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

Procedurerequest.questionnaire.json

Raw JSON (canonical form)

Generated Questionnaire for ProcedureRequest

{
  "resourceType": "Questionnaire",
  "id": "qs1",
  "contained": [
    {
      "resourceType": "ValueSet",
      "id": "vs2",
      "url": "urn:uuid:3e0cc5ae-7be2-4def-a8e7-28b9eff31080",
      "name": "Type options for ProcedureRequest.bodySite.site[x]",
      "description": "Type options for ProcedureRequest.bodySite.site[x]",
      "status": "active",
      "expansion": {
        "identifier": "urn:uuid:a1d4c797-3110-4578-aaf5-3b0a85033251",
        "timestamp": "2015-03-27T00:22:53+11:00",
        "contains": [
          {
            "system": "http://hl7.org/fhir/data-types",
            "code": "CodeableConcept",
            "display": "CodeableConcept"
          },
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "BodySite",
            "display": "BodySite"
          }
        ]
      }
    },
    {
      "resourceType": "ValueSet",
      "id": "vs3",
      "url": "urn:uuid:ba89e45d-e273-44a8-80f5-3824b074b032",
      "name": "Type options for ProcedureRequest.timing[x]",
      "description": "Type options for ProcedureRequest.timing[x]",
      "status": "active",
      "expansion": {
        "identifier": "urn:uuid:cd309b66-84b2-4334-9bcc-ee88854f2797",
        "timestamp": "2015-03-27T00:22:53+11:00",
        "contains": [
          {
            "system": "http://hl7.org/fhir/data-types",
            "code": "dateTime",
            "display": "dateTime"
          },
          {
            "system": "http://hl7.org/fhir/data-types",
            "code": "Period",
            "display": "Period"
          },
          {
            "system": "http://hl7.org/fhir/data-types",
            "code": "Timing",
            "display": "Timing"
          }
        ]
      }
    },
    {
      "resourceType": "ValueSet",
      "id": "vs4",
      "url": "urn:uuid:96abba0b-f5ac-4586-ae0f-cbf34f2e1f0f",
      "name": "Type options for ProcedureRequest.performer",
      "description": "Type options for ProcedureRequest.performer",
      "status": "active",
      "expansion": {
        "identifier": "urn:uuid:78dffee6-77d7-47df-9d24-a756c98eb626",
        "timestamp": "2015-03-27T00:22:53+11:00",
        "contains": [
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "Practitioner",
            "display": "Practitioner"
          },
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "Organization",
            "display": "Organization"
          },
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "Patient",
            "display": "Patient"
          },
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "RelatedPerson",
            "display": "RelatedPerson"
          }
        ]
      }
    },
    {
      "resourceType": "ValueSet",
      "id": "vs5",
      "url": "urn:uuid:65ebcab4-053a-4201-9ba0-c0853a0df2ac",
      "name": "Type options for ProcedureRequest.asNeeded[x]",
      "description": "Type options for ProcedureRequest.asNeeded[x]",
      "status": "active",
      "expansion": {
        "identifier": "urn:uuid:e56ac70b-bf07-4874-8e12-556e145c76f3",
        "timestamp": "2015-03-27T00:22:53+11:00",
        "contains": [
          {
            "system": "http://hl7.org/fhir/data-types",
            "code": "boolean",
            "display": "boolean"
          },
          {
            "system": "http://hl7.org/fhir/data-types",
            "code": "CodeableConcept",
            "display": "CodeableConcept"
          }
        ]
      }
    },
    {
      "resourceType": "ValueSet",
      "id": "vs6",
      "url": "urn:uuid:d2f4010c-a067-44a1-ac66-9c215a0db7ca",
      "name": "Type options for ProcedureRequest.orderer",
      "description": "Type options for ProcedureRequest.orderer",
      "status": "active",
      "expansion": {
        "identifier": "urn:uuid:5b627856-c04c-4fb1-bd81-332238f48a16",
        "timestamp": "2015-03-27T00:22:53+11:00",
        "contains": [
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "Practitioner",
            "display": "Practitioner"
          },
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "Patient",
            "display": "Patient"
          },
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "RelatedPerson",
            "display": "RelatedPerson"
          },
          {
            "system": "http://hl7.org/fhir/resource-types",
            "code": "Device",
            "display": "Device"
          }
        ]
      }
    }
  ],
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986"
    }
  ],
  "status": "draft",
  "date": "2015-03-27T00:13:00+11:00",
  "publisher": "HL7 FHIR Project (Patient Care)",
  "group": {
    "extension": [
      {
        "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
        "valueString": "A request for a procedure to be performed. May be a proposal or an order."
