Release 5 Preview #3

This page is part of the FHIR Specification (v4.5.0: R5 Preview #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 . Page versions: R5 R4B R4 R3

Questionnaireresponse-example-ussg-fht-answers.json

FHIR Infrastructure Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Device, Encounter, Patient, Practitioner, RelatedPerson

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

Example response to the SDC-LOINC USSG Family History questionnaire

{
  "resourceType": "QuestionnaireResponse",
  "id": "ussg-fht-answers",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><div>todo</div></div>"
  },
  "questionnaire": "http://hl7.org/fhir/Questionnaire/ussg-fht",
  "status": "in-progress",
  "subject": {
    "reference": "http://hl7.org/fhir/Patient/proband",
    "type": "Patient"
  },
  "authored": "2008-01-17",
  "item": [
    {
      "linkId": "0",
      "item": [
        {
          "linkId": "0.1",
          "text": "Date Done",
          "answer": [
            {
              "valueDate": "2008-01-17"
            }
          ]
        }
      ]
    },
    {
      "linkId": "1",
      "definition": "http://loinc.org/fhir/DataElement/54126-8",
      "text": "Your health information",
      "item": [
        {
          "linkId": "1.1",
          "item": [
            {
              "linkId": "1.1.1",
              "definition": "http://loinc.org/fhir/DataElement/54125-0",
              "text": "Name",
              "answer": [
                {
                  "valueString": "Annie Proband"
                }
              ]
            },
            {
              "linkId": "1.1.2",
              "definition": "http://loinc.org/fhir/DataElement/54131-8",
              "text": "Gender",
              "answer": [
                {
                  "valueCoding": {
                    "system": "http://loinc.org",
                    "code": "LA3-6",
                    "display": "Female"
                  }
                }
              ]
            },
            {
              "linkId": "1.1.3",
              "definition": "http://loinc.org/fhir/DataElement/21112-8",
              "text": "Date of Birth",
              "answer": [
                {
                  "valueDate": "1966-04-04"
                }
              ]
            },
            {
              "linkId": "1.1.4",
              "definition": "http://loinc.org/fhir/DataElement/54132-6",
              "text": "Were you born a twin?",
              "answer": [
                {
                  "valueCoding": {
                    "system": "http://loinc.org",
                    "code": "LA32-8",
                    "display": "No"
                  }
                }
              ]
            },
            {
              "linkId": "1.1.5",
              "definition": "http://loinc.org/fhir/DataElement/54128-4",
              "text": "Were you adopted?",
              "answer": [
                {
                  "valueCoding": {
                    "system": "http://loinc.org",
                    "code": "LA32-8",
                    "display": "No"
                  }
                }
              ]
            },
            {
              "linkId": "1.1.6",
              "definition": "http://loinc.org/fhir/DataElement/54135-9",
              "text": "Are your parents related to each other in any way other than marriage?",
              "answer": [
                {
                  "valueCoding": {
                    "system": "http://loinc.org",
                    "code": "LA32-8",
                    "display": "No"
                  }
                }
              ]
            },
            {
              "linkId": "1.1.7",
              "definition": "http://loinc.org/fhir/DataElement/8302-2",
              "text": "Height",
              "answer": [
                {
                  "valueDecimal": 63,
                  "item": [
                    {
                      "linkId": "1.1.7.1",
                      "item": [
                        {
                          "linkId": "1.1.7.1.1",
                          "text": "Units",
                          "answer": [
                            {
                              "valueCoding": {
                                "system": "http://unitsofmeasure.org",
                                "code": "[in_i]",
                                "display": "inches"
                              }
                            }
                          ]
                        }
                      ]
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "1.1.8",
              "definition": "http://loinc.org/fhir/DataElement/29463-7",
              "text": "Weight",
              "answer": [
                {
                  "valueDecimal": 127,
                  "item": [
                    {
                      "linkId": "1.1.8.1",
                      "item": [
                        {
                          "linkId": "1.1.8.1.1",
                          "text": "Units",
                          "answer": [
                            {
                              "valueCoding": {
                                "system": "http://unitsofmeasure.org",
                                "code": "[lb_av]",
                                "display": "pounds"
                              }
                            }
                          ]
                        }
                      ]
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "1.1.9",
              "definition": "http://loinc.org/fhir/DataElement/39156-5",
              "text": "Body mass index (BMI) [Ratio]",
              "answer": [
                {
                  "valueDecimal": 22.5
                }
              ]
            },
            {
              "linkId": "1.1.10",
              "definition": "http://loinc.org/fhir/DataElement/54134-2",
              "text": "Race",
              "answer": [
                {
                  "valueCoding": {
                    "system": "http://loinc.org",
                    "code": "LA4457-3",
                    "display": "White"
                  }
                }
              ]
            },
            {
              "linkId": "1.1.11",
              "definition": "http://loinc.org/fhir/DataElement/54133-4",
              "text": "Ethnicity",
              "answer": [
                {
                  "valueCoding": {
                    "system": "http://loinc.org",
                    "code": "LA10602-3",
                    "display": "-- Mexican"
                  }
                },
                {
                  "valueCoding": {
                    "system": "http://loinc.org",
                    "code": "LA10606-4",
                    "display": "-- South American"
                  }
                }
              ]
            }
          ]
        }
      ]
    },
    {
      "linkId": "2",
      "definition": "http://loinc.org/fhir/DataElement/54114-4",
      "text": "Family member health information",
