SDOH Clinical Care
2.0.0 - STU 2
US
SDOH Clinical Care
2.0.0 - STU 2
US
This page is part of the SDOH Clinical Care for Multiple Domains (v2.0.0: STU 2) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions 
| Draft as of 2021-04-01 |
@prefix fhir: <http://hl7.org/fhir/> .
@prefix loinc: <http://loinc.org/rdf#> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
a fhir:Questionnaire;
fhir:nodeRole fhir:treeRoot;
fhir:Resource.id [ fhir:value "SDOHCC-QuestionnairePRAPARE"];
fhir:Resource.meta [
fhir:Meta.versionId [ fhir:value "5" ];
fhir:Meta.lastUpdated [ fhir:value "2022-09-14T20:05:52.007+00:00"^^xsd:dateTime ];
fhir:Meta.source [ fhir:value "#triqDuazdqHqt7bE" ];
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap";
fhir:index 0;
fhir:link <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap> ]
];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><b>Structure</b><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The linkId for the item\">LinkId</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the the itemcan appear in the instance\">Cardinality</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Type</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the item\">Description & Constraints</a><span style=\"float: right\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireRoot\" class=\"hierarchy\"/> SDOHCCQuestionnairePRAPARE</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">http://hl7.org/fhir/us/sdoh-clinicalcare/Questionnaire/SDOHCC-QuestionnairePRAPARE#2.0.0</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)\" id=\"item./93025-5\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> /93025-5</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)\" id=\"item./93043-8\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> /93043-8</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Personal characteristics</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93043-8/56051-6\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93043-8/56051-6</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Do you consider yourself Hispanic/Latino?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93043-8/56051-6\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93043-8/32624-9\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93043-8/32624-9</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Race</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93043-8/32624-9\">8 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93043-8/93035-4\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93043-8/93035-4</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93043-8/93035-4\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93043-8/93034-7\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93043-8/93034-7</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Have you been discharged from the armed forces of the United States?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93043-8/93034-7\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0100.png)\" id=\"item./93043-8/54899-0\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93043-8/54899-0</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Preferred language</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93043-8/54899-0\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)\" id=\"item./93042-0\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> /93042-0</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Family and home</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93042-0/63512-8\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Integer\" class=\"hierarchy\"/> /93042-0/63512-8</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">How many people are living or staying at this address?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0111.png)\" id=\"item./93042-0/71802-3\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93042-0/71802-3</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Housing status</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93042-0/71802-3\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01100.png)\" id=\"item./93042-0/71802-3-help\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-display.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Display\" class=\"hierarchy\"/> /93042-0/71802-3-help</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Describes patients living arrangement</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display\">display</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93042-0/93033-9\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93042-0/93033-9</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Are you worried about losing your housing?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93042-0/93033-9\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0100.png)\" id=\"item./93042-0/56799-0\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"String\" class=\"hierarchy\"/> /93042-0/56799-0</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Address</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)\" id=\"item./93041-2\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> /93041-2</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Money and resources</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93041-2/82589-3\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93041-2/82589-3</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Highest level of educ</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93041-2/82589-3\">4 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93041-2/67875-5\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93041-2/67875-5</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Employment status current</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93041-2/67875-5\">5 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93041-2/76437-3\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93041-2/76437-3</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Primary insurance</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93041-2/76437-3\">7 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93041-2/63586-2\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-decimal.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Decimal\" class=\"hierarchy\"/> /93041-2/63586-2</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">What was your best estimate of the total income of all family members from all sources, before taxes, in last year?