This page is part of the U.S. Physical Activity IG (v1.0.0-ballot: STU 1.0 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

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: Example Physical Activity Referral - XML Representation

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<ServiceRequest xmlns="http://hl7.org/fhir">
  <id value="ExampleServiceRequest"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: ServiceRequest</b><a name="ExampleServiceRequest"> </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 &quot;ExampleServiceRequest&quot; </p></div><p><b>pertains to goal</b>: <a href="Goal-ExampleGoal.html">Goal/ExampleGoal</a></p><p><b>status</b>: active</p><p><b>intent</b>: original-order</p><p><b>category</b>: Counseling <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#409063005)</span>, Physical Activity <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-pa-temporary-codes.html">Temporary Codes</a>#PhysicalActivity)</span></p><p><b>priority</b>: routine</p><p><b>code</b>: Referral to physical activity program (Procedure) <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#390893007)</span></p><p><b>subject</b>: <a href="http://example.org/Patient/1">http://example.org/Patient/1: Example Patient</a></p><p><b>occurrence</b>: 2022-06-08 --&gt; 2022-08-01</p><p><b>authoredOn</b>: 2022-06-08</p><p><b>requester</b>: <a href="http://example.org/PractitionerRole/1">http://example.org/PractitionerRole/1: Ordering Clinician</a></p><p><b>performer</b>: <a href="http://example.org/Organization/1">http://example.org/Organization/1</a></p><p><b>reasonReference</b>: <a href="Condition-ExampleCondition.html">Condition/ExampleCondition</a></p></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal">
    <valueReference>
      <reference value="Goal/ExampleGoal"/>
    </valueReference>
  </extension>
  <status value="active"/>
  <intent value="original-order"/>
  <category>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="409063005"/>
      <display value="Counseling"/>
    </coding>
  </category>
  <category>
    <coding>
      <system
              value="http://hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes"/>
      <code value="PhysicalActivity"/>
    </coding>
  </category>
  <priority value="routine"/>
  <code>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="390893007"/>
      <display value="Referral to physical activity program (Procedure)"/>
    </coding>
  </code>
  <subject>
    <reference value="http://example.org/Patient/1"/>
    <display value="Example Patient"/>
  </subject>
  <occurrencePeriod>
    <start value="2022-06-08"/>
    <end value="2022-08-01"/>
  </occurrencePeriod>
  <authoredOn value="2022-06-08"/>
  <requester>
    <reference value="http://example.org/PractitionerRole/1"/>
    <display value="Ordering Clinician"/>
  </requester>
  <performer>
    <reference value="http://example.org/Organization/1"/>
  </performer>
  <reasonReference>
    <reference value="Condition/ExampleCondition"/>
  </reasonReference>
</ServiceRequest>