      }
    ],
    "linkId": "ProcedureRequest",
    "title": "A request for a procedure to be performed",
    "required": true,
    "repeats": false,
    "group": [
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "The logical id of the resource, as used in the url for the resoure. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Bundles always have an id, though it is usually a generated UUID."
          },
          {
            "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
            "valueString": "string"
          }
        ],
        "linkId": "ProcedureRequest.id",
        "required": false,
        "repeats": true,
        "question": [
          {
            "linkId": "ProcedureRequest.id.value",
            "text": "Logical id of this artefact",
            "type": "string",
            "required": false,
            "repeats": false
          }
        ]
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource."
          }
        ],
        "linkId": "ProcedureRequest.meta",
        "text": "Metadata about the resource",
        "required": false,
        "repeats": true
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible."
          },
          {
            "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
            "valueString": "uri"
          }
        ],
        "linkId": "ProcedureRequest.implicitRules",
        "required": false,
        "repeats": true,
        "question": [
          {
            "linkId": "ProcedureRequest.implicitRules.value",
            "text": "A set of rules under which this content was created",
            "type": "string",
            "required": false,
            "repeats": false
          }
        ]
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource\n\nNot all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."
          },
          {
            "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
            "valueString": "code"
          }
        ],
        "linkId": "ProcedureRequest.language",
        "required": false,
        "repeats": true,
        "question": [
          {
            "linkId": "ProcedureRequest.language.value",
            "text": "language",
            "type": "choice",
            "required": false,
            "repeats": false
          }
        ]
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative."
          }
        ],
        "linkId": "ProcedureRequest.text",
        "text": "Text summary of the resource, for human interpretation",
        "required": false,
        "repeats": true
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again."
          }
        ],
        "linkId": "ProcedureRequest.contained",
        "text": "Contained, inline Resources",
        "required": false,
        "repeats": true
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "Identifiers assigned to this order by the order or by the receiver."
          },
          {
            "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
            "valueString": "Identifier"
          }
        ],
        "linkId": "ProcedureRequest.identifier",
        "text": "Identifier",
        "required": false,
        "repeats": true,
        "question": [
          {
            "linkId": "ProcedureRequest.identifier.label",
            "text": "label:",
            "type": "string",
            "required": false,
            "repeats": false
          },
          {
            "linkId": "ProcedureRequest.identifier.system",
            "text": "system:",
            "type": "string",
            "required": false,
            "repeats": false
          },
          {
            "linkId": "ProcedureRequest.identifier.value",
            "text": "value:",
            "type": "string",
            "required": false,
            "repeats": false
          }
        ]
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "The patient who will receive the procedure."
          },
          {
            "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
            "valueString": "Reference"
          }
        ],
        "linkId": "ProcedureRequest.subject",
        "required": true,
        "repeats": true,
        "question": [
          {
            "extension": [
              {
                "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#reference",
                "valueString": "/Patient?subject=$subj&patient=$subj&encounter=$encounter"
              }
            ],
            "linkId": "ProcedureRequest.subject.value",
            "text": "Subject",
            "type": "reference",
            "required": false,
            "repeats": false
          }
        ]
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "The specific procedure that is ordered. Use text if the exact nature of the procedure can't be coded."
          },
          {
            "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
            "valueString": "CodeableConcept"
          }
        ],
        "linkId": "ProcedureRequest.type",
        "text": "Procedure Type",
        "required": true,
        "repeats": true,
        "question": [
          {
            "linkId": "ProcedureRequest.type.coding",
            "text": "code:",
            "type": "open-choice",
            "required": false,
            "repeats": false
          },
          {
            "linkId": "ProcedureRequest.type.text",
            "text": "text:",
            "type": "string",
            "required": false,
            "repeats": false
          }
        ]
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "Indicates the sites on the subject's body where the procedure should be performed ( i.e. the target sites)."
          }
        ],
        "linkId": "ProcedureRequest.bodySite",
        "title": "Target body sites",
        "text": "Only used if not implicit in code found in ProcedureRequest.type.",
        "required": false,
        "repeats": true,
        "group": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
                "valueString": "unique id for the element within a resource (for internal references)."
              },
              {
                "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
                "valueString": "string"
              }
            ],
            "linkId": "ProcedureRequest.bodySite.id",
            "required": false,
            "repeats": true,
            "question": [
              {
                "linkId": "ProcedureRequest.bodySite.id.value",
                "text": "xml:id (or equivalent in JSON)",
                "type": "string",
                "required": false,
                "repeats": false
              }
            ]
          },
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
                "valueString": "Indicates the site on the subject's body where the procedure should be performed ( i.e. the target sites). Only used if not implicit in code found in ProcedureRequest.type."