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal\">decimal</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93041-2/93031-3\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93041-2/93031-3</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93041-2/93031-3\">8 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0100.png)\" id=\"item./93041-2/93030-5\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93041-2/93030-5</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93041-2/93030-5\">4 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)\" id=\"item./93040-4\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> /93040-4</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Social and emotional health</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93040-4/93029-7\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93040-4/93029-7</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93040-4/93029-7\">5 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0100.png)\" id=\"item./93040-4/93038-8\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93040-4/93038-8</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Stress is when someone feels tense, nervous, anxious or can't sleep at night because their mind is troubled. How stressed are you?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93040-4/93038-8\">6 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck001.png)\" id=\"item./93039-6\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> /93039-6</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Optional additional questions</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" id=\"item./93039-6/93028-9\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93039-6/93028-9</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93039-6/93028-9\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" id=\"item./93039-6/93027-1\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93039-6/93027-1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Are you a refugee?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93039-6/93027-1\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" id=\"item./93039-6/93026-3\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93039-6/93026-3</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Do you feel physically and emotionally safe where you currently live?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93039-6/93026-3\">4 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0000.png)\" id=\"item./93039-6/76501-6\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93039-6/76501-6</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Within the last year, have you been afraid of your partner or ex-partner?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93039-6/76501-6\">2 options</a></td></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table><hr/><p><b>Option Sets</b></p><a name=\"opt-item./93043-8/56051-6\"> </a><p><b>Answer options for /93043-8/56051-6</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 ("Yes")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 ("No")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93043-8/32624-9\"> </a><p><b>Answer options for /93043-8/32624-9</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA6156-9 ("Asian")</li><li style=\"font-size: 11px\">http://loinc.org#LA14045-1 ("Native Hawaiian")</li><li style=\"font-size: 11px\">http://loinc.org#LA30187-1 ("Pacific Islander")</li><li style=\"font-size: 11px\">http://loinc.org#LA14042-8 ("Black/African American")</li><li style=\"font-size: 11px\">http://loinc.org#LA4457-3 ("White")</li><li style=\"font-size: 11px\">http://loinc.org#LA4-4 ("American Indian/Alaskan Native")</li><li style=\"font-size: 11px\">http://loinc.org#LA46-8 ("Other")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93043-8/93035-4\"> </a><p><b>Answer options for /93043-8/93035-4</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 ("Yes")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 ("No")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93043-8/93034-7\"> </a><p><b>Answer options for /93043-8/93034-7</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 ("Yes")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 ("No")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93043-8/54899-0\"> </a><p><b>Answer options for /93043-8/54899-0</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA43-5 ("English")</li><li style=\"font-size: 11px\">http://loinc.org#LA30188-9 ("Language other than English")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93042-0/71802-3\"> </a><p><b>Answer options for /93042-0/71802-3</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA30189-7 ("I have housing")</li><li style=\"font-size: 11px\">http://loinc.org#LA30190-5 ("I do not have housing (staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, or in a park)")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93042-0/93033-9\"> </a><p><b>Answer options for /93042-0/93033-9</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 ("Yes")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 ("No")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93041-2/82589-3\"> </a><p><b>Answer options for /93041-2/82589-3</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA30191-3 ("Less than high school degree")</li><li style=\"font-size: 11px\">http://loinc.org#LA30192-1 ("High school diploma or GED")</li><li style=\"font-size: 11px\">http://loinc.org#LA30193-9 ("More than high school")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93041-2/67875-5\"> </a><p><b>Answer options for /93041-2/67875-5</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA17956-6 ("Unemployed")</li><li style=\"font-size: 11px\">http://loinc.org#LA30138-4 ("Part-time or temporary work")</li><li style=\"font-size: 11px\">http://loinc.org#LA30136-8 ("Full-time work")</li><li style=\"font-size: 11px\">http://loinc.org#LA30137-6 ("Otherwise unemployed but not seeking work (ex: student, retired, disabled, unpaid primary care giver)")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93041-2/76437-3\"> </a><p><b>Answer options for /93041-2/76437-3</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA30194-7 ("None/uninsured")</li><li style=\"font-size: 11px\">http://loinc.org#LA17849-3 ("Medicaid")</li><li style=\"font-size: 