      "item": [
        {
          "linkId": "2.1",
          "item": [
            {
              "linkId": "2.1.1.1",
              "definition": "http://loinc.org/fhir/DataElement/54136-7",
              "text": "Relationship to you",
              "answer": [
                {
                  "valueCoding": {
                    "system": "http://loinc.org",
                    "code": "LA10405-1",
                    "display": "Daughter"
                  }
                }
              ]
            },
            {
              "linkId": "2.1.1.2",
              "definition": "http://loinc.org/fhir/DataElement/54138-3",
              "text": "Name",
              "answer": [
                {
                  "valueString": "Susan"
                }
              ]
            },
            {
              "linkId": "2.1.1.3",
              "definition": "http://loinc.org/fhir/DataElement/54123-5",
              "text": "Gender",
              "answer": [
                {
                  "valueCoding": {
                    "system": "http://loinc.org",
                    "code": "LA3-6",
                    "display": "Female"
                  }
                }
              ]
            },
            {
              "linkId": "2.1.1.4",
              "definition": "http://loinc.org/fhir/DataElement/54139-1",
              "text": "Living?",
              "answer": [
                {
                  "valueCoding": {
                    "system": "http://loinc.org",
                    "code": "LA33-6",
                    "display": "Yes"
                  },
                  "item": [
                    {
                      "linkId": "2.1.1.4.2",
                      "item": [
                        {
                          "linkId": "2.1.1.4.2.2",
                          "definition": "http://loinc.org/fhir/DataElement/54141-7",
                          "text": "Age",
                          "answer": [
                            {
                              "valueDecimal": 17
                            }
                          ]
                        }
                      ]
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "2.1.1.5",
              "definition": "http://loinc.org/fhir/DataElement/54121-9",
              "text": "Was this person born a twin?",
              "answer": [
                {
                  "valueCoding": {
                    "system": "http://loinc.org",
                    "code": "LA32-8",
                    "display": "No"
                  }
                }
              ]
            },
            {
              "linkId": "2.1.1.6",
              "definition": "http://loinc.org/fhir/DataElement/54122-7",
              "text": "Was this person adopted?",
              "answer": [
                {
                  "valueCoding": {
                    "system": "http://loinc.org",
                    "code": "LA32-8",
                    "display": "No"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.1",
          "item": [
            {
              "linkId": "2.1.1",
              "item": [
                {
                  "linkId": "2.1.1.1",
                  "definition": "http://loinc.org/fhir/DataElement/54136-7",
                  "text": "Relationship to you",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10415-0",
                        "display": "Brother"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.2",
                  "definition": "http://loinc.org/fhir/DataElement/54138-3",
                  "text": "Name",
                  "answer": [
                    {
                      "valueString": "Brian"
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.3",
                  "definition": "http://loinc.org/fhir/DataElement/54123-5",
                  "text": "Gender",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA2-8",
                        "display": "Male"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.4",
                  "definition": "http://loinc.org/fhir/DataElement/54139-1",
                  "text": "Living?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA33-6",
                        "display": "Yes"
                      },
                      "item": [
                        {
                          "linkId": "2.1.1.4.2",
                          "item": [
                            {
                              "linkId": "2.1.1.4.2.2",
                              "definition": "http://loinc.org/fhir/DataElement/54141-7",
                              "text": "Age",
                              "answer": [
                                {
                                  "valueDecimal": 32
                                }
                              ]
                            }
                          ]
                        }
                      ]
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.5",
                  "definition": "http://loinc.org/fhir/DataElement/54121-9",
                  "text": "Was this person born a twin?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.6",
                  "definition": "http://loinc.org/fhir/DataElement/54122-7",
                  "text": "Was this person adopted?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "2.1.2",
              "text": "This family member's history of disease",
              "item": [
                {
                  "linkId": "2.1.2.1",
                  "text": "Disease or Condition",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10550-4",
                        "display": "-- Other Cancer"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.2.2",
                  "text": "Age at Diagnosis",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10397-0",
                        "display": "30-39"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.1",
          "item": [
            {
              "linkId": "2.1.1",
              "item": [
                {
                  "linkId": "2.1.1.1",
                  "definition": "http://loinc.org/fhir/DataElement/54136-7",
                  "text": "Relationship to you",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10418-4",
                        "display": "Sister"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.2",
                  "definition": "http://loinc.org/fhir/DataElement/54138-3",
                  "text": "Name",
                  "answer": [
                    {
                      "valueString": "Janet"
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.3",
                  "definition": "http://loinc.org/fhir/DataElement/54123-5",
                  "text": "Gender",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA3-6",
                        "display": "Female"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.4",
                  "definition": "http://loinc.org/fhir/DataElement/54139-1",
                  "text": "Living?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA33-6",
