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 Referralrequest.questionnaire This is an example form generated from the questionnaire. See also the XML or JSON format. Referralrequest.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 ReferralRequest Generated Questionnaire This is an example form generated from the questionnaire. See also the XML or JSON format A request for referral or transfer of care ReferralRequest ReferralRequest.id ReferralRequest.id.value Logical id of this artefact ReferralRequest.id 1 Metadata about the resource ReferralRequest.meta ReferralRequest.meta 1 ReferralRequest.implicitRules ReferralRequest.implicitRules.value A set of rules under which this content was created ReferralRequest.implicitRules 1 ReferralRequest.language ReferralRequest.language.value language ReferralRequest.language 1 Text summary of the resource, for human interpretation ReferralRequest.text ReferralRequest.text 1 Contained, inline Resources ReferralRequest.contained ReferralRequest.contained 1 ReferralRequest.status ReferralRequest.status.value status ReferralRequest.status 1 Identifier of request ReferralRequest.identifier ReferralRequest.identifier.label label: ReferralRequest.identifier.system system: ReferralRequest.identifier.value value: ReferralRequest.identifier 1 Referral/Transition of care request type ReferralRequest.type ReferralRequest.type.coding code: ReferralRequest.type.text text: ReferralRequest.type 1 The clinical specialty (discipline) that the referral is requested for ReferralRequest.specialty ReferralRequest.specialty.coding code: ReferralRequest.specialty.text text: ReferralRequest.specialty 1 Urgency of referral / transfer of care request ReferralRequest.priority ReferralRequest.priority.coding code: ReferralRequest.priority.text text: ReferralRequest.priority 1 ReferralRequest.patient ReferralRequest.patient.value Patient referred to care or transfer Edit ReferralRequest.patient 1 Requester of referral / transfer of care ReferralRequest.requester ReferralRequest.requester._type type ReferralRequest.requester._Practitioner ReferralRequest.requester._Practitioner.value Practitioner Edit ReferralRequest.requester._Practitioner 1 ReferralRequest.requester._Organization ReferralRequest.requester._Organization.value Organization Edit ReferralRequest.requester._Organization 1 ReferralRequest.requester._Patient ReferralRequest.requester._Patient.value Patient Edit ReferralRequest.requester._Patient 1 ReferralRequest.requester 1 Receiver of referral / transfer of care request ReferralRequest.recipient ReferralRequest.recipient._type type ReferralRequest.recipient._Practitioner ReferralRequest.recipient._Practitioner.value Practitioner Edit ReferralRequest.recipient._Practitioner 1 ReferralRequest.recipient._Organization ReferralRequest.recipient._Organization.value Organization Edit ReferralRequest.recipient._Organization 1 ReferralRequest.recipient 1 ReferralRequest.encounter ReferralRequest.encounter.value Encounter Edit ReferralRequest.encounter 1 ReferralRequest.dateSent ReferralRequest.dateSent.value Date referral/transfer of care request is sent ReferralRequest.dateSent 1 Reason for referral / Transfer of care request ReferralRequest.reason ReferralRequest.reason.coding code: ReferralRequest.reason.text text: ReferralRequest.reason 1 ReferralRequest.description ReferralRequest.description.value A textual description of the referral ReferralRequest.description 1 Service(s) requested ReferralRequest.serviceRequested ReferralRequest.serviceRequested.coding code: ReferralRequest.serviceRequested.text text: ReferralRequest.serviceRequested 1 ReferralRequest.supportingInformation ReferralRequest.supportingInformation.value Additonal information to support referral or transfer of care request Edit ReferralRequest.supportingInformation 1 Requested service(s) fulfillment time ReferralRequest.fulfillmentTime ReferralRequest.fulfillmentTime.low start: ReferralRequest.fulfillmentTime.end end: ReferralRequest.fulfillmentTime 1 ReferralRequest 1 Save as Draft Save as Complete © HL7.org 2011+. FHIR DSTU (v0.4.0-4902) generated on Fri, Mar 27, 2015 00:23+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 00:23+1100. Links: What's a DSTU? | Version History | Specification Map | Compare to DSTU1 | | Propose a change