11px\">http://loinc.org#LA30195-4 ("CHIP Medicaid")</li><li style=\"font-size: 11px\">http://loinc.org#LA15652-3 ("Medicare")</li><li style=\"font-size: 11px\">http://loinc.org#LA30196-2 ("Other public insurance (not CHIP)")</li><li style=\"font-size: 11px\">http://loinc.org#LA30197-0 ("Other public insurance (CHIP)")</li><li style=\"font-size: 11px\">http://loinc.org#LA6350-8 ("Private insurance")</li></ul><a name=\"opt-item./93041-2/93031-3\"> </a><p><b>Answer options for /93041-2/93031-3</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA30125-1 ("Food")</li><li style=\"font-size: 11px\">http://loinc.org#LA30126-9 ("Clothing")</li><li style=\"font-size: 11px\">http://loinc.org#LA30124-4 ("Utilities")</li><li style=\"font-size: 11px\">http://loinc.org#LA30127-7 ("Child care")</li><li style=\"font-size: 11px\">http://loinc.org#LA30128-5 ("Medicine or Any Health Care (Medical, Dental, Mental Health, Vision)")</li><li style=\"font-size: 11px\">http://loinc.org#LA30129-3 ("Phone")</li><li style=\"font-size: 11px\">http://loinc.org#LA46-8 ("Other")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93041-2/93030-5\"> </a><p><b>Answer options for /93041-2/93030-5</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA30133-5 ("Yes, it has kept me from medical appointments or from getting my medications")</li><li style=\"font-size: 11px\">http://loinc.org#LA30134-3 ("Yes, it has kept me from non-medical meetings, appointments, work, or from getting things that I need")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 ("No")</li><li style=\"font-size: 11px\">http://loinc.org#LA30257-2 ("Patient unable to respond")</li></ul><a name=\"opt-item./93040-4/93029-7\"> </a><p><b>Answer options for /93040-4/93029-7</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA27722-0 ("Less than once a week")</li><li style=\"font-size: 11px\">http://loinc.org#LA30130-1 ("1 or 2 times a week")</li><li style=\"font-size: 11px\">http://loinc.org#LA30131-9 ("3 to 5 times a week")</li><li style=\"font-size: 11px\">http://loinc.org#LA30132-7 ("5 or more times a week")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93040-4/93038-8\"> </a><p><b>Answer options for /93040-4/93038-8</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA6568-5 ("Not at all")</li><li style=\"font-size: 11px\">http://loinc.org#LA13863-8 ("A little bit")</li><li style=\"font-size: 11px\">http://loinc.org#LA13909-9 ("Somewhat")</li><li style=\"font-size: 11px\">http://loinc.org#LA13902-4 ("Quite a bit")</li><li style=\"font-size: 11px\">http://loinc.org#LA13914-9 ("Very much")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93039-6/93028-9\"> </a><p><b>Answer options for /93039-6/93028-9</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 ("Yes")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 ("No")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93039-6/93027-1\"> </a><p><b>Answer options for /93039-6/93027-1</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 ("Yes")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 ("No")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93039-6/93026-3\"> </a><p><b>Answer options for /93039-6/93026-3</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 ("Yes")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 ("No")</li><li style=\"font-size: 11px\">http://loinc.org#LA14072-5 ("Unsure")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93039-6/76501-6\"> </a><p><b>Answer options for /93039-6/76501-6</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 ("Yes")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 ("No")</li></ul></div>"
];
fhir:DomainResource.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-targetStructureMap" ];
fhir:Extension.valueCanonical [
fhir:value "http://hl7.org/fhir/us/sdoh-clinicalcare/StructureMap/SDOHCC-StructureMapPRAPARE";
fhir:link <http://hl7.org/fhir/us/sdoh-clinicalcare/StructureMap/SDOHCC-StructureMapPRAPARE> ]
];
fhir:Questionnaire.url [ fhir:value "http://hl7.org/fhir/us/sdoh-clinicalcare/Questionnaire/SDOHCC-QuestionnairePRAPARE"];
fhir:Questionnaire.version [ fhir:value "2.0.0"];
fhir:Questionnaire.name [ fhir:value "SDOHCCQuestionnairePRAPARE"];
fhir:Questionnaire.title [ fhir:value "SDOHCC Questionnaire PRAPARE"];
fhir:Questionnaire.status [ fhir:value "draft"];
fhir:Questionnaire.subjectType [
fhir:value "Patient";
fhir:index 0
];
fhir:Questionnaire.date [ fhir:value "2021-04-01T04:01:34+00:00"^^xsd:dateTime];
fhir:Questionnaire.publisher [ fhir:value "HL7 International - Patient Care WG"];
fhir:Questionnaire.contact [
fhir:index 0;
fhir:ContactDetail.name [ fhir:value "HL7 International - Patient Care" ];
fhir:ContactDetail.telecom [
fhir:index 0;
fhir:ContactPoint.system [ fhir:value "url" ];
fhir:ContactPoint.value [ fhir:value "http://www.hl7.org/Special/committees/patientcare" ] ]
];
fhir:Questionnaire.jurisdiction [
fhir:index 0;
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ];
fhir:Coding.code [ fhir:value "US" ];
fhir:Coding.display [ fhir:value "United States of America" ] ];
fhir:CodeableConcept.text [ fhir:value "United States of America" ]
];
fhir:Questionnaire.item [
fhir:index 0;
fhir:Questionnaire.item.linkId [ fhir:value "/93025-5" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:93025-5;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "93025-5" ];
fhir:Coding.display [ fhir:value "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]" ] ];
fhir:Questionnaire.item.text [ fhir:value "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]" ];
fhir:Questionnaire.item.type [ fhir:value "group" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.item [
fhir:index 0;
fhir:Questionnaire.item.linkId [ fhir:value "/93043-8" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:93043-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "93043-8" ];
fhir:Coding.display [ fhir:value "Personal characteristics" ] ];
fhir:Questionnaire.item.text [ fhir:value "Personal characteristics" ];
fhir:Questionnaire.item.type [ fhir:value "group" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.item [
fhir:index 0;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ];
fhir:Coding.code [ fhir:value "drop-down" ];
fhir:Coding.display [ fhir:value "Drop down" ] ];
fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93043-8/56051-6" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:56051-6;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "56051-6" ];