                        "display": "Yes"
                      },
                      "item": [
                        {
                          "linkId": "2.1.1.4.2",
                          "item": [
                            {
                              "linkId": "2.1.1.4.2.2",
                              "definition": "http://loinc.org/fhir/DataElement/54141-7",
                              "text": "Age",
                              "answer": [
                                {
                                  "valueDecimal": 36
                                }
                              ]
                            }
                          ]
                        }
                      ]
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.5",
                  "definition": "http://loinc.org/fhir/DataElement/54121-9",
                  "text": "Was this person born a twin?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.6",
                  "definition": "http://loinc.org/fhir/DataElement/54122-7",
                  "text": "Was this person adopted?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "2.1.2",
              "text": "This family member's history of disease",
              "item": [
                {
                  "linkId": "2.1.2.1",
                  "text": "Disease or Condition",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10536-3",
                        "display": "-- Breast Cancer"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.2.2",
                  "text": "Age at Diagnosis",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10397-0",
                        "display": "30-39"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.1",
          "item": [
            {
              "linkId": "2.1.1",
              "item": [
                {
                  "linkId": "2.1.1.1",
                  "definition": "http://loinc.org/fhir/DataElement/54136-7",
                  "text": "Relationship to you",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10419-2",
                        "display": "Nephew"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.2",
                  "definition": "http://loinc.org/fhir/DataElement/54138-3",
                  "text": "Name",
                  "answer": [
                    {
                      "valueString": "Ian"
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.3",
                  "definition": "http://loinc.org/fhir/DataElement/54123-5",
                  "text": "Gender",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA2-8",
                        "display": "Male"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.4",
                  "definition": "http://loinc.org/fhir/DataElement/54139-1",
                  "text": "Living?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA33-6",
                        "display": "Yes"
                      },
                      "item": [
                        {
                          "linkId": "2.1.1.4.2",
                          "item": [
                            {
                              "linkId": "2.1.1.4.2.2",
                              "definition": "http://loinc.org/fhir/DataElement/54141-7",
                              "text": "Age",
                              "answer": [
                                {
                                  "valueDecimal": 16
                                }
                              ]
                            }
                          ]
                        }
                      ]
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.5",
                  "definition": "http://loinc.org/fhir/DataElement/54121-9",
                  "text": "Was this person born a twin?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.6",
                  "definition": "http://loinc.org/fhir/DataElement/54122-7",
                  "text": "Was this person adopted?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.1",
          "item": [
            {
              "linkId": "2.1.1",
              "item": [
                {
                  "linkId": "2.1.1.1",
                  "definition": "http://loinc.org/fhir/DataElement/54136-7",
                  "text": "Relationship to you",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10420-0",
                        "display": "Niece"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.2",
                  "definition": "http://loinc.org/fhir/DataElement/54138-3",
                  "text": "Name",
                  "answer": [
                    {
                      "valueString": "Helen"
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.3",
                  "definition": "http://loinc.org/fhir/DataElement/54123-5",
                  "text": "Gender",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA3-6",
                        "display": "Female"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.4",
                  "definition": "http://loinc.org/fhir/DataElement/54139-1",
                  "text": "Living?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA33-6",
                        "display": "Yes"
                      },
                      "item": [
                        {
                          "linkId": "2.1.1.4.2",
                          "item": [
                            {
                              "linkId": "2.1.1.4.2.2",
                              "definition": "http://loinc.org/fhir/DataElement/54141-7",
                              "text": "Age",
                              "answer": [
                                {
                                  "valueDecimal": 15
                                }
                              ]
                            }
                          ]
                        }
                      ]
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.5",
                  "definition": "http://loinc.org/fhir/DataElement/54121-9",
                  "text": "Was this person born a twin?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.6",
                  "definition": "http://loinc.org/fhir/DataElement/54122-7",
                  "text": "Was this person adopted?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.1",
          "item": [
            {
              "linkId": "2.1.1",
              "item": [
                {
                  "linkId": "2.1.1.1",
                  "definition": "http://loinc.org/fhir/DataElement/54136-7",
                  "text": "Relationship to you",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10416-8",
                        "display": "Father"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.2",
                  "definition": "http://loinc.org/fhir/DataElement/54138-3",
                  "text": "Name",
                  "answer": [
                    {
                      "valueString": "Donald"
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.3",
