This page is part of the FHIR Specification (v0.0.82: DSTU 1). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions Immunization.questionnaire This is an example form generated from the questionnaire. See also the XML or JSON format. Immunization.questionnaire - FHIR v0.4.0                           div.fhir-code-form { background-color: Lemonchiffon; border-bottom: 1px solid #778899; border-right: 1px solid #778899; padding: 10px 10px 0px 10px; margin: 0px 0px 0px 0px; position: fixed; width: 520px; top: 0; left: 0; opacity: 1.0; z-order: 50; } div.fhir-code-form,div.fhir-reference-form { background-color: Lemonchiffon; border-bottom: 1px solid #778899; border-right: 1px solid #778899; padding: 10px 10px 0px 10px; margin: 0px 0px 0px 0px; position: fixed; width: 520px; top: 0; left: 0; opacity: 1.0; z-order: 50; } .combo {position:relative;width:310px;text-align:left;padding:0;margin:0;} .combo * {padding:0;margin:0;} .combo label {display:block;float:left;width:92px;text-align:right;} .combo input {width:300px; height:1.5em;z-index:50;} .combo ul {padding:1px;border:2px solid #ccc;width: 600px;background-color:#fff;position:absolute;left:3px;top:1.8em;display:none;z-index:51;} .combo li {display:block; width: 100%;} Form Development Version FHIR Home Documentation Implementation Resources Clinical Administrative Infrastructure Financial Home Clinical Immunization Generated Questionnaire This is an example form generated from the questionnaire. See also the XML or JSON format Immunization event information Immunization Immunization.id Immunization.id.value Logical id of this artefact Immunization.id 1 Metadata about the resource Immunization.meta Immunization.meta 1 Immunization.implicitRules Immunization.implicitRules.value A set of rules under which this content was created Immunization.implicitRules 1 Immunization.language Immunization.language.value language Immunization.language 1 Text summary of the resource, for human interpretation Immunization.text Immunization.text 1 Contained, inline Resources Immunization.contained Immunization.contained 1 Business identifier Immunization.identifier Immunization.identifier.label label: Immunization.identifier.system system: Immunization.identifier.value value: Immunization.identifier 1 Immunization.date Immunization.date.value Vaccination administration date Immunization.date 1 Vaccine product administered Immunization.vaccineType Immunization.vaccineType.coding code: Immunization.vaccineType.text text: Immunization.vaccineType 1 Immunization.patient Immunization.patient.value Who was immunized? Edit Immunization.patient 1 Immunization.wasNotGiven Immunization.wasNotGiven.value Was immunization given? Yes No Immunization.wasNotGiven 1 Immunization.reported Immunization.reported.value Is this a self-reported record? Yes No Immunization.reported 1 Immunization.performer Immunization.performer.value Who administered vaccine? Edit Immunization.performer 1 Immunization.requester Immunization.requester.value Who ordered vaccination? Edit Immunization.requester 1 Immunization.encounter Immunization.encounter.value Encounter administered as part of Edit Immunization.encounter 1 Immunization.manufacturer Immunization.manufacturer.value Vaccine manufacturer Edit Immunization.manufacturer 1 Immunization.location Immunization.location.value Where did vaccination occur? Edit Immunization.location 1 Immunization.lotNumber Immunization.lotNumber.value Vaccine lot number Immunization.lotNumber 1 Immunization.expirationDate Immunization.expirationDate.value Vaccine expiration date Immunization.expirationDate 1 Body site vaccine was administered Immunization.site Immunization.site.coding code: Immunization.site.text text: Immunization.site 1 How vaccine entered body Immunization.route Immunization.route.coding code: Immunization.route.text text: Immunization.route 1 Amount of vaccine administered Immunization.doseQuantity Immunization.doseQuantity.comparator comp: Immunization.doseQuantity.value value: Immunization.doseQuantity.units units: Immunization.doseQuantity.code coded units: Immunization.doseQuantity.system units system: Immunization.doseQuantity 1 Administration / non-administration reasons Immunization.explanation Immunization.explanation.id Immunization.explanation.id.value xml:id (or equivalent in JSON) Immunization.explanation.id 1 Why immunization occurred Immunization.explanation.reason Immunization.explanation.reason.coding code: Immunization.explanation.reason.text text: Immunization.explanation.reason 1 Why immunization did not occur Immunization.explanation.reasonNotGiven Immunization.explanation.reasonNotGiven.coding code: Immunization.explanation.reasonNotGiven.text text: Immunization.explanation.reasonNotGiven 1 Immunization.explanation 1 Details of a reaction that follows immunization Immunization.reaction Immunization.reaction.id Immunization.reaction.id.value xml:id (or equivalent in JSON) Immunization.reaction.id 1 Immunization.reaction.date Immunization.reaction.date.value When did reaction start? Immunization.reaction.date 1 Immunization.reaction.detail Immunization.reaction.detail.value Additional information on reaction Edit Immunization.reaction.detail 1 Immunization.reaction.reported Immunization.reaction.reported.value Was reaction self-reported? Yes No Immunization.reaction.reported 1 Immunization.reaction 1 What protocol was followed Immunization.vaccinationProtocol Immunization.vaccinationProtocol.id Immunization.vaccinationProtocol.id.value xml:id (or equivalent in JSON) Immunization.vaccinationProtocol.id 1 Immunization.vaccinationProtocol.doseSequence Immunization.vaccinationProtocol.doseSequence.value What dose number within series? Immunization.vaccinationProtocol.doseSequence 1 Immunization.vaccinationProtocol.description Immunization.vaccinationProtocol.description.value Details of vaccine protocol Immunization.vaccinationProtocol.description 1 Immunization.vaccinationProtocol.authority Immunization.vaccinationProtocol.authority.value Who is responsible for protocol Edit Immunization.vaccinationProtocol.authority 1 Immunization.vaccinationProtocol.series Immunization.vaccinationProtocol.series.value Name of vaccine series Immunization.vaccinationProtocol.series 1 Immunization.vaccinationProtocol.seriesDoses Immunization.vaccinationProtocol.seriesDoses.value Recommended number of doses for immunity Immunization.vaccinationProtocol.seriesDoses 1 Disease immunized against Immunization.vaccinationProtocol.doseTarget Immunization.vaccinationProtocol.doseTarget.coding code: Immunization.vaccinationProtocol.doseTarget.text text: Immunization.vaccinationProtocol.doseTarget 1 Does dose count towards immunity? Immunization.vaccinationProtocol.doseStatus Immunization.vaccinationProtocol.doseStatus.coding code: Immunization.vaccinationProtocol.doseStatus.text text: Immunization.vaccinationProtocol.doseStatus 1 Why does does count/not count? Immunization.vaccinationProtocol.doseStatusReason Immunization.vaccinationProtocol.doseStatusReason.coding code: Immunization.vaccinationProtocol.doseStatusReason.text text: Immunization.vaccinationProtocol.doseStatusReason 1 Immunization.vaccinationProtocol 1 Immunization 1 Save as Draft Save as Complete © HL7.org 2011+. FHIR DSTU (v0.4.0-4902) generated on Fri, Mar 27, 2015 00:20+1100. Links: What's a DSTU? | Version History | Specification Map | Compare to DSTU1 | | Propose a change   © HL7.org 2011+. FHIR DSTU (v0.4.0-4902) generated on Fri, Mar 27, 2015 00:20+1100. Links: What's a DSTU? | Version History | Specification Map | Compare to DSTU1 | | Propose a change