              }
            ],
            "linkId": "ProcedureRequest.bodySite.site[x]",
            "text": "Target body site",
            "required": true,
            "repeats": true,
            "question": [
              {
                "linkId": "ProcedureRequest.bodySite.site[x]._type",
                "text": "type",
                "type": "choice",
                "required": false,
                "repeats": false,
                "options": {
                  "reference": "#vs2"
                },
                "group": [
                  {
                    "extension": [
                      {
                        "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
                        "valueString": "CodeableConcept"
                      }
                    ],
                    "linkId": "ProcedureRequest.bodySite.site[x]._CodeableConcept",
                    "text": "CodeableConcept",
                    "question": [
                      {
                        "linkId": "ProcedureRequest.bodySite.site[x]._CodeableConcept.coding",
                        "text": "code:",
                        "type": "open-choice",
                        "required": false,
                        "repeats": false
                      },
                      {
                        "linkId": "ProcedureRequest.bodySite.site[x]._CodeableConcept.text",
                        "text": "text:",
                        "type": "string",
                        "required": false,
                        "repeats": false
                      }
                    ]
                  },
                  {
                    "extension": [
                      {
                        "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
                        "valueString": "Reference"
                      }
                    ],
                    "linkId": "ProcedureRequest.bodySite.site[x]._BodySite",
                    "question": [
                      {
                        "extension": [
                          {
                            "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#reference",
                            "valueString": "/BodySite?subject=$subj&patient=$subj&encounter=$encounter"
                          }
                        ],
                        "linkId": "ProcedureRequest.bodySite.site[x]._BodySite.value",
                        "text": "BodySite",
                        "type": "reference",
                        "required": false,
                        "repeats": false
                      }
                    ]
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "The reason why the procedure is proposed or ordered. This procedure request may be motivated by a Condition for instance."
          },
          {
            "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
            "valueString": "CodeableConcept"
          }
        ],
        "linkId": "ProcedureRequest.indication",
        "text": "Indication",
        "required": false,
        "repeats": true,
        "question": [
          {
            "linkId": "ProcedureRequest.indication.coding",
            "text": "code:",
            "type": "open-choice",
            "required": false,
            "repeats": false
          },
          {
            "linkId": "ProcedureRequest.indication.text",
            "text": "text:",
            "type": "string",
            "required": false,
            "repeats": false
          }
        ]
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "The timing schedule for the proposed or ordered procedure. The Schedule data type allows many different expressions, for example. \"Every 8 hours\"; \"Three times a day\"; \"1/2 an hour before breakfast for 10 days from 23-Dec 2011:\"; \"15 Oct 2013, 17 Oct 2013 and 1 Nov 2013\"."
          }
        ],
        "linkId": "ProcedureRequest.timing[x]",
        "text": "Procedure timing schedule",
        "required": false,
        "repeats": true,
        "question": [
          {
            "linkId": "ProcedureRequest.timing[x]._type",
            "text": "type",
            "type": "choice",
            "required": false,
            "repeats": false,
            "options": {
              "reference": "#vs3"
            },
            "group": [
              {
                "extension": [
                  {
                    "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
                    "valueString": "datetime"
                  }
                ],
                "linkId": "ProcedureRequest.timing[x]._dateTime",
                "question": [
                  {
                    "linkId": "ProcedureRequest.timing[x]._dateTime.value",
                    "text": "dateTime",
                    "type": "dateTime",
                    "required": false,
                    "repeats": false
                  }
                ]
              },
              {
                "extension": [
                  {
                    "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
                    "valueString": "Period"
                  }
                ],
                "linkId": "ProcedureRequest.timing[x]._Period",
                "text": "Period",
                "question": [
                  {
                    "linkId": "ProcedureRequest.timing[x]._Period.low",
                    "text": "start:",
                    "type": "dateTime",
                    "required": false,
                    "repeats": false
                  },
                  {
                    "linkId": "ProcedureRequest.timing[x]._Period.end",
                    "text": "end:",
                    "type": "dateTime",
                    "required": false,
                    "repeats": false
                  }
                ]
              },
              {
                "extension": [
                  {
                    "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
                    "valueString": "Schedule"
                  }
                ],
                "linkId": "ProcedureRequest.timing[x]._Timing",
                "text": "Timing"
              }
            ]
          }
        ]
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "The encounter within which the procedure proposal or request was created."