                  "definition": "http://loinc.org/fhir/DataElement/54123-5",
                  "text": "Gender",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA2-8",
                        "display": "Male"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.4",
                  "definition": "http://loinc.org/fhir/DataElement/54139-1",
                  "text": "Living?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA33-6",
                        "display": "Yes"
                      },
                      "item": [
                        {
                          "linkId": "2.1.1.4.2",
                          "item": [
                            {
                              "linkId": "2.1.1.4.2.2",
                              "definition": "http://loinc.org/fhir/DataElement/54141-7",
                              "text": "Age",
                              "answer": [
                                {
                                  "valueDecimal": 52
                                }
                              ]
                            }
                          ]
                        }
                      ]
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.5",
                  "definition": "http://loinc.org/fhir/DataElement/54121-9",
                  "text": "Was this person born a twin?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.6",
                  "definition": "http://loinc.org/fhir/DataElement/54122-7",
                  "text": "Was this person adopted?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.1",
          "item": [
            {
              "linkId": "2.1.1",
              "item": [
                {
                  "linkId": "2.1.1.1",
                  "definition": "http://loinc.org/fhir/DataElement/54136-7",
                  "text": "Relationship to you",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10425-9",
                        "display": "Paternal Uncle"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.2",
                  "definition": "http://loinc.org/fhir/DataElement/54138-3",
                  "text": "Name",
                  "answer": [
                    {
                      "valueString": "Eric"
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.3",
                  "definition": "http://loinc.org/fhir/DataElement/54123-5",
                  "text": "Gender",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA2-8",
                        "display": "Male"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.4",
                  "definition": "http://loinc.org/fhir/DataElement/54139-1",
                  "text": "Living?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA33-6",
                        "display": "Yes"
                      },
                      "item": [
                        {
                          "linkId": "2.1.1.4.2",
                          "item": [
                            {
                              "linkId": "2.1.1.4.2.2",
                              "definition": "http://loinc.org/fhir/DataElement/54141-7",
                              "text": "Age",
                              "answer": [
                                {
                                  "valueDecimal": 56
                                }
                              ]
                            }
                          ]
                        }
                      ]
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.5",
                  "definition": "http://loinc.org/fhir/DataElement/54121-9",
                  "text": "Was this person born a twin?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.6",
                  "definition": "http://loinc.org/fhir/DataElement/54122-7",
                  "text": "Was this person adopted?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.1",
          "item": [
            {
              "linkId": "2.1.1",
              "item": [
                {
                  "linkId": "2.1.1.1",
                  "definition": "http://loinc.org/fhir/DataElement/54136-7",
                  "text": "Relationship to you",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10421-8",
                        "display": "Paternal Aunt"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.2",
                  "definition": "http://loinc.org/fhir/DataElement/54138-3",
                  "text": "Name",
                  "answer": [
                    {
                      "valueString": "Fiona"
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.3",
                  "definition": "http://loinc.org/fhir/DataElement/54123-5",
                  "text": "Gender",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA3-6",
                        "display": "Female"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.4",
                  "definition": "http://loinc.org/fhir/DataElement/54139-1",
                  "text": "Living?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA33-6",
                        "display": "Yes"
                      },
                      "item": [
                        {
                          "linkId": "2.1.1.4.2",
                          "item": [
                            {
                              "linkId": "2.1.1.4.2.2",
                              "definition": "http://loinc.org/fhir/DataElement/54141-7",
                              "text": "Age",
                              "answer": [
                                {
                                  "valueDecimal": 57
                                }
                              ]
                            }
                          ]
                        }
                      ]
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.5",
                  "definition": "http://loinc.org/fhir/DataElement/54121-9",
                  "text": "Was this person born a twin?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.6",
                  "definition": "http://loinc.org/fhir/DataElement/54122-7",
                  "text": "Was this person adopted?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "2.1.2",
              "text": "This family member's history of disease",
              "item": [
                {
                  "linkId": "2.1.2.1",
                  "text": "Disease or Condition",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10543-9",
                        "display": "-- Skin Cancer"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.1",
          "item": [
            {
              "linkId": "2.1.1",
              "item": [
                {
                  "linkId": "2.1.1.1",
                  "definition": "http://loinc.org/fhir/DataElement/54136-7",
                  "text": "Relationship to you",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10423-4",
                        "display": "Paternal Grandfather"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.2",
                  "definition": "http://loinc.org/fhir/DataElement/54138-3",
