This page is part of the Structured Data Capture FHIR IG (v3.0.0: STU 3) 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
Page standards status: Informative |
<Questionnaire xmlns="http://hl7.org/fhir">
<id value="questionnaire-sdc-profile-example-form-behavior"/>
<text>
<status value="generated"/>
<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="Other attributes of the item">Flags</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"/> SDCAdvancedRenderingExample</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"></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">http://build.fhir.org/ig/HL7/sdc/questionnaire-sdc-profile-example-form-behavior#3.0.0</td></tr>
<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_bck11.png)" id="item.1" class="hierarchy"><img src="tbl_spacer.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"/> 1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Value constraints</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"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></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_bck110.png)" id="item.1.1" class="hierarchy"><img src="tbl_spacer.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-string.png" alt="." style="background-color: white; background-color: inherit" title="String" class="hierarchy"/> 1.1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">First Name</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-string">string</a></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">Max Length: 50</td></tr>
<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_bck110.png)" id="item.1.2" class="hierarchy"><img src="tbl_spacer.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-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="String" class="hierarchy"/> 1.2</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Last Name</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"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></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_bck110.png)" id="item.1.3" class="hierarchy"><img src="tbl_spacer.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-string.png" alt="." style="background-color: white; background-color: inherit" title="String" class="hierarchy"/> 1.3</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Postal Code (A1A 1A1)</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-string">string</a></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"/></tr>
<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_bck110.png)" id="item.1.4" class="hierarchy"><img src="tbl_spacer.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: #F7F7F7; background-color: inherit" title="Decimal" class="hierarchy"/> 1.4</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enter your weight in kg</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-decimal">decimal</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></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_bck110.png)" id="item.1.5" class="hierarchy"><img src="tbl_spacer.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-quantity.png" alt="." style="background-color: white; background-color: inherit" title="Quantity" class="hierarchy"/> 1.5</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Body Weight</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-quantity">quantity</a></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"/></tr>
<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_bck100.png)" id="item.1.6" class="hierarchy"><img src="tbl_spacer.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-attachment.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Attachment" class="hierarchy"/> 1.6</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Attach Proof of Citizenship</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-attachment">attachment</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></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_bck11.png)" id="item.2" class="hierarchy"><img src="tbl_spacer.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"/> 2</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Value constraints</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"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<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_bck110.png)" id="item.2.1" class="hierarchy"><img src="tbl_spacer.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"/> 2.1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">(I/We) worried whether (my/our) food would run out before (I/we) got money to buy more.</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"/><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.2.1">4 options</a></td></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_bck110.png)" id="item.2.3" class="hierarchy"><img src="tbl_spacer.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"/> 2.3</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Activity Level</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"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Value Set: http://loinc.org/vs/LL4882-8</td></tr>
<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_bck110.png)" id="item.2.5" class="hierarchy"><img src="tbl_spacer.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"/> 2.5</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Applicable health conditions</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"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Value Set: #vsConditionsAll</td></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_bck110.png)" id="item.2.6" class="hierarchy"><img src="tbl_spacer.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-string.png" alt="." style="background-color: white; background-color: inherit" title="String" class="hierarchy"/> 2.6</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Email*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..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-string">string</a></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"/></tr>
<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_bck110.png)" id="item.2.7" class="hierarchy"><img src="tbl_spacer.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-date.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Date" class="hierarchy"/> 2.7</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Current Date:</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-date">date</a></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/questionnaire-definitions.html#Questionnaire.item.readOnly" title="Is Readonly"><img src="icon-qi-readonly.png"/></a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">Initial Value</a>: <code>today()</code></li></ul></td></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_bck110.png)" id="item.2.7.1" class="hierarchy"><img src="tbl_spacer.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-display.png" alt="." style="background-color: white; background-color: inherit" title="Display" class="hierarchy"/> 2.7.1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">null</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-display">display</a></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"/></tr>
<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_bck110.png)" id="item.2.8" class="hierarchy"><img src="tbl_spacer.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"/> 2.8</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Heart History (check all that applies)</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-open-choice">open-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"/><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.2.8">5 options</a></td></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_bck110.png)" id="item.2.9" class="hierarchy"><img src="tbl_spacer.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"/> 2.9</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Heart History (check at least 2):</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">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"/><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.2.9">5 options</a></td></tr>
<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_bck110.png)" id="item.2.10" class="hierarchy"><img src="tbl_spacer.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"/> 2.10</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Heart History (check no more than 3):</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">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"/><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.2.10">5 options</a></td></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_bck110.png)" id="item.2.11" class="hierarchy"><img src="tbl_spacer.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"/> 2.11</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">What treatments do you now have for heart disease? (select all that applies)</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"/><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.2.11">6 options</a></td></tr>