fhir:Coding.display [ fhir:value "Do you consider yourself Hispanic/Latino?" ] ];
fhir:Questionnaire.item.text [ fhir:value "Do you consider yourself Hispanic/Latino?" ];
fhir:Questionnaire.item.type [ fhir:value "choice" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.answerOption [
fhir:index 0;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA33-6;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA33-6" ];
fhir:Coding.display [ fhir:value "Yes" ] ] ], [
fhir:index 1;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA32-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA32-8" ];
fhir:Coding.display [ fhir:value "No" ] ] ], [
fhir:index 2;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30122-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30122-8" ];
fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [
fhir:index 1;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ];
fhir:Coding.code [ fhir:value "drop-down" ];
fhir:Coding.display [ fhir:value "Drop down" ] ];
fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93043-8/32624-9" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:32624-9;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "32624-9" ];
fhir:Coding.display [ fhir:value "Race" ] ];
fhir:Questionnaire.item.text [ fhir:value "Race" ];
fhir:Questionnaire.item.type [ fhir:value "choice" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ];
fhir:Questionnaire.item.answerOption [
fhir:index 0;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA6156-9;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA6156-9" ];
fhir:Coding.display [ fhir:value "Asian" ] ] ], [
fhir:index 1;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA14045-1;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA14045-1" ];
fhir:Coding.display [ fhir:value "Native Hawaiian" ] ] ], [
fhir:index 2;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30187-1;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30187-1" ];
fhir:Coding.display [ fhir:value "Pacific Islander" ] ] ], [
fhir:index 3;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA14042-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA14042-8" ];
fhir:Coding.display [ fhir:value "Black/African American" ] ] ], [
fhir:index 4;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA4457-3;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA4457-3" ];
fhir:Coding.display [ fhir:value "White" ] ] ], [
fhir:index 5;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA4-4;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA4-4" ];
fhir:Coding.display [ fhir:value "American Indian/Alaskan Native" ] ] ], [
fhir:index 6;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA46-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA46-8" ];
fhir:Coding.display [ fhir:value "Other" ] ] ], [
fhir:index 7;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30122-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30122-8" ];
fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [
fhir:index 2;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ];
fhir:Coding.code [ fhir:value "drop-down" ];
fhir:Coding.display [ fhir:value "Drop down" ] ];
fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93043-8/93035-4" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:93035-4;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "93035-4" ];
fhir:Coding.display [ fhir:value "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?" ] ];
fhir:Questionnaire.item.text [ fhir:value "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?" ];
fhir:Questionnaire.item.type [ fhir:value "choice" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.answerOption [
fhir:index 0;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA33-6;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA33-6" ];
fhir:Coding.display [ fhir:value "Yes" ] ] ], [
fhir:index 1;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA32-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA32-8" ];
fhir:Coding.display [ fhir:value "No" ] ] ], [
fhir:index 2;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30122-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30122-8" ];
fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [
fhir:index 3;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ];
fhir:Coding.code [ fhir:value "drop-down" ];
fhir:Coding.display [ fhir:value "Drop down" ] ];
fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93043-8/93034-7" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:93034-7;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "93034-7" ];
fhir:Coding.display [ fhir:value "Have you been discharged from the armed forces of the United States?" ] ];
fhir:Questionnaire.item.text [ fhir:value "Have you been discharged from the armed forces of the United States?" ];
fhir:Questionnaire.item.type [ fhir:value "choice" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.answerOption [
fhir:index 0;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA33-6;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA33-6" ];
fhir:Coding.display [ fhir:value "Yes" ] ] ], [
fhir:index 1;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA32-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA32-8" ];
fhir:Coding.display [ fhir:value "No" ] ] ], [
fhir:index 2;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30122-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30122-8" ];
fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [
fhir:index 4;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ];
fhir:Coding.code [ fhir:value "drop-down" ];
fhir:Coding.display [ fhir:value "Drop down" ] ];
fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93043-8/54899-0" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:54899-0;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "54899-0" ];
fhir:Coding.display [ fhir:value "Preferred language" ] ];
fhir:Questionnaire.item.text [ fhir:value "Preferred language" ];
fhir:Questionnaire.item.type [ fhir:value "choice" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.answerOption [
fhir:index 0;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA43-5;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA43-5" ];
fhir:Coding.display [ fhir:value "English" ] ] ], [
fhir:index 1;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30188-9;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30188-9" ];
fhir:Coding.display [ fhir:value "Language other than English" ] ] ], [
