DSTU2 STU 3 Candidate
This page is part of the FHIR Specification (v1.0.2: DSTU 2). The current version which supercedes this version is

This page is part of the FHIR Specification (v1.4.0: STU 3 Ballot 3). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . For a full list of available versions, see the Directory of published versions . Page versions: . Page versions: R5 R4B R4 R3 R2

Questionnaire-example-f201-lifelines.json Raw JSON (

Raw JSON ( canonical form canonical form ) Real-world lifelines questionnaire (fictively taken from the patient) )

Real-world lifelines questionnaire (fictively taken from the patient) 

{
  "resourceType": "Questionnaire",
  "id": "f201",
  "text": {
    "status": "generated",
    "div": "<div>\n<pre>Lifelines Questionnaire 1 part 1\n  1. Do you have allergies?\n  2. General Questions:\n    2.a) What is your gender?\n    2.b) What is your date of birth?\n    2.c) What is your country of birth?\n    2.d) What is your marital status?\n    3. Intoxications:\n      3.a) Do you smoke?\n      3.b) Do you drink alcohol?</pre>\n    </div>"

    "div": "<div>\n      <pre>Lifelines Questionnaire 1 part 1\n  1. Do you have allergies?\n  2. General Questions:\n    2.a) What is your gender?\n    2.b) What is your date of birth?\n    2.c) What is your country of birth?\n    2.d) What is your marital status?\n    3. Intoxications:\n      3.a) Do you smoke?\n      3.b) Do you drink alcohol?</pre>\n    </div>"

  },
  "status": "published",
  "date": "2010",
  "concept": [
    {
      "system": "http://example.org/system/code/lifelines/nl",
      "code": "VL 1-1, 18-65_1.2.2",
      "display": "Lifelines Questionnaire 1 part 1"
    }
  ],

  "subjectType": [
    "Patient"
  ],
  "group": {
    "linkId": "root",
    "concept": [
      {
        "system": "http://example.org/system/code/lifelines/nl",
        "code": "VL 1-1, 18-65_1.2.2",
        "display": "Lifelines Questionnaire 1 part 1"
      }
    ],
    "required": true,
    "group": [
      {
        "linkId": "1",
        "question": [
          {
            "linkId": "1.1",
            "_linkId": {
              "fhir_comments": [
                " Separate answer "
              ]
            },
            "text": "Do you have allergies?"
          }
        ]
      },
      {
        "linkId": "2",
        "_linkId": {
          "fhir_comments": [
            " Answers to general questions "
          ]

  "item": [
    {
      "linkId": "1",
      "text": "Do you have allergies?",
      "type": "boolean"
    },
    {
      "linkId": "2",
      "text": "General questions",
      "type": "group",
      "item": [
        {
          "linkId": "2.1",
          "text": "What is your gender?",
          "type": "string"

        },
        "text": "General questions",
        "question": [
          {
            "linkId": "2.1",
            "text": "What is your gender?"
          },
          {
            "linkId": "2.2",
            "text": "What is your date of birth?"
          },
          {
            "linkId": "2.3",
            "text": "What is your country of birth?"
          },
          {
            "linkId": "2.4",
            "text": "What is your marital status?"
          }
        ]
      },
      {
        "linkId": "3",
        "title": "Intoxications",
        "_title": {
          "fhir_comments": [
            " Answers to intoxications "
          ]

        {
          "linkId": "2.2",
          "text": "What is your date of birth?",
          "type": "date"

        },
        "question": [
          {
            "linkId": "3.1",
            "text": "Do you smoke?"
          },
          {
            "linkId": "3.2",
            "text": "Do you drink alchohol?"
          }
        ]
      }
    ]
  }

        {
          "linkId": "2.3",
          "text": "What is your country of birth?",
          "type": "string"
        },
        {
          "linkId": "2.4",
          "text": "What is your marital status?",
          "type": "string"
        }
      ]
    },
    {
      "linkId": "3",
      "text": "Intoxications",
      "type": "group",
      "item": [
        {
          "linkId": "3.1",
          "text": "Do you smoke?",
          "type": "boolean"
        },
        {
          "linkId": "3.2",
          "text": "Do you drink alchohol?",
          "type": "boolean"
        }
      ]
    }
  ]

}
Usage
note:
every
effort
has
been
made
to
ensure
that
the
examples
are
correct
and
useful,
but
they
are
not
a
normative
part
of
the
specification.
©
HL7.org
2011+.
FHIR
DSTU2
(v1.0.2-7202)
generated
on
Sat,
Oct
24,
2015
07:44+1100.
Links:

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.