Release 5 Draft Ballot

This page is part of the FHIR Specification (v4.6.0: R5 Draft Ballot). 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

Consent-example.xml

Community Based Collaborative Care Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Patient

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

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General Consent Example (id = "consent-example-basic")

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

<Consent xmlns="http://hl7.org/fhir">
  <id value="consent-example-basic"/> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p> 
        Authorize Normal access for Treatment
      </p> 
      <p> 
      Patient &quot;Peter James Chalmers (&quot;Jim&quot;)&quot; wishes to have all of
         the PHI collected at the Burgers University Medical Center available for normal treatment
         use.
      </p> 
    </div> 
  </text> 
  <status value="active"/> 
  <scope> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/consentscope"/> 
      <code value="patient-privacy"/> 
    </coding> 
  </scope> 
  <category> 
    <coding> 
      <system value="http://loinc.org"/> 
      <code value="59284-0"/> 
    </coding> 
  </category> 
  <subject> 
    <reference value="Patient/Example"/> 
    <display value="Peter James Chalmers"/> 
  </subject> 
  <dateTime value="2018-12-28"/> 
  <controller> 
    <reference value="Organization/f001"/> 
  </controller> 
  <!--   the terms of the consent as signed by the patient in ink   -->
  <sourceAttachment> 
    <title value="The terms of the consent in lawyer speak."/> 
    <!--   likely use url pointer to common text   -->
  </sourceAttachment> 
  <!--   this is plain out opt-in with no exceptions   -->
  <policyRule> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/> 
      <code value="INFA"/> 
    </coding> 
  </policyRule> 
  <provision> 
    <type value="deny"/> 
    <provision> 
      <type value="permit"/> 
      <!--   bound by a timeframe between 1964 and 2019 - consent.applies   -->
      <period> 
        <start value="1964-01-01"/> 
        <end value="2019-01-01"/> 
      </period> 
    </provision> 
  </provision> 
</Consent> 

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.