fhir:index 2;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30122-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30122-8" ];
fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ] ], [
fhir:index 1;
fhir:Questionnaire.item.linkId [ fhir:value "/93042-0" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:93042-0;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "93042-0" ];
fhir:Coding.display [ fhir:value "Family and home" ] ];
fhir:Questionnaire.item.text [ fhir:value "Family and home" ];
fhir:Questionnaire.item.type [ fhir:value "group" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.item [
fhir:index 0;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-unit" ];
fhir:Extension.valueCoding [
fhir:Coding.system [ fhir:value "http://unitsofmeasure.org" ];
fhir:Coding.code [ fhir:value "{#}" ];
fhir:Coding.display [ fhir:value "{#}" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93042-0/63512-8" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:63512-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "63512-8" ];
fhir:Coding.display [ fhir:value "How many people are living or staying at this address?" ] ];
fhir:Questionnaire.item.text [ fhir:value "How many people are living or staying at this address?" ];
fhir:Questionnaire.item.type [ fhir:value "integer" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ], [
fhir:index 1;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ];
fhir:Coding.code [ fhir:value "drop-down" ];
fhir:Coding.display [ fhir:value "Drop down" ] ];
fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93042-0/71802-3" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:71802-3;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "71802-3" ];
fhir:Coding.display [ fhir:value "Housing status" ] ];
fhir:Questionnaire.item.text [ fhir:value "Housing status" ];
fhir:Questionnaire.item.type [ fhir:value "choice" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.answerOption [
fhir:index 0;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30189-7;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30189-7" ];
fhir:Coding.display [ fhir:value "I have housing" ] ] ], [
fhir:index 1;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30190-5;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30190-5" ];
fhir:Coding.display [ fhir:value "I do not have housing (staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, or in a park)" ] ] ], [
fhir:index 2;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30122-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30122-8" ];
fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ];
fhir:Questionnaire.item.item [
fhir:index 0;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ];
fhir:Coding.code [ fhir:value "help" ];
fhir:Coding.display [ fhir:value "Help-Button" ] ];
fhir:CodeableConcept.text [ fhir:value "Help-Button" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93042-0/71802-3-help" ];
fhir:Questionnaire.item.text [ fhir:value "Describes patients living arrangement" ];
fhir:Questionnaire.item.type [ fhir:value "display" ] ] ], [
fhir:index 2;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ];
fhir:Coding.code [ fhir:value "drop-down" ];
fhir:Coding.display [ fhir:value "Drop down" ] ];
fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93042-0/93033-9" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:93033-9;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "93033-9" ];
fhir:Coding.display [ fhir:value "Are you worried about losing your housing?" ] ];
fhir:Questionnaire.item.text [ fhir:value "Are you worried about losing your housing?" ];
fhir:Questionnaire.item.type [ fhir:value "choice" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.answerOption [
fhir:index 0;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA33-6;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA33-6" ];
fhir:Coding.display [ fhir:value "Yes" ] ] ], [
fhir:index 1;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA32-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA32-8" ];
fhir:Coding.display [ fhir:value "No" ] ] ], [
fhir:index 2;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30122-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30122-8" ];
fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [
fhir:index 3;
fhir:Questionnaire.item.linkId [ fhir:value "/93042-0/56799-0" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:56799-0;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "56799-0" ];
fhir:Coding.display [ fhir:value "Address" ] ];
fhir:Questionnaire.item.text [ fhir:value "Address" ];
fhir:Questionnaire.item.type [ fhir:value "string" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ] ], [
fhir:index 2;
fhir:Questionnaire.item.linkId [ fhir:value "/93041-2" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:93041-2;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "93041-2" ];
fhir:Coding.display [ fhir:value "Money and resources" ] ];
fhir:Questionnaire.item.text [ fhir:value "Money and resources" ];
fhir:Questionnaire.item.type [ fhir:value "group" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.item [
fhir:index 0;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ];
fhir:Coding.code [ fhir:value "drop-down" ];
fhir:Coding.display [ fhir:value "Drop down" ] ];
fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93041-2/82589-3" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:82589-3;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "82589-3" ];
fhir:Coding.display [ fhir:value "Highest level of educ" ] ];
fhir:Questionnaire.item.text [ fhir:value "Highest level of educ" ];
fhir:Questionnaire.item.type [ fhir:value "choice" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.answerOption [
fhir:index 0;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30191-3;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30191-3" ];
fhir:Coding.display [ fhir:value "Less than high school degree" ] ] ], [
fhir:index 1;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30192-1;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30192-1" ];
fhir:Coding.display [ fhir:value "High school diploma or GED" ] ] ], [
fhir:index 2;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30193-9;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30193-9" ];
fhir:Coding.display [ fhir:value "More than high school" ] ] ], [