                  "text": "Name",
                  "answer": [
                    {
                      "valueString": "Bob"
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.3",
                  "definition": "http://loinc.org/fhir/DataElement/54123-5",
                  "text": "Gender",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA2-8",
                        "display": "Male"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.4",
                  "definition": "http://loinc.org/fhir/DataElement/54139-1",
                  "text": "Living?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      },
                      "item": [
                        {
                          "linkId": "2.1.1.4.1",
                          "item": [
                            {
                              "linkId": "2.1.1.4.1.1",
                              "definition": "http://loinc.org/fhir/DataElement/54112-8",
                              "text": "Cause of Death",
                              "answer": [
                                {
                                  "valueCoding": {
                                    "system": "http://loinc.org",
                                    "code": "LA10537-1",
                                    "display": "-- Colon Cancer"
                                  }
                                }
                              ]
                            },
                            {
                              "linkId": "2.1.1.4.1.2",
                              "definition": "http://loinc.org/fhir/DataElement/54113-6",
                              "text": "Age at Death",
                              "answer": [
                                {
                                  "valueCoding": {
                                    "system": "http://loinc.org",
                                    "code": "LA10400-2",
                                    "display": "OVER 60"
                                  }
                                }
                              ]
                            }
                          ]
                        }
                      ]
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.5",
                  "definition": "http://loinc.org/fhir/DataElement/54121-9",
                  "text": "Was this person born a twin?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.6",
                  "definition": "http://loinc.org/fhir/DataElement/54122-7",
                  "text": "Was this person adopted?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "2.1.2",
              "text": "This family member's history of disease",
              "item": [
                {
                  "linkId": "2.1.2.1",
                  "text": "Disease or Condition",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10537-1",
                        "display": "-- Colon Cancer"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.2.2",
                  "text": "Age at Diagnosis",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10400-2",
                        "display": "OVER 60"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.1",
          "item": [
            {
              "linkId": "2.1.1",
              "item": [
                {
                  "linkId": "2.1.1.1",
                  "definition": "http://loinc.org/fhir/DataElement/54136-7",
                  "text": "Relationship to you",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10424-2",
                        "display": "Paternal Grandmother"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.2",
                  "definition": "http://loinc.org/fhir/DataElement/54138-3",
                  "text": "Name",
                  "answer": [
                    {
                      "valueString": "Claire"
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.3",
                  "definition": "http://loinc.org/fhir/DataElement/54123-5",
                  "text": "Gender",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA3-6",
                        "display": "Female"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.4",
                  "definition": "http://loinc.org/fhir/DataElement/54139-1",
                  "text": "Living?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      },
                      "item": [
                        {
                          "linkId": "2.1.1.4.1",
                          "item": [
                            {
                              "linkId": "2.1.1.4.1.1",
                              "definition": "http://loinc.org/fhir/DataElement/54112-8",
                              "text": "Cause of Death",
                              "answer": [
                                {
                                  "valueCoding": {
                                    "system": "http://loinc.org",
                                    "code": "LA10589-2",
                                    "display": "-- Other/Unexpected"
                                  },
                                  "item": [
                                    {
                                      "linkId": "2.1.1.4.1.1.1",
                                      "text": "Please specify",
                                      "answer": [
                                        {
                                          "valueString": "Lou Gehrigs"
                                        }
                                      ]
                                    }
                                  ]
                                }
                              ]
                            },
                            {
                              "linkId": "2.1.1.4.1.2",
                              "definition": "http://loinc.org/fhir/DataElement/54113-6",
                              "text": "Age at Death",
                              "answer": [
                                {
                                  "valueCoding": {
                                    "system": "http://loinc.org",
                                    "code": "LA10400-2",
                                    "display": "OVER 60"
                                  }
                                }
                              ]
                            }
                          ]
                        }
                      ]
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.5",
                  "definition": "http://loinc.org/fhir/DataElement/54121-9",
                  "text": "Was this person born a twin?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.6",
                  "definition": "http://loinc.org/fhir/DataElement/54122-7",
                  "text": "Was this person adopted?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.1",
          "item": [
            {
              "linkId": "2.1.1",
              "item": [
                {
                  "linkId": "2.1.1.1",
