story.append(row)
for row in checkbox_row("Maintained full range of motion in both shoulders (no restriction)"):
    story.append(row)
story.append(Spacer(1, 0.2*cm))

story.append(sub_heading("Breathing Exercises"))
story.append(Spacer(1, 0.1*cm))
for row in checkbox_row("Used incentive spirometer — 10 deep breaths every 2 hours while awake",
                         "This prepares your lungs for surgery and reduces risk of chest infection afterwards."):
    story.append(row)
for row in checkbox_row("Practised diaphragmatic (belly) breathing — 5 minutes, twice daily"):
    story.append(row)
for row in checkbox_row("Practised slow deep breathing: 5 seconds in, 5 seconds out (vagal breathing)"):
    story.append(row)
story.append(Spacer(1, 0.35*cm))

story.append(tip_box(
    "Exercise safety tip",
    "Stop exercising and contact your team if you experience chest pain, severe shortness of breath, "
    "dizziness, or arm swelling. Light fatigue and mild muscle soreness are normal and expected."
))
story.append(Spacer(1, 0.3*cm))

# ═══════════════════════════════════════════════════════════════════════
# SECTION 3 — NUTRITION
# ═══════════════════════════════════════════════════════════════════════
story.append(section_header("SECTION 3 — NUTRITION & HYDRATION",
                             "Good nutrition builds your reserves before surgery or chemotherapy"))
story.append(Spacer(1, 0.2*cm))

for row in checkbox_row("Met with the dietitian for a personalised nutrition plan"):
    story.append(row)
for row in checkbox_row("Eating protein at EVERY meal — aim for 1.2–2.0 g of protein per kg of body weight per day",
                         "Good sources: eggs, fish, chicken, dairy, legumes, tofu, nuts."):
    story.append(row)
for row in checkbox_row("Eating 5+ portions of fruit and vegetables daily"):
    story.append(row)
for row in checkbox_row("Drinking 6–8 glasses of water or fluids daily (unless told otherwise)"):
    story.append(row)
for row in checkbox_row("Taking prescribed oral nutritional supplements (ONS) if recommended by dietitian"):
    story.append(row)
for row in checkbox_row("Taking prescribed vitamin and mineral supplements (Vitamin D, iron, etc.)"):
    story.append(row)
for row in checkbox_row("Maintaining or improving body weight (not losing weight unintentionally)",
                         "Unintentional weight loss of >5% in 3 months should be reported immediately."):
    story.append(row)
for row in checkbox_row("Completed pre-surgery carbohydrate loading drink (night before + morning of surgery)",
                         "Use the prescribed carbohydrate drink — do NOT eat solid food within 6 hours of surgery."):
    story.append(row)
story.append(Spacer(1, 0.35*cm))

# ═══════════════════════════════════════════════════════════════════════
# SECTION 4 — MENTAL WELLBEING
# ═══════════════════════════════════════════════════════════════════════
story.append(section_header("SECTION 4 — MENTAL WELLBEING & SLEEP",
                             "Your mental and emotional health is part of your recovery"))
story.append(Spacer(1, 0.2*cm))

for row in checkbox_row("Attended or was referred to psychological support / counselling (if needed)"):
    story.append(row)
for row in checkbox_row("Practised a relaxation technique daily (mindfulness, guided imagery, yoga, or meditation)",
                         "Even 10 minutes per day reduces anxiety and improves sleep quality."):
    story.append(row)
for row in checkbox_row("Getting 7–9 hours of sleep per night"):
    story.append(row)
for row in checkbox_row("Reported sleep problems to my nurse or doctor — received treatment if needed",
                         "Sleep difficulties before treatment are very common and very treatable."):
    story.append(row)
for row in checkbox_row("Connected with a breast cancer support group or peer navigator (if wished)"):
    story.append(row)
for row in checkbox_row("Talked to a family member or friend about my concerns and treatment"):
    story.append(row)
for row in checkbox_row("Know how to reach the on-call nurse or support line if I feel very anxious or distressed"):
    story.append(row)
story.append(Spacer(1, 0.35*cm))

story.append(tip_box(
    "It is normal to feel anxious or worried",
    "Over half of cancer patients experience significant anxiety before treatment. Telling your nurse is the first step. "
    "Cognitive Behavioural Therapy (CBT) and mindfulness are proven, effective options — ask your team for a referral."
))
story.append(Spacer(1, 0.3*cm))

