# Example: Discharge Service Request for PT referral - PACIO Transitions of Care Implementation Guide v1.0.0

* [**Table of Contents**](toc.md)
* [**FHIR Artifacts**](artifacts.md)
* **Example: Discharge Service Request for PT referral**

## Example ServiceRequest: Example: Discharge Service Request for PT referral

| |
| :--- |
| *Page standards status:*[Informative](http://hl7.org/fhir/R4/versions.html#std-process) |

Profile: [US Core ServiceRequest Profile](http://hl7.org/fhir/us/core/STU8.0.1/StructureDefinition-us-core-servicerequest.html) version: 8.0.1

**status**: Active

**intent**: Order

**category**: Evaluation procedure (procedure)

**priority**: Routine

**code**: Physical therapy assessment (procedure)

**subject**: [Smith-Johnson, Betsy Female, DoB: 1958-11-01 ( http://hl7.org/fhir/sid/us-medicare#United States Medicare Number#1AA3D58WH16)](Patient-Example-Smith-Johnson-Patient1.md)

**occurrence**: 2024-05-18 --> (ongoing)

**authoredOn**: 2024-05-18

**requester**: [PractitionerRole Geriatric Medicine (Family Medicine) Physician](PractitionerRole-Role-SNFDoc-GeraldPark.md)

**reasonReference**: [Condition Right hemiparesis (disorder)](Condition-BSJ-HemiparesisDiagnosis.md)



## Resource Content

```json
{
  "resourceType" : "ServiceRequest",
  "id" : "BSJ-SNFDischargePTRefer",
  "meta" : {
    "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-servicerequest|8.0.1"]
  },
  "status" : "active",
  "intent" : "order",
  "category" : [{
    "coding" : [{
      "system" : "http://snomed.info/sct",
      "code" : "386053000",
      "display" : "Evaluation procedure (procedure)"
    }]
  }],
  "priority" : "routine",
  "code" : {
    "coding" : [{
      "system" : "http://snomed.info/sct",
      "code" : "410158009",
      "display" : "Physical therapy assessment (procedure)"
    }]
  },
  "subject" : {
    "reference" : "Patient/Example-Smith-Johnson-Patient1"
  },
  "occurrencePeriod" : {
    "start" : "2024-05-18"
  },
  "authoredOn" : "2024-05-18",
  "requester" : {
    "reference" : "PractitionerRole/Role-SNFDoc-GeraldPark"
  },
  "reasonReference" : [{
    "reference" : "Condition/BSJ-HemiparesisDiagnosis"
  }]
}

```