                  "definition": "http://loinc.org/fhir/DataElement/54136-7",
                  "text": "Relationship to you",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10417-6",
                        "display": "Mother"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.2",
                  "definition": "http://loinc.org/fhir/DataElement/54138-3",
                  "text": "Name",
                  "answer": [
                    {
                      "valueString": "Harriet"
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.3",
                  "definition": "http://loinc.org/fhir/DataElement/54123-5",
                  "text": "Gender",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA3-6",
                        "display": "Female"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.4",
                  "definition": "http://loinc.org/fhir/DataElement/54139-1",
                  "text": "Living?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      },
                      "item": [
                        {
                          "linkId": "2.1.1.4.1",
                          "item": [
                            {
                              "linkId": "2.1.1.4.1.1",
                              "definition": "http://loinc.org/fhir/DataElement/54112-8",
                              "text": "Cause of Death",
                              "answer": [
                                {
                                  "valueCoding": {
                                    "system": "http://loinc.org",
                                    "code": "LA10539-7",
                                    "display": "-- Ovarian Cancer"
                                  }
                                }
                              ]
                            },
                            {
                              "linkId": "2.1.1.4.1.2",
                              "definition": "http://loinc.org/fhir/DataElement/54113-6",
                              "text": "Age at Death",
                              "answer": [
                                {
                                  "valueCoding": {
                                    "system": "http://loinc.org",
                                    "code": "LA10399-6",
                                    "display": "50-59"
                                  }
                                }
                              ]
                            }
                          ]
                        }
                      ]
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.5",
                  "definition": "http://loinc.org/fhir/DataElement/54121-9",
                  "text": "Was this person born a twin?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.6",
                  "definition": "http://loinc.org/fhir/DataElement/54122-7",
                  "text": "Was this person adopted?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "2.1.2",
              "text": "This family member's history of disease",
              "item": [
                {
                  "linkId": "2.1.2.1",
                  "text": "Disease or Condition",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10539-7",
                        "display": "-- Ovarian Cancer"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.2.2",
                  "text": "Age at Diagnosis",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10398-8",
                        "display": "40-49"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.1",
          "item": [
            {
              "linkId": "2.1.1",
              "item": [
                {
                  "linkId": "2.1.1.1",
                  "definition": "http://loinc.org/fhir/DataElement/54136-7",
                  "text": "Relationship to you",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10414-3",
                        "display": "Maternal Uncle"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.2",
                  "definition": "http://loinc.org/fhir/DataElement/54138-3",
                  "text": "Name",
                  "answer": [
                    {
                      "valueString": "Rudy"
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.3",
                  "definition": "http://loinc.org/fhir/DataElement/54123-5",
                  "text": "Gender",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA2-8",
                        "display": "Male"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.4",
                  "definition": "http://loinc.org/fhir/DataElement/54139-1",
                  "text": "Living?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA33-6",
                        "display": "Yes"
                      },
                      "item": [
                        {
                          "linkId": "2.1.1.4.2",
                          "item": [
                            {
                              "linkId": "2.1.1.4.2.2",
                              "definition": "http://loinc.org/fhir/DataElement/54141-7",
                              "text": "Age",
                              "answer": [
                                {
                                  "valueDecimal": 60
                                }
                              ]
                            }
                          ]
                        }
                      ]
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.5",
                  "definition": "http://loinc.org/fhir/DataElement/54121-9",
                  "text": "Was this person born a twin?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.6",
                  "definition": "http://loinc.org/fhir/DataElement/54122-7",
                  "text": "Was this person adopted?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.1",
          "item": [
            {
              "linkId": "2.1.1",
              "item": [
                {
                  "linkId": "2.1.1.1",
                  "definition": "http://loinc.org/fhir/DataElement/54136-7",
                  "text": "Relationship to you",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10410-1",
                        "display": "Maternal Aunt"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.2",
                  "definition": "http://loinc.org/fhir/DataElement/54138-3",
                  "text": "Name",
                  "answer": [
                    {
                      "valueString": "Julie"
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.3",
                  "definition": "http://loinc.org/fhir/DataElement/54123-5",
                  "text": "Gender",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA3-6",
                        "display": "Female"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.4",
                  "definition": "http://loinc.org/fhir/DataElement/54139-1",
                  "text": "Living?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA33-6",
                        "display": "Yes"
                      },