          },
          {
            "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
            "valueString": "Reference"
          }
        ],
        "linkId": "ProcedureRequest.encounter",
        "required": false,
        "repeats": true,
        "question": [
          {
            "extension": [
              {
                "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#reference",
                "valueString": "/Encounter?subject=$subj&patient=$subj&encounter=$encounter"
              }
            ],
            "linkId": "ProcedureRequest.encounter.value",
            "text": "Encounter",
            "type": "reference",
            "required": false,
            "repeats": false
          }
        ]
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "E.g. surgeon, anaethetist, endoscopist."
          }
        ],
        "linkId": "ProcedureRequest.performer",
        "text": "Performer",
        "required": false,
        "repeats": true,
        "question": [
          {
            "linkId": "ProcedureRequest.performer._type",
            "text": "type",
            "type": "choice",
            "required": false,
            "repeats": false,
            "options": {
              "reference": "#vs4"
            },
            "group": [
              {
                "extension": [
                  {
                    "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
                    "valueString": "Reference"
                  }
                ],
                "linkId": "ProcedureRequest.performer._Practitioner",
                "question": [
                  {
                    "extension": [
                      {
                        "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#reference",
                        "valueString": "/Practitioner?subject=$subj&patient=$subj&encounter=$encounter"
                      }
                    ],
                    "linkId": "ProcedureRequest.performer._Practitioner.value",
                    "text": "Practitioner",
                    "type": "reference",
                    "required": false,
                    "repeats": false
                  }
                ]
              },
              {
                "extension": [
                  {
                    "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
                    "valueString": "Reference"
                  }
                ],
                "linkId": "ProcedureRequest.performer._Organization",
                "question": [
                  {
                    "extension": [
                      {
                        "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#reference",
                        "valueString": "/Organization?subject=$subj&patient=$subj&encounter=$encounter"
                      }
                    ],
                    "linkId": "ProcedureRequest.performer._Organization.value",
                    "text": "Organization",
                    "type": "reference",
                    "required": false,
                    "repeats": false
                  }
                ]
              },
              {
                "extension": [
                  {
                    "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
                    "valueString": "Reference"
                  }
                ],
                "linkId": "ProcedureRequest.performer._Patient",
                "question": [
                  {
                    "extension": [
                      {
                        "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#reference",
                        "valueString": "/Patient?subject=$subj&patient=$subj&encounter=$encounter"
                      }
                    ],
                    "linkId": "ProcedureRequest.performer._Patient.value",
                    "text": "Patient",
                    "type": "reference",
                    "required": false,
                    "repeats": false
                  }
                ]
              },
              {
                "extension": [
                  {
                    "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
                    "valueString": "Reference"
                  }
                ],
                "linkId": "ProcedureRequest.performer._RelatedPerson",
                "question": [
                  {
                    "extension": [
                      {
                        "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#reference",
                        "valueString": "/RelatedPerson?subject=$subj&patient=$subj&encounter=$encounter"
                      }
                    ],
                    "linkId": "ProcedureRequest.performer._RelatedPerson.value",
                    "text": "RelatedPerson",
                    "type": "reference",
                    "required": false,
                    "repeats": false
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "The status of the order."
          },
          {
            "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
            "valueString": "code"
          }
        ],
        "linkId": "ProcedureRequest.status",
        "required": false,
        "repeats": true,
        "question": [
          {
            "linkId": "ProcedureRequest.status.value",
            "text": "status",
            "type": "choice",
            "required": false,
            "repeats": false
          }
        ]
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "Any other notes associated with this proposal or order - e.g., provider instructions."
          },
          {
            "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
            "valueString": "string"
          }
        ],
        "linkId": "ProcedureRequest.notes",
        "required": false,
        "repeats": true,
        "question": [
          {
            "linkId": "ProcedureRequest.notes.value",
            "text": "Notes",
            "type": "string",
            "required": false,
            "repeats": false
          }
        ]
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "If a CodeableConcept is present, it indicates the pre-condition for performing the procedure."
