Structured Data Capture
4.0.0-ballot - STU 4 ballot International flag

This page is part of the Structured Data Capture FHIR IG (v4.0.0-ballot: STU 4 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 3.0.0. For a full list of available versions, see the Directory of published versions

: Request-based solicitation example - ServiceRequest - XML Representation

Page standards status: Informative

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<ServiceRequest xmlns="http://hl7.org/fhir">
  <id value="example"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-servicerequest"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ServiceRequest example</b></p><a name="example"> </a><a name="hcexample"> </a><a name="example-en-US"> </a><p><b>ServiceRequest Questionnaire</b>: <a href="Questionnaire-questionnaire-sdc-profile-example-PHQ9.html">Patient Health Questionnaire - 9 Item</a></p><p><b>status</b>: Active</p><p><b>intent</b>: Order</p><p><b>code</b>: <span title="Codes:{http://hl7.org/fhir/uv/sdc/CodeSystem/temp complete-questionnaire}">Complete Questionnaire</span></p><p><b>subject</b>: <a href="http://hl7.org/fhir/Patient/proband">Annie Proband</a></p><p><b>occurrence</b>: Once per 1 months</p><p><b>requester</b>: <a href="http://hl7.org/fhir/PractitionerRole/example">Dr. Adam Careful, Acme Hospital</a></p><p><b>performer</b>: <a href="http://hl7.org/fhir/Patient/proband">Annie Proband</a></p><p><b>reasonCode</b>: <span title="Codes:">Monitor effects of new anti-depressant</span></p></div>
  </text>
  <extension
             url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-servicerequest-questionnaire">
    <valueCanonical
                    value="http://hl7.org/fhir/uv/sdc/Questionnaire/questionnaire-sdc-profile-example-PHQ9"/>
  </extension>
  <status value="active"/>
  <intent value="order"/>
  <code>
    <coding>
      <system value="http://hl7.org/fhir/uv/sdc/CodeSystem/temp"/>
      <code value="complete-questionnaire"/>
    </coding>
  </code>
  <subject>
    <reference value="http://hl7.org/fhir/Patient/proband"/>
    <display value="Annie Proband"/>
  </subject>
  <occurrenceTiming>
    <repeat>
      <frequency value="1"/>
      <period value="1"/>
      <periodUnit value="mo"/>
    </repeat>
  </occurrenceTiming>
  <requester>
    <reference value="http://hl7.org/fhir/PractitionerRole/example"/>
    <display value="Dr. Adam Careful, Acme Hospital"/>
  </requester>
  <performer>
    <reference value="http://hl7.org/fhir/Patient/proband"/>
    <display value="Annie Proband"/>
  </performer>
  <reasonCode>
    <text value="Monitor effects of new anti-depressant"/>
  </reasonCode>
</ServiceRequest>