fhir:index 3;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30122-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30122-8" ];
fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [
fhir:index 1;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ];
fhir:Coding.code [ fhir:value "drop-down" ];
fhir:Coding.display [ fhir:value "Drop down" ] ];
fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93041-2/67875-5" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:67875-5;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "67875-5" ];
fhir:Coding.display [ fhir:value "Employment status current" ] ];
fhir:Questionnaire.item.text [ fhir:value "Employment status current" ];
fhir:Questionnaire.item.type [ fhir:value "choice" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.answerOption [
fhir:index 0;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA17956-6;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA17956-6" ];
fhir:Coding.display [ fhir:value "Unemployed" ] ] ], [
fhir:index 1;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30138-4;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30138-4" ];
fhir:Coding.display [ fhir:value "Part-time or temporary work" ] ] ], [
fhir:index 2;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30136-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30136-8" ];
fhir:Coding.display [ fhir:value "Full-time work" ] ] ], [
fhir:index 3;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30137-6;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30137-6" ];
fhir:Coding.display [ fhir:value "Otherwise unemployed but not seeking work (ex: student, retired, disabled, unpaid primary care giver)" ] ] ], [
fhir:index 4;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30122-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30122-8" ];
fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [
fhir:index 2;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ];
fhir:Coding.code [ fhir:value "drop-down" ];
fhir:Coding.display [ fhir:value "Drop down" ] ];
fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93041-2/76437-3" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:76437-3;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "76437-3" ];
fhir:Coding.display [ fhir:value "Primary insurance" ] ];
fhir:Questionnaire.item.text [ fhir:value "Primary insurance" ];
fhir:Questionnaire.item.type [ fhir:value "choice" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.answerOption [
fhir:index 0;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30194-7;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30194-7" ];
fhir:Coding.display [ fhir:value "None/uninsured" ] ] ], [
fhir:index 1;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA17849-3;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA17849-3" ];
fhir:Coding.display [ fhir:value "Medicaid" ] ] ], [
fhir:index 2;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30195-4;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30195-4" ];
fhir:Coding.display [ fhir:value "CHIP Medicaid" ] ] ], [
fhir:index 3;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA15652-3;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA15652-3" ];
fhir:Coding.display [ fhir:value "Medicare" ] ] ], [
fhir:index 4;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30196-2;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30196-2" ];
fhir:Coding.display [ fhir:value "Other public insurance (not CHIP)" ] ] ], [
fhir:index 5;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30197-0;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30197-0" ];
fhir:Coding.display [ fhir:value "Other public insurance (CHIP)" ] ] ], [
fhir:index 6;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA6350-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA6350-8" ];
fhir:Coding.display [ fhir:value "Private insurance" ] ] ] ], [
fhir:index 3;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-unit" ];
fhir:Extension.valueCoding [
fhir:Coding.system [ fhir:value "http://unitsofmeasure.org" ];
fhir:Coding.code [ fhir:value "/a" ];
fhir:Coding.display [ fhir:value "/a" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93041-2/63586-2" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:63586-2;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "63586-2" ];
fhir:Coding.display [ fhir:value "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?" ] ];
fhir:Questionnaire.item.text [ fhir:value "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?" ];
fhir:Questionnaire.item.type [ fhir:value "decimal" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ], [
fhir:index 4;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ];
fhir:Coding.code [ fhir:value "drop-down" ];
fhir:Coding.display [ fhir:value "Drop down" ] ];
fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93041-2/93031-3" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:93031-3;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "93031-3" ];
fhir:Coding.display [ fhir:value "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?" ] ];
fhir:Questionnaire.item.text [ fhir:value "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?" ];
fhir:Questionnaire.item.type [ fhir:value "choice" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ];
fhir:Questionnaire.item.answerOption [
fhir:index 0;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30125-1;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30125-1" ];
fhir:Coding.display [ fhir:value "Food" ] ] ], [
fhir:index 1;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30126-9;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30126-9" ];
fhir:Coding.display [ fhir:value "Clothing" ] ] ], [
fhir:index 2;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30124-4;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30124-4" ];
fhir:Coding.display [ fhir:value "Utilities" ] ] ], [
fhir:index 3;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30127-7;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30127-7" ];
fhir:Coding.display [ fhir:value "Child care" ] ] ], [
fhir:index 4;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30128-5;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30128-5" ];
fhir:Coding.display [ fhir:value "Medicine or Any Health Care (Medical, Dental, Mental Health, Vision)" ] ] ], [
fhir:index 5;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30129-3;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30129-3" ];