<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_bck110.png)" id="item.2.12" class="hierarchy"><img src="tbl_spacer.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-quantity.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Quantity" class="hierarchy"/> 2.12</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Dosage</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-quantity">quantity</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></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_bck110.png)" id="item.2.13" class="hierarchy"><img src="tbl_spacer.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-quantity.png" alt="." style="background-color: white; background-color: inherit" title="Quantity" class="hierarchy"/> 2.13</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Specify age:</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-quantity">quantity</a></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"/></tr>
<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_bck100.png)" id="item.2.14" class="hierarchy"><img src="tbl_spacer.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-reference.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Reference" class="hierarchy"/> 2.14</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Select your preferred practitioner:</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-reference">reference</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></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_bck11.png)" id="item.3" class="hierarchy"><img src="tbl_spacer.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"/> 3</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Calculation</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"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<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_bck110.png)" id="item.3.1" class="hierarchy"><img src="tbl_spacer.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-date.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Date" class="hierarchy"/> 3.1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Deadline for submission (7 days from now)</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-date">date</a></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/questionnaire-definitions.html#Questionnaire.item.readOnly" title="Is Readonly"><img src="icon-qi-readonly.png"/></a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">Initial Value</a>: <code>today() + 7 days</code></li></ul></td></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_bck111.png)" id="item.3.2" class="hierarchy"><img src="tbl_spacer.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-group.png" alt="." style="background-color: white; background-color: inherit" title="Group" class="hierarchy"/> 3.2</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">null</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"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<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_bck1110.png)" id="item.3.2.1" class="hierarchy"><img src="tbl_spacer.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.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"/> 3.2.1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Last Name:</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"><a href="http://hl7.org/fhir/R4/questionnaire-definitions.html#Questionnaire.item.readOnly" title="Is Readonly"><img src="icon-qi-readonly.png"/></a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">Initial Value</a>: <code>%patient.name.where(use='official').given.first()</code></li></ul></td></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_bck1110.png)" id="item.3.2.2" class="hierarchy"><img src="tbl_spacer.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.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="." style="background-color: white; background-color: inherit" title="String" class="hierarchy"/> 3.2.2</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">First Name:</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-string">string</a></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/questionnaire-definitions.html#Questionnaire.item.readOnly" title="Is Readonly"><img src="icon-qi-readonly.png"/></a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">Initial Value</a>: <code>%patient.name.where(use='official').family()</code></li></ul></td></tr>
<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_bck1100.png)" id="item.3.2.3" class="hierarchy"><img src="tbl_spacer.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-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="String" class="hierarchy"/> 3.2.3</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Gender:</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"><a href="http://hl7.org/fhir/R4/questionnaire-definitions.html#Questionnaire.item.readOnly" title="Is Readonly"><img src="icon-qi-readonly.png"/></a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">Initial Value</a>: <code>%patient.gender</code></li></ul></td></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_bck111.png)" id="item.3.3" class="hierarchy"><img src="tbl_spacer.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-group.png" alt="." style="background-color: white; background-color: inherit" title="Group" class="hierarchy"/> 3.3</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Calculated Expression</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"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<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_bck1110.png)" id="item.3.3.1" class="hierarchy"><img src="tbl_spacer.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.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-decimal.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Decimal" class="hierarchy"/> 3.3.1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Weight (kg)</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-decimal">decimal</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></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_bck1110.png)" id="item.3.3.2" class="hierarchy"><img src="tbl_spacer.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.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"/> 3.3.2</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Body Height (inches)</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"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<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_bck1100.png)" id="item.3.3.3" class="hierarchy"><img src="tbl_spacer.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-decimal.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Decimal" class="hierarchy"/> 3.3.3</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Your Body Mass Index (BMI) is</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-decimal">decimal</a></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/questionnaire-definitions.html#Questionnaire.item.readOnly" title="Is Readonly"><img src="icon-qi-readonly.png"/></a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression">Calculated Value</a>: <code>(%weight/(%height.power(2))).round(1)</code></li></ul></td></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_bck111.png)" id="item.3.4" class="hierarchy"><img src="tbl_spacer.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-group.png" alt="." style="background-color: white; background-color: inherit" title="Group" class="hierarchy"/> 3.4</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">CQF-related Example</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"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<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_bck1110.png)" id="item.3.4.1" class="hierarchy"><img src="tbl_spacer.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.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-decimal.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Decimal" class="hierarchy"/> 3.4.1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enter weight in kg</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-decimal">decimal</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></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_bck1100.png)" id="item.3.4.2" class="hierarchy"><img src="tbl_spacer.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-string.png" alt="." style="background-color: white; background-color: inherit" title="String" class="hierarchy"/> 3.4.2</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enter email address</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-string">string</a></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"/></tr>
