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Official URL: http://hl7.org/fhir/us/davinci-dtr/Questionnaire/home-o2-sdc-questionnaire | Version: 1.1.0-ballot | |||
Draft as of 2020-01-13 | Computable Name: HomeOxygenTherapySDCQuestionnaire |
LinkId | Text | Cardinality | Type | Flags | Description & Constraints![]() |
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![]() ![]() | Questionnaire | http://hl7.org/fhir/us/davinci-dtr/Questionnaire/home-o2-sdc-questionnaire#1.1.0-ballot | |||
![]() ![]() ![]() | Patient Information | 0..1 | group | ||
![]() ![]() ![]() ![]() | Last Name | 1..1 | string | ||
![]() ![]() ![]() ![]() | Fist Name | 1..1 | string | ||
![]() ![]() ![]() ![]() | Middle Name | 0..1 | string | ||
![]() ![]() ![]() | Postal Code (A1A 1A1) | 0..1 | string | ||
![]() ![]() ![]() | Enter your weight in lb | 0..1 | decimal | ||
![]() ![]() ![]() | Attach latest x-ray | 0..1 | attachment | ||
![]() ![]() ![]() | Calculation | 0..1 | group | ||
![]() ![]() ![]() ![]() | Deadline for submission (7 days from now) | 0..1 | date | ![]() | Expressions:
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