fhir:Coding.display [ fhir:value "Phone" ] ] ], [
fhir:index 6;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA46-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA46-8" ];
fhir:Coding.display [ fhir:value "Other" ] ] ], [
fhir:index 7;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30122-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30122-8" ];
fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [
fhir:index 5;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ];
fhir:Coding.code [ fhir:value "drop-down" ];
fhir:Coding.display [ fhir:value "Drop down" ] ];
fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93041-2/93030-5" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:93030-5;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "93030-5" ];
fhir:Coding.display [ fhir:value "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living?" ] ];
fhir:Questionnaire.item.text [ fhir:value "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living?" ];
fhir:Questionnaire.item.type [ fhir:value "choice" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ];
fhir:Questionnaire.item.answerOption [
fhir:index 0;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix" ];
fhir:Extension.valueString [ fhir:value "A" ] ];
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30133-5;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30133-5" ];
fhir:Coding.display [ fhir:value "Yes, it has kept me from medical appointments or from getting my medications" ] ] ], [
fhir:index 1;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix" ];
fhir:Extension.valueString [ fhir:value "B" ] ];
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30134-3;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30134-3" ];
fhir:Coding.display [ fhir:value "Yes, it has kept me from non-medical meetings, appointments, work, or from getting things that I need" ] ] ], [
fhir:index 2;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix" ];
fhir:Extension.valueString [ fhir:value "C" ] ];
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA32-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA32-8" ];
fhir:Coding.display [ fhir:value "No" ] ] ], [
fhir:index 3;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix" ];
fhir:Extension.valueString [ fhir:value "X" ] ];
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30257-2;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30257-2" ];
fhir:Coding.display [ fhir:value "Patient unable to respond" ] ] ] ] ], [
fhir:index 3;
fhir:Questionnaire.item.linkId [ fhir:value "/93040-4" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:93040-4;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "93040-4" ];
fhir:Coding.display [ fhir:value "Social and emotional health" ] ];
fhir:Questionnaire.item.text [ fhir:value "Social and emotional health" ];
fhir:Questionnaire.item.type [ fhir:value "group" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.item [
fhir:index 0;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ];
fhir:Coding.code [ fhir:value "drop-down" ];
fhir:Coding.display [ fhir:value "Drop down" ] ];
fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93040-4/93029-7" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:93029-7;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "93029-7" ];
fhir:Coding.display [ fhir:value "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?" ] ];
fhir:Questionnaire.item.text [ fhir:value "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?" ];
fhir:Questionnaire.item.type [ fhir:value "choice" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.answerOption [
fhir:index 0;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA27722-0;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA27722-0" ];
fhir:Coding.display [ fhir:value "Less than once a week" ] ] ], [
fhir:index 1;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30130-1;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30130-1" ];
fhir:Coding.display [ fhir:value "1 or 2 times a week" ] ] ], [
fhir:index 2;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30131-9;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30131-9" ];
fhir:Coding.display [ fhir:value "3 to 5 times a week" ] ] ], [
fhir:index 3;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30132-7;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30132-7" ];
fhir:Coding.display [ fhir:value "5 or more times a week" ] ] ], [
fhir:index 4;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30122-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30122-8" ];
fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [
fhir:index 1;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ];
fhir:Coding.code [ fhir:value "drop-down" ];
fhir:Coding.display [ fhir:value "Drop down" ] ];
fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93040-4/93038-8" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:93038-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "93038-8" ];
fhir:Coding.display [ fhir:value "Stress is when someone feels tense, nervous, anxious or can't sleep at night because their mind is troubled. How stressed are you?" ] ];
fhir:Questionnaire.item.text [ fhir:value "Stress is when someone feels tense, nervous, anxious or can't sleep at night because their mind is troubled. How stressed are you?" ];
fhir:Questionnaire.item.type [ fhir:value "choice" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.answerOption [
fhir:index 0;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA6568-5;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA6568-5" ];
fhir:Coding.display [ fhir:value "Not at all" ] ] ], [
fhir:index 1;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA13863-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA13863-8" ];
fhir:Coding.display [ fhir:value "A little bit" ] ] ], [
fhir:index 2;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA13909-9;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA13909-9" ];
fhir:Coding.display [ fhir:value "Somewhat" ] ] ], [
fhir:index 3;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA13902-4;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA13902-4" ];
fhir:Coding.display [ fhir:value "Quite a bit" ] ] ], [
fhir:index 4;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA13914-9;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA13914-9" ];
fhir:Coding.display [ fhir:value "Very much" ] ] ], [