# ═══════════════════════════════════════════════════════════════════════
# SECTION 5 — SMOKING & ALCOHOL
# ═══════════════════════════════════════════════════════════════════════
story.append(section_header("SECTION 5 — SMOKING & ALCOHOL",
                             "Stopping smoking and reducing alcohol improves surgical outcomes significantly"))
story.append(Spacer(1, 0.2*cm))

for row in checkbox_row("I do not smoke — ✓ tick and move to next section"):
    story.append(row)
for row in checkbox_row("Discussed smoking cessation with my doctor or nurse"):
    story.append(row)
for row in checkbox_row("Set a quit date (ideally 6–8 weeks before surgery)"):
    story.append(row)
for row in checkbox_row("Started nicotine replacement therapy (NRT), varenicline, or other support"):
    story.append(row)
for row in checkbox_row("Have not smoked for at least 4 weeks before surgery"):
    story.append(row)
story.append(Spacer(1, 0.2*cm))

for row in checkbox_row("Not drinking alcohol, or drinking within safe limits (≤14 units/week)",
                         "Even small reductions in alcohol intake before surgery reduce infection and recovery risks."):
    story.append(row)
for row in checkbox_row("Discussed alcohol intake honestly with my doctor or nurse"):
    story.append(row)
story.append(Spacer(1, 0.35*cm))

# ═══════════════════════════════════════════════════════════════════════
# SECTION 6 — MEDICAL OPTIMISATION
# ═══════════════════════════════════════════════════════════════════════
story.append(section_header("SECTION 6 — MEDICAL OPTIMISATION",
                             "Ensuring your body is in the best medical condition before treatment"))
story.append(Spacer(1, 0.2*cm))

for row in checkbox_row("Blood tests completed (full blood count, kidney function, HbA1c, iron, Vitamin D)"):
    story.append(row)
for row in checkbox_row("Anaemia (low blood count) addressed — iron tablets or other treatment started if needed",
                         "Target haemoglobin ≥ 10 g/dL before elective surgery."):
    story.append(row)
for row in checkbox_row("Blood sugar well controlled if diabetic (HbA1c discussed with doctor)"):
    story.append(row)
for row in checkbox_row("Blood pressure and heart conditions reviewed by GP or specialist"):
    story.append(row)
for row in checkbox_row("Cardiac echo or other heart scan completed (if recommended)"):
    story.append(row)
for row in checkbox_row("All current medications reviewed by doctor before surgery"):
    story.append(row)
for row in checkbox_row("Told my doctor about ALL supplements and herbal remedies I am taking"):
    story.append(row)
for row in checkbox_row("Blood thinners (aspirin, warfarin, DOACs) management plan agreed with doctor"):
    story.append(row)
story.append(Spacer(1, 0.35*cm))

# ═══════════════════════════════════════════════════════════════════════
# SECTION 7 — WEEK BEFORE SURGERY / TREATMENT
# ═══════════════════════════════════════════════════════════════════════
story.append(section_header("SECTION 7 — THE WEEK BEFORE YOUR SURGERY OR FIRST TREATMENT",
                             "Final preparations — complete all items in the 7 days before your procedure"))
story.append(Spacer(1, 0.2*cm))

for row in checkbox_row("Continued walking and breathing exercises every day this week"):
    story.append(row)
for row in checkbox_row("Continued eating high-protein meals and staying well hydrated"):
    story.append(row)
for row in checkbox_row("Completed the pre-admission COVID / infection screening (if required)"):
    story.append(row)
for row in checkbox_row("Performed chlorhexidine skin wash the night before and morning of surgery",
                         "Use the wash cloth / soap provided — do not apply moisturiser or deodorant on the day."):
    story.append(row)
for row in checkbox_row("Taken prescribed carbohydrate loading drink (400 mL) at bedtime the night before surgery"):
    story.append(row)
for row in checkbox_row("Taken prescribed carbohydrate loading drink (400 mL) — 2 hours before surgery start time"):
    story.append(row)
for row in checkbox_row("Fasted from solid food for at least 6 hours before surgery"):
    story.append(row)
for row in checkbox_row("Arranged transport to and from hospital; arranged post-discharge carer if needed"):
    story.append(row)
for row in checkbox_row("Packed hospital bag: comfortable loose clothing, incentive spirometer, this checklist"):
    story.append(row)
for row in checkbox_row("Reviewed postoperative shoulder exercise sheet — I know which exercises to start on Day 1"):
    story.append(row)
for row in checkbox_row("Attended pre-operative patient education session with nurse / physiotherapist"):
    story.append(row)
story.append(Spacer(1, 0.3*cm))