          }
        ],
        "linkId": "ProcedureRequest.asNeeded[x]",
        "text": "PRN",
        "required": false,
        "repeats": true,
        "question": [
          {
            "linkId": "ProcedureRequest.asNeeded[x]._type",
            "text": "type",
            "type": "choice",
            "required": false,
            "repeats": false,
            "options": {
              "reference": "#vs5"
            },
            "group": [
              {
                "extension": [
                  {
                    "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
                    "valueString": "boolean"
                  }
                ],
                "linkId": "ProcedureRequest.asNeeded[x]._boolean",
                "question": [
                  {
                    "linkId": "ProcedureRequest.asNeeded[x]._boolean.value",
                    "text": "boolean",
                    "type": "boolean",
                    "required": false,
                    "repeats": false
                  }
                ]
              },
              {
                "extension": [
                  {
                    "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
                    "valueString": "CodeableConcept"
                  }
                ],
                "linkId": "ProcedureRequest.asNeeded[x]._CodeableConcept",
                "text": "CodeableConcept",
                "question": [
                  {
                    "linkId": "ProcedureRequest.asNeeded[x]._CodeableConcept.coding",
                    "text": "code:",
                    "type": "open-choice",
                    "required": false,
                    "repeats": false
                  },
                  {
                    "linkId": "ProcedureRequest.asNeeded[x]._CodeableConcept.text",
                    "text": "text:",
                    "type": "string",
                    "required": false,
                    "repeats": false
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "The time when the request was made."
          },
          {
            "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
            "valueString": "datetime"
          }
        ],
        "linkId": "ProcedureRequest.orderedOn",
        "required": false,
        "repeats": true,
        "question": [
          {
            "linkId": "ProcedureRequest.orderedOn.value",
            "text": "When Requested",
            "type": "dateTime",
            "required": false,
            "repeats": false
          }
        ]
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "The healthcare professional responsible for proposing or ordering the procedure."
          }
        ],
        "linkId": "ProcedureRequest.orderer",
        "text": "Ordering Party",
        "required": false,
        "repeats": true,
        "question": [
          {
            "linkId": "ProcedureRequest.orderer._type",
            "text": "type",
            "type": "choice",
            "required": false,
            "repeats": false,
            "options": {
              "reference": "#vs6"
            },
            "group": [
              {
                "extension": [
                  {
                    "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
                    "valueString": "Reference"
                  }
                ],
                "linkId": "ProcedureRequest.orderer._Practitioner",
                "question": [
                  {
                    "extension": [
                      {
                        "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#reference",
                        "valueString": "/Practitioner?subject=$subj&patient=$subj&encounter=$encounter"
                      }
                    ],
                    "linkId": "ProcedureRequest.orderer._Practitioner.value",
                    "text": "Practitioner",
                    "type": "reference",
                    "required": false,
                    "repeats": false
                  }
                ]
              },
              {
                "extension": [
                  {
                    "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
                    "valueString": "Reference"
                  }
                ],
                "linkId": "ProcedureRequest.orderer._Patient",
                "question": [
                  {
                    "extension": [
                      {
                        "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#reference",
                        "valueString": "/Patient?subject=$subj&patient=$subj&encounter=$encounter"
                      }
                    ],
                    "linkId": "ProcedureRequest.orderer._Patient.value",
                    "text": "Patient",
                    "type": "reference",
                    "required": false,
                    "repeats": false
                  }
                ]
              },
              {
                "extension": [
                  {
                    "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
                    "valueString": "Reference"
                  }
                ],
                "linkId": "ProcedureRequest.orderer._RelatedPerson",
                "question": [
                  {
                    "extension": [
                      {
                        "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#reference",
                        "valueString": "/RelatedPerson?subject=$subj&patient=$subj&encounter=$encounter"
                      }
                    ],
                    "linkId": "ProcedureRequest.orderer._RelatedPerson.value",
                    "text": "RelatedPerson",
                    "type": "reference",
                    "required": false,
                    "repeats": false
                  }
                ]
              },
              {
                "extension": [
                  {
                    "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
                    "valueString": "Reference"
                  }
                ],
                "linkId": "ProcedureRequest.orderer._Device",
                "question": [
                  {
                    "extension": [
                      {
                        "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#reference",
                        "valueString": "/Device?subject=$subj&patient=$subj&encounter=$encounter"
                      }
                    ],
                    "linkId": "ProcedureRequest.orderer._Device.value",
                    "text": "Device",
                    "type": "reference",
                    "required": false,
                    "repeats": false
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/Profile/questionnaire-extensions#flyover",
            "valueString": "The clinical priority associated with this order."
          },
          {
            "url": "http://www.healthintersections.com.au/fhir/Profile/metadata#type",
            "valueString": "code"
          }
        ],
        "linkId": "ProcedureRequest.priority",
        "required": false,
        "repeats": true,
        "question": [
          {
            "linkId": "ProcedureRequest.priority.value",
            "text": "priority",
            "type": "choice",
            "required": false,
            "repeats": false
          }
        ]
      }
    ]
  }
}

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.