                      "item": [
                        {
                          "linkId": "2.1.1.4.2",
                          "item": [
                            {
                              "linkId": "2.1.1.4.2.2",
                              "definition": "http://loinc.org/fhir/DataElement/54141-7",
                              "text": "Age",
                              "answer": [
                                {
                                  "valueDecimal": 57
                                }
                              ]
                            }
                          ]
                        }
                      ]
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.5",
                  "definition": "http://loinc.org/fhir/DataElement/54121-9",
                  "text": "Was this person born a twin?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.6",
                  "definition": "http://loinc.org/fhir/DataElement/54122-7",
                  "text": "Was this person adopted?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.1",
          "item": [
            {
              "linkId": "2.1.1",
              "item": [
                {
                  "linkId": "2.1.1.1",
                  "definition": "http://loinc.org/fhir/DataElement/54136-7",
                  "text": "Relationship to you",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10412-7",
                        "display": "Maternal Grandfather"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.2",
                  "definition": "http://loinc.org/fhir/DataElement/54138-3",
                  "text": "Name",
                  "answer": [
                    {
                      "valueString": "Ian"
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.3",
                  "definition": "http://loinc.org/fhir/DataElement/54123-5",
                  "text": "Gender",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA2-8",
                        "display": "Male"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.4",
                  "definition": "http://loinc.org/fhir/DataElement/54139-1",
                  "text": "Living?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      },
                      "item": [
                        {
                          "linkId": "2.1.1.4.1",
                          "item": [
                            {
                              "linkId": "2.1.1.4.1.1",
                              "definition": "http://loinc.org/fhir/DataElement/54112-8",
                              "text": "Cause of Death",
                              "answer": [
                                {
                                  "valueCoding": {
                                    "system": "http://loinc.org",
                                    "code": "LA10558-7",
                                    "display": "-- Heart Attack"
                                  }
                                }
                              ]
                            },
                            {
                              "linkId": "2.1.1.4.1.2",
                              "definition": "http://loinc.org/fhir/DataElement/54113-6",
                              "text": "Age at Death",
                              "answer": [
                                {
                                  "valueCoding": {
                                    "system": "http://loinc.org",
                                    "code": "LA10400-2",
                                    "display": "OVER 60"
                                  }
                                }
                              ]
                            }
                          ]
                        }
                      ]
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.5",
                  "definition": "http://loinc.org/fhir/DataElement/54121-9",
                  "text": "Was this person born a twin?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.6",
                  "definition": "http://loinc.org/fhir/DataElement/54122-7",
                  "text": "Was this person adopted?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.1",
          "item": [
            {
              "linkId": "2.1.1",
              "item": [
                {
                  "linkId": "2.1.1.1",
                  "definition": "http://loinc.org/fhir/DataElement/54136-7",
                  "text": "Relationship to you",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10413-5",
                        "display": "Maternal Grandmother"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.2",
                  "definition": "http://loinc.org/fhir/DataElement/54138-3",
                  "text": "Name",
                  "answer": [
                    {
                      "valueString": "Gladys"
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.3",
                  "definition": "http://loinc.org/fhir/DataElement/54123-5",
                  "text": "Gender",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA3-6",
                        "display": "Female"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.4",
                  "definition": "http://loinc.org/fhir/DataElement/54139-1",
                  "text": "Living?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      },
                      "item": [
                        {
                          "linkId": "2.1.1.4.1",
                          "item": [
                            {
                              "linkId": "2.1.1.4.1.1",
                              "definition": "http://loinc.org/fhir/DataElement/54112-8",
                              "text": "Cause of Death",
                              "answer": [
                                {
                                  "valueCoding": {
                                    "system": "http://loinc.org",
                                    "code": "LA10571-0",
                                    "display": "-- Other/Unknown"
                                  }
                                }
                              ]
                            },
                            {
                              "linkId": "2.1.1.4.1.2",
                              "definition": "http://loinc.org/fhir/DataElement/54113-6",
                              "text": "Age at Death",
                              "answer": [
                                {
                                  "valueCoding": {
                                    "system": "http://loinc.org",
                                    "code": "LA10400-2",
                                    "display": "OVER 60"
                                  }
                                }
                              ]
                            }
                          ]
                        }
                      ]
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.5",
                  "definition": "http://loinc.org/fhir/DataElement/54121-9",
