Electronic Long-Term Services and Supports (eLTSS) Release 1 - US Realm
2.0.0-ballot - ballot United States of America flag

This page is part of the electronic Long-Term Services and Supports Implementation Guide (v2.0.0-ballot: STU2 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

Example Contract: contract1

Page standards status: Informative

Generated Narrative: Contract

Resource Contract "contract1" Version "1" Updated "2020-09-03 10:16:03-0400"

Information Source: #KZ0jzPjXDrhCiMif!

Profile: Contract_eltss

signer

type: Patient (Details: http://terminology.hl7.org/CodeSystem/contractsignertypecodes code PAT = 'Patient', stated as 'null')

party: Patient/patientBSJ1 " SMITH-JOHNSON"

Signatures

-TypeWhenWhoData
*Consent Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.7 = 'Consent Signature', stated as 'null')Apr 2, 2020, 3:00:00 AMPatient/patientBSJ1 " SMITH-JOHNSON"(base64 data - 187 bytes)

signer

type: Guardian (Details: http://terminology.hl7.org/CodeSystem/contractsignertypecodes code GUARD = 'Guardian', stated as 'null')

party: RelatedPerson/guardian1 " CHARLES"

Signatures

-TypeWhenWhoData
*Consent Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.7 = 'Consent Signature', stated as 'null')Apr 2, 2020, 3:00:00 AMRelatedPerson/guardian1 " CHARLES"(base64 data - 187 bytes)

signer

type: Author (Details: http://terminology.hl7.org/CodeSystem/contractsignertypecodes code AUT = 'Author', stated as 'null')

party: Practitioner/planner1 " PLANNER"

Signatures

-TypeWhenWhoData
*Author's Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.1 = 'Author's Signature', stated as 'null')Apr 2, 2020, 3:00:00 AMPractitioner/planner1 " PLANNER"(base64 data - 187 bytes)

signer

type: Co-Author (Details: http://terminology.hl7.org/CodeSystem/contractsignertypecodes code COAUTH = 'Co-Author', stated as 'null')

party: Practitioner/caremgr1 " MONITOR"

Signatures

-TypeWhenWhoData
*Author's Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.1 = 'Author's Signature', stated as 'null')Apr 2, 2020, 3:00:00 AMPractitioner/caremgr1 " MONITOR"(base64 data - 187 bytes)

signer

type: Healthcare Provider (Details: http://terminology.hl7.org/CodeSystem/contractsignertypecodes code HPROV = 'Healthcare Provider', stated as 'null')

party: Practitioner/provider3 " EDUCATOR"

Signatures

-TypeWhenWhoData
*Consent Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.7 = 'Consent Signature', stated as 'null')Apr 2, 2020, 3:00:00 AMPractitioner/provider3 " EDUCATOR"(base64 data - 187 bytes)

signer

type: Healthcare Provider (Details: http://terminology.hl7.org/CodeSystem/contractsignertypecodes code HPROV = 'Healthcare Provider', stated as 'null')

party: Practitioner/provider2b " DRIVER"

Signatures

-TypeWhenWhoData
*Consent Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.7 = 'Consent Signature', stated as 'null')Apr 2, 2020, 3:00:00 AMPractitioner/provider2b " DRIVER"(base64 data - 187 bytes)

signer

type: Healthcare Provider (Details: http://terminology.hl7.org/CodeSystem/contractsignertypecodes code HPROV = 'Healthcare Provider', stated as 'null')

party: RelatedPerson/son1 " CHARLES"

Signatures

-TypeWhenWhoData
*Consent Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.7 = 'Consent Signature', stated as 'null')Apr 2, 2020, 3:00:00 AMRelatedPerson/son1 " CHARLES"(base64 data - 187 bytes)

signer

type: Healthcare Provider (Details: http://terminology.hl7.org/CodeSystem/contractsignertypecodes code HPROV = 'Healthcare Provider', stated as 'null')

party: Practitioner/provider4 " TRAINER"

Signatures

-TypeWhenWhoData
*Consent Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.7 = 'Consent Signature', stated as 'null')Apr 2, 2020, 3:00:00 AMPractitioner/provider4 " TRAINER"(base64 data - 187 bytes)