fhir:index 5;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30122-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30122-8" ];
fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ] ], [
fhir:index 4;
fhir:Questionnaire.item.linkId [ fhir:value "/93039-6" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:93039-6;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "93039-6" ];
fhir:Coding.display [ fhir:value "Optional additional questions" ] ];
fhir:Questionnaire.item.text [ fhir:value "Optional additional questions" ];
fhir:Questionnaire.item.type [ fhir:value "group" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.item [
fhir:index 0;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ];
fhir:Coding.code [ fhir:value "drop-down" ];
fhir:Coding.display [ fhir:value "Drop down" ] ];
fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93039-6/93028-9" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:93028-9;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "93028-9" ];
fhir:Coding.display [ fhir:value "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?" ] ];
fhir:Questionnaire.item.text [ fhir:value "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?" ];
fhir:Questionnaire.item.type [ fhir:value "choice" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.answerOption [
fhir:index 0;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA33-6;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA33-6" ];
fhir:Coding.display [ fhir:value "Yes" ] ] ], [
fhir:index 1;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA32-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA32-8" ];
fhir:Coding.display [ fhir:value "No" ] ] ], [
fhir:index 2;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30122-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30122-8" ];
fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [
fhir:index 1;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ];
fhir:Coding.code [ fhir:value "drop-down" ];
fhir:Coding.display [ fhir:value "Drop down" ] ];
fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93039-6/93027-1" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:93027-1;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "93027-1" ];
fhir:Coding.display [ fhir:value "Are you a refugee?" ] ];
fhir:Questionnaire.item.text [ fhir:value "Are you a refugee?" ];
fhir:Questionnaire.item.type [ fhir:value "choice" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.answerOption [
fhir:index 0;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA33-6;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA33-6" ];
fhir:Coding.display [ fhir:value "Yes" ] ] ], [
fhir:index 1;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA32-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA32-8" ];
fhir:Coding.display [ fhir:value "No" ] ] ], [
fhir:index 2;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30122-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30122-8" ];
fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [
fhir:index 2;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ];
fhir:Coding.code [ fhir:value "drop-down" ];
fhir:Coding.display [ fhir:value "Drop down" ] ];
fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93039-6/93026-3" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:93026-3;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "93026-3" ];
fhir:Coding.display [ fhir:value "Do you feel physically and emotionally safe where you currently live?" ] ];
fhir:Questionnaire.item.text [ fhir:value "Do you feel physically and emotionally safe where you currently live?" ];
fhir:Questionnaire.item.type [ fhir:value "choice" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.answerOption [
fhir:index 0;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA33-6;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA33-6" ];
fhir:Coding.display [ fhir:value "Yes" ] ] ], [
fhir:index 1;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA32-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA32-8" ];
fhir:Coding.display [ fhir:value "No" ] ] ], [
fhir:index 2;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA14072-5;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA14072-5" ];
fhir:Coding.display [ fhir:value "Unsure" ] ] ], [
fhir:index 3;
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA30122-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA30122-8" ];
fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [
fhir:index 3;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ];
fhir:Coding.code [ fhir:value "drop-down" ];
fhir:Coding.display [ fhir:value "Drop down" ] ];
fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ];
fhir:Questionnaire.item.linkId [ fhir:value "/93039-6/76501-6" ];
fhir:Questionnaire.item.code [
fhir:index 0;
a loinc:76501-6;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "76501-6" ];
fhir:Coding.display [ fhir:value "Within the last year, have you been afraid of your partner or ex-partner?" ] ];
fhir:Questionnaire.item.text [ fhir:value "Within the last year, have you been afraid of your partner or ex-partner?" ];
fhir:Questionnaire.item.type [ fhir:value "choice" ];
fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ];
fhir:Questionnaire.item.answerOption [
fhir:index 0;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix" ];
fhir:Extension.valueString [ fhir:value "1" ] ], [
fhir:index 1;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/ordinalValue" ];
fhir:Extension.valueDecimal [ fhir:value "1"^^xsd:decimal ] ];
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA33-6;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA33-6" ];
fhir:Coding.display [ fhir:value "Yes" ] ] ], [
fhir:index 1;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix" ];
fhir:Extension.valueString [ fhir:value "0" ] ], [
fhir:index 1;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/ordinalValue" ];
fhir:Extension.valueDecimal [ fhir:value "0"^^xsd:decimal ] ];
fhir:Questionnaire.item.answerOption.valueCoding [
a loinc:LA32-8;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "LA32-8" ];
fhir:Coding.display [ fhir:value "No" ] ] ] ] ]
].
# - ontology header ------------------------------------------------------------
a owl:Ontology;
owl:imports fhir:fhir.ttl.
IG © 2020+ HL7 International - Patient Care WG. Package hl7.fhir.us.sdoh-clinicalcare#2.0.0 based on FHIR 4.0.1. Generated 2022-11-21
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