                  "text": "Was this person born a twin?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.6",
                  "definition": "http://loinc.org/fhir/DataElement/54122-7",
                  "text": "Was this person adopted?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "2.1.2",
              "text": "This family member's history of disease",
              "item": [
                {
                  "linkId": "2.1.2.1",
                  "text": "Disease or Condition",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10536-3",
                        "display": "-- Breast Cancer"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.2.2",
                  "text": "Age at Diagnosis",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10399-6",
                        "display": "50-59"
                      }
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "2.1.2",
              "text": "This family member's history of disease",
              "item": [
                {
                  "linkId": "2.1.2.1",
                  "text": "Disease or Condition",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10564-5",
                        "display": "-- Asthma"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.2.2",
                  "text": "Age at Diagnosis",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10395-4",
                        "display": "Childhood"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.1",
          "item": [
            {
              "linkId": "2.1.1",
              "item": [
                {
                  "linkId": "2.1.1.1",
                  "definition": "http://loinc.org/fhir/DataElement/54136-7",
                  "text": "Relationship to you",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10411-9",
                        "display": "Maternal Cousin"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.2",
                  "definition": "http://loinc.org/fhir/DataElement/54138-3",
                  "text": "Name",
                  "answer": [
                    {
                      "valueString": "Karren"
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.3",
                  "definition": "http://loinc.org/fhir/DataElement/54123-5",
                  "text": "Gender",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA3-6",
                        "display": "Female"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.4",
                  "definition": "http://loinc.org/fhir/DataElement/54139-1",
                  "text": "Living?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA33-6",
                        "display": "Yes"
                      },
                      "item": [
                        {
                          "linkId": "2.1.1.4.2",
                          "item": [
                            {
                              "linkId": "2.1.1.4.2.2",
                              "definition": "http://loinc.org/fhir/DataElement/54141-7",
                              "text": "Age",
                              "answer": [
                                {
                                  "valueDecimal": 30
                                }
                              ]
                            }
                          ]
                        }
                      ]
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.5",
                  "definition": "http://loinc.org/fhir/DataElement/54121-9",
                  "text": "Was this person born a twin?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.6",
                  "definition": "http://loinc.org/fhir/DataElement/54122-7",
                  "text": "Was this person adopted?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                }
              ]
            },
            {
              "linkId": "2.1.2",
              "text": "This family member's history of disease",
              "item": [
                {
                  "linkId": "2.1.2.1",
                  "text": "Disease or Condition",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10536-3",
                        "display": "-- Breast Cancer"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.2.2",
                  "text": "Age at Diagnosis",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10397-0",
                        "display": "30-39"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "2.1",
          "item": [
            {
              "linkId": "2.1.1",
              "item": [
                {
                  "linkId": "2.1.1.1",
                  "definition": "http://loinc.org/fhir/DataElement/54136-7",
                  "text": "Relationship to you",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA10411-9",
                        "display": "Maternal Cousin"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.2",
                  "definition": "http://loinc.org/fhir/DataElement/54138-3",
                  "text": "Name",
                  "answer": [
                    {
                      "valueString": "Mary"
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.3",
                  "definition": "http://loinc.org/fhir/DataElement/54123-5",
                  "text": "Gender",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA3-6",
                        "display": "Female"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.4",
                  "definition": "http://loinc.org/fhir/DataElement/54139-1",
                  "text": "Living?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA33-6",
                        "display": "Yes"
                      },
                      "item": [
                        {
                          "linkId": "2.1.1.4.2",
                          "item": [
                            {
                              "linkId": "2.1.1.4.2.2",
                              "definition": "http://loinc.org/fhir/DataElement/54141-7",
                              "text": "Age",
                              "answer": [
                                {
                                  "valueDecimal": 31
                                }
                              ]
                            }
                          ]
                        }
                      ]
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.5",
                  "definition": "http://loinc.org/fhir/DataElement/54121-9",
                  "text": "Was this person born a twin?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                },
                {
                  "linkId": "2.1.1.6",
                  "definition": "http://loinc.org/fhir/DataElement/54122-7",
                  "text": "Was this person adopted?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://loinc.org",
                        "code": "LA32-8",
                        "display": "No"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        }
      ]
    }
  ]
}

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.