Release 4B R5 Final QA

This page is part of the FHIR Specification (v4.3.0: R4B (v5.0.0-draft-final: Final QA Preview for R5 - STU see ballot notes ). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Questionnaireresponse-example-f201-lifelines.xml

Example QuestionnaireResponse/f201 (XML)

FHIR Infrastructure Work Group Maturity Level : N/A Standards Status : Informative Compartments : Device , Encounter , Patient , Practitioner , RelatedPerson

Raw XML ( canonical form + also see XML Format Specification )

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Real-world lifelines questionnaire response (fictively taken from the patient) (id = "f201") 

<?xml version="1.0" encoding="UTF-8"?>

<QuestionnaireResponse xmlns="http://hl7.org/fhir">
 <id value="f201"/> 
   vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4px
vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0

   <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align:
       top;"><tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align:
         top"><th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px"><a href="formats.html#table" title="The linkId for the item">LinkId</a> </th> <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px"><a href="formats.html#table" title="Text for the item">Text</a> </th> <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px"><a href="formats.html#table" title="Minimum and Maximum # of times the the itemcan appear in the instance">Definition</a> </th> <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px"><a href="formats.html#table" title="The type of the item">Answer</a> <span style="float: right"><a href="formats.html#table" title="Legend for this format"><img alt="doco" src="help16.png" style="background-color: inherit"/> </a> </span> </th> </tr> <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white"><td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)"><img alt="." class="hierarchy" src="tbl_spacer.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="icon_q_root.gif" style="background-color: white; background-color: inherit" title="QuestionnaireResponseRoot"/>  f201</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px">QuestionnaireResponse</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0

           solid; padding:0px 4px 0px 4px"/> </tr> 
vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4px
vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0

<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7"><td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(tbl_bck10.png)"><img alt="." class="hierarchy" src="tbl_spacer.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="tbl_vjoin.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="icon-q-string.png" style="background-color: #F7F7F7; background-color: inherit" title="Item"/>  1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Do you have allergies?</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px">true</td> </tr> 
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:

         white"><td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)"><img alt="." class="hierarchy" src="tbl_spacer.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="tbl_vjoin.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="icon-q-group.png" style="background-color: white; background-color: inherit" title="Group"/>  2</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px">General questions</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0

           solid; padding:0px 4px 0px 4px"/> </tr> 
vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4px
vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0

<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7"><td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(tbl_bck110.png)"><img alt="." class="hierarchy" src="tbl_spacer.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="tbl_vline.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="tbl_vjoin.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="icon-q-string.png" style="background-color: #F7F7F7; background-color: inherit" title="Item"/>  2.1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px">What is your gender?</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Male</td> </tr> 
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:

         white"><td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)"><img alt="." class="hierarchy" src="tbl_spacer.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="tbl_vline.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="tbl_vjoin.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="icon-q-string.png" style="background-color: white; background-color: inherit" title="Item"/>  2.2</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px">What is your date of birth?</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0

           solid; padding:0px 4px 0px 4px">1960-03-13</td> </tr> 
vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4px
vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0

<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7"><td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(tbl_bck110.png)"><img alt="." class="hierarchy" src="tbl_spacer.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="tbl_vline.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="tbl_vjoin.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="icon-q-string.png" style="background-color: #F7F7F7; background-color: inherit" title="Item"/>  2.3</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px">What is your country of birth?</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px">The Netherlands</td> </tr> 
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:

         white"><td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)"><img alt="." class="hierarchy" src="tbl_spacer.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="tbl_vline.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="tbl_vjoin_end.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="icon-q-string.png" style="background-color: white; background-color: inherit" title="Item"/>  2.4</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px">What is your marital status?</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0

           solid; padding:0px 4px 0px 4px">married</td> </tr> 
vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4px
vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px
vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4pxvertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid;
           padding:0px 4px 0px 4px

  

<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7"><td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(tbl_bck01.png)"><img alt="." class="hierarchy" src="tbl_spacer.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="tbl_vjoin_end.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="icon-q-group.png" style="background-color: #F7F7F7; background-color: inherit" title="Group"/>  3</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Intoxications</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> </tr> 
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:

         white"><td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)"><img alt="." class="hierarchy" src="tbl_spacer.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="tbl_blank.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="tbl_vjoin.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="icon-q-string.png" style="background-color: white; background-color: inherit" title="Item"/>  3.1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px">Do you smoke?</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0
           solid; padding:0px 4px 0px 4px">false</td> </tr> 
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:

         #F7F7F7"><td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(tbl_bck000.png)"><img alt="." class="hierarchy" src="tbl_spacer.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="tbl_blank.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="tbl_vjoin_end.png" style="background-color: inherit"/> <img alt="." class="hierarchy" src="icon-q-string.png" style="background-color: #F7F7F7; background-color: inherit" title="Item"/>  3.2</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Do you drink alchohol?</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px
           #F0F0F0 solid; padding:0px 4px 0px 4px">false</td> </tr> 
<tr> <td class="hierarchy" colspan="4"><br/>  <a href="formats.html#table" title="Legend for this format"><img alt="doco" src="help16.png" style="background-color: inherit"/>  Documentation for this format</a> </td> </tr> </table> </div> </text> <questionnaire> 
    <extension url="http://hl7.org/fhir/StructureDefinition/display">
      <valueString value="Lifelines"/> 
    </extension> 
   </questionnaire> 
   <status value="completed"/> 
      <!--   Fictive, only the below answers are non-fictive   -->
  <subject> 
    <reference value="Patient/f201"/> 
    <display value="Roel"/> 
  </subject> 
  <authored value="2013-06-18T00:00:00+01:00"/> 
  <author> 
    <reference value="Practitioner/f201"/> 
  </author> 
  <source> 
    <reference value="Practitioner/f201"/> 
  </source> 
  <item> 
    <linkId value="1"/> 
    
      

      
      
        
      
    

    <text value="Do you have allergies?"/> 
    <answer> 
      <valueBoolean value="true"/> 
    </answer> 
  </item> 
  <item> 
    

        <!--   Answers to general questions   -->
    <linkId value="2"/> 
    <text value="General questions"/> 
    <item> 
      <linkId value="2.1"/> 
      <text value="What is your gender?"/> 
      <answer> 
        <valueString value="Male"/> 
      </answer> 
    </item> 
    <item> 
      <linkId value="2.2"/> 
      <text value="What is your date of birth?"/> 
      <answer> 
        <valueDate value="1960-03-13"/> 
      </answer> 
    </item> 
    <item> 
      <linkId value="2.3"/> 
      <text value="What is your country of birth?"/> 
      <answer> 
        <valueString value="The Netherlands"/> 
      </answer> 
    </item> 
    <item> 
      <linkId value="2.4"/> 
      <text value="What is your marital status?"/> 
      <answer> 
        <valueString value="married"/> 
      </answer> 
    </item> 
  </item> 
  <item> 
    

        <!--   Answers to intoxications   -->
    <linkId value="3"/> 
    <text value="Intoxications"/> 
    <item> 
      <linkId value="3.1"/> 
      <text value="Do you smoke?"/> 
      <answer> 
        

        <valueBoolean value="false"/> 
      </answer> 
    </item> 
    <item> 
      <linkId value="3.2"/> 
      <text value="Do you drink alchohol?"/> 
      <answer> 
        

        <valueBoolean value="false"/> 
      </answer> 
    </item> 
  </item> 


</

QuestionnaireResponse

>

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.