story.append(tip_box(
    "After surgery — lymphedema awareness",
    "After axillary (armpit) surgery, protect your arm: avoid blood pressure cuffs, injections, and tight jewellery "
    "on that side. Report any arm swelling, heaviness, or tightness to your team immediately. "
    "Your arm exercises during prehabilitation have already helped reduce your risk."
))
story.append(Spacer(1, 0.4*cm))

# ═══════════════════════════════════════════════════════════════════════
# SECTION 8 — MY CARE TEAM CONTACTS
# ═══════════════════════════════════════════════════════════════════════
story.append(section_header("SECTION 8 — MY CARE TEAM CONTACTS"))
story.append(Spacer(1, 0.2*cm))

contact_data = [
    [Paragraph("<b>Role</b>", styles["Normal"]),
     Paragraph("<b>Name</b>", styles["Normal"]),
     Paragraph("<b>Phone / Bleep</b>", styles["Normal"]),
     Paragraph("<b>Notes</b>", styles["Normal"])],
    ["Breast Surgeon", "________________", "________________", "________________"],
    ["Oncologist",     "________________", "________________", "________________"],
    ["Physiotherapist","________________", "________________", "________________"],
    ["Dietitian",      "________________", "________________", "________________"],
    ["Breast Nurse Navigator", "________________", "________________", "________________"],
    ["Psychologist / Counsellor", "________________", "________________", "________________"],
    ["GP / Family Doctor", "________________", "________________", "________________"],
    ["24-hr Support Line", "________________", "________________", "________________"],
]

contact_table = Table(contact_data, colWidths=[4.0*cm, 3.8*cm, 3.8*cm, 5.4*cm])
contact_table.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0), PINK_LIGHT),
    ("FONTNAME",      (0,0), (-1,0), "Helvetica-Bold"),
    ("FONTSIZE",      (0,0), (-1,-1), 8.5),
    ("ROWBACKGROUNDS",(0,1), (-1,-1), [WHITE, PINK_PALE]),
    ("BOX",           (0,0), (-1,-1), 0.8, GREY_LINE),
    ("INNERGRID",     (0,0), (-1,-1), 0.5, GREY_LINE),
    ("TOPPADDING",    (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING",   (0,0), (-1,-1), 6),
    ("ALIGN",         (0,0), (-1,-1), "LEFT"),
    ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
]))
story.append(contact_table)
story.append(Spacer(1, 0.4*cm))

# ── Personal notes ────────────────────────────────────────────────────────────
story.append(sub_heading("My Personal Notes / Questions for My Team"))
story.append(Spacer(1, 0.15*cm))
for _ in range(6):
    story.append(HRFlowable(width="100%", thickness=0.5, color=GREY_LINE, spaceAfter=0.5*cm))

story.append(Spacer(1, 0.4*cm))

# ── Final disclaimer ──────────────────────────────────────────────────────────
story.append(Paragraph(
    "<i>Based on: Sabiston Textbook of Surgery (2023) | Toohey et al., Breast Cancer Res Treat 2023 "
    "[PMID 36269525] | WCRF/AICR Physical Activity Guidelines | ESPEN Cancer Nutrition Guidelines 2021. "
    "Reviewed June 2026 — Oncology Rehabilitation Unit.</i>",
    S("disc", fontName="Helvetica-Oblique", fontSize=7.5, textColor=GREY_MID, leading=11)
))

# ── Build ─────────────────────────────────────────────────────────────────────
doc.build(story, onFirstPage=on_page, onLaterPages=on_page)
print(f"PDF saved to: {OUTPUT}")