This page is part of the FHIR Specification (v5.0.0: R5 - STU). This is the current published version in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions 
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Example ServiceRequest/physical-therapy (XML)
Raw XML (canonical form + also see XML Format Specification)
Jump past Narrative
Example of an order for a physical therapy evaluation procedure (id = "physical-therapy")
<?xml version="1.0" encoding="UTF-8"?>
<ServiceRequest xmlns="http://hl7.org/fhir">
<id value="physical-therapy"/>
<text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative: ServiceRequest</b> <a name="physical-therapy"> </a> </p> <div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border:
1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource ServiceRequest "physical-therapy" </p> </div> <p> <b> status</b> : <span title=" insert contents here ">completed</span> </p> <p> <b> intent</b> : order</p> <p> <b> category</b> : Evaluation <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #386053000 "Evaluation procedure (procedure)")</span> </p> <h3> Codes</h3> <table class="grid"><tr> <td> -</td> <td> <b> Concept</b> </td> </tr> <tr> <td> *</td> <td> Assessment of passive range of motion <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #710830005 "Assessment of passive range of motion (procedure)")</span> </td> </tr> </table> <p> <b> subject</b> : <a href="patient-example.html">Patient/example</a> "Peter CHALMERS"</p> <p> <b> occurrence</b> : 2016-09-27</p> <p> <b> authoredOn</b> : 2016-09-20</p> <p> <b> requester</b> : <span> : Ollie Ortho, MD</span> </p> <p> <b> performer</b> : <span> : Paul Therapist, PT</span> </p> <h3> Reasons</h3> <table class="grid"><tr> <td> -</td> <td> <b> Concept</b> </td> </tr> <tr> <td> *</td> <td> assessment of mobility limitations due to osteoarthritis <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span> </td> </tr> </table> <p> <b> bodySite</b> : Both knees <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #36701003 "Both knees (body structure)")</span> </p> </div> </text> <status value="completed"/>
<intent value="order"/>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="386053000"/>
<display value="Evaluation procedure (procedure)"/>
</coding>
<text value="Evaluation"/>
</category>
<code>
<concept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="710830005"/>
<display value="Assessment of passive range of motion (procedure)"/>
</coding>
<text value="Assessment of passive range of motion"/>
</concept>
</code>
<subject>
<reference value="Patient/example"/>
</subject>
<occurrenceDateTime value="2016-09-27"/>
<authoredOn value="2016-09-20"/>
<requester>
<display value="Ollie Ortho, MD"/>
</requester>
<performer>
<display value="Paul Therapist, PT"/>
</performer>
<reason>
<concept>
<text value="assessment of mobility limitations due to osteoarthritis"/>
</concept>
</reason>
<bodySite>
<coding>
<system value="http://snomed.info/sct"/>
<code value="36701003"/>
<display value="Both knees (body structure)"/>
</coding>
<text value="Both knees"/>
</bodySite>
</ServiceRequest>
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.
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