<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_bck100.png)" id="item.3.5" class="hierarchy"><img src="tbl_spacer.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"/> 3.5</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">null</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"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></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_bck01.png)" id="item.4" 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: white; background-color: inherit" title="Group" class="hierarchy"/> 4</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Other Controls</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"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<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_bck010.png)" id="item.4.1" 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_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"/> 4.1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Marital Status</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"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Value Set: <a href="http://hl7.org/fhir/R4/valueset-marital-status.html">MaritalStatus</a><br/>Initial Value: Coding = <a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-MaritalStatus.html" title="http://terminology.hl7.org/CodeSystem/v3-MaritalStatus">MaritalStatus</a>#D "Divorced"</td></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_bck011.png)" id="item.4.2" 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"/> 4.2</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">null</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"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<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.4.2.1" 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_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"/> 4.2.1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Choose Gender</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"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Value Set: <a href="http://hl7.org/fhir/R4/valueset-administrative-gender.html">AdministrativeGender</a></td></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_bck0110.png)" id="item.4.2.2" 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-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 4.2.2</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 pregnant? (enableWhen = gender is Female)</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"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.4.2.1">4.2.1</a> = Female (AdministrativeGender#female)</span><br/>Value Set: <a href="http://hl7.org/fhir/R4/valueset-example-yesnodontknow.html">Yes/No/Don't Know</a></td></tr>
<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.4.2.3" 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"/> 4.2.3</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Are you diabetic? (enableWhen = gender is Female)</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"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.4.2.1">4.2.1</a> = Female (AdministrativeGender#female)</span><br/>Value Set: <a href="http://hl7.org/fhir/R4/valueset-example-yesnodontknow.html">Yes/No/Don't Know</a></td></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_bck0110.png)" id="item.4.2.4" 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: white; background-color: inherit" title="Coding" class="hierarchy"/> 4.2.4</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 diagnosed with Gestational Diabetes? (enableBehavior = only when pregnant and diabetic)</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"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <ul><li><a href="#item.4.2.2">4.2.2</a> = Yes (v2 Y/N Indicator#Y)</li><li><a href="#item.4.2.3">4.2.3</a> = Yes (v2 Y/N Indicator#Y)</li></ul><br/>Value Set: <a href="http://hl7.org/fhir/R4/valueset-example-yesnodontknow.html">Yes/No/Don't Know</a></td></tr>
<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.4.2.5" 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-date.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Date" class="hierarchy"/> 4.2.5</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enter your birthdate (MM/DD/YYYY)</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-date">date</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Value Set: <a href="http://hl7.org/fhir/R4/valueset-administrative-gender.html">AdministrativeGender</a></td></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_bck0100.png)" id="item.4.2.6" 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_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"/> 4.2.6</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 had mammogram before?(enableWhenExpression = only when gender is female and age > 40)</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"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Value Set: <a href="http://hl7.org/fhir/R4/valueset-example-yesnodontknow.html">Yes/No/Don't Know</a><br/>Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression">Enable When</a>: <code>%resource.repeat(item).where(linkId='4.2.b.1').answer.value.code ='female' and today().toString().substring(0, 4).toInteger() - %resource.repeat(item).where(linkId='4.2.b.5').answer.value.toString().substring(0, 4).toInteger() >= 40</code></li></ul></td></tr>
<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_bck010.png)" id="item.4.4" 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-attachment.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Attachment" class="hierarchy"/> 4.4</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Signature of Patient</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..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-attachment">attachment</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></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_bck010.png)" id="item.4.5" 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_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-reference.png" alt="." style="background-color: white; background-color: inherit" title="Reference" class="hierarchy"/> 4.5</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">All the practitioners below can speak the patient's language. Choose all preferred practioners:</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-reference">reference</a></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">Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-candidateExpression">Candidates</a>: <code>Practitioner?communication=&active=true</code></li></ul></td></tr>
<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_bck001.png)" id="item.4.6" 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: #F7F7F7; background-color: inherit" title="Group" class="hierarchy"/> 4.6</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">null</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"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></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_bck0010.png)" id="item.4.6.1" 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-display.png" alt="." style="background-color: white; background-color: inherit" title="Display" class="hierarchy"/> 4.6.1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Home Address</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-display">display</a></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"/></tr>
<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.4.6.2" 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_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-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="String" class="hierarchy"/> 4.6.2</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"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Definition: <a href="http://hl7.org/fhir/R4/patient.html#Patient.address.line">Patient.address.line</a><br/>Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">Initial Value</a>: <code>line[0]</code></li></ul></td></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_bck0010.png)" id="item.4.6.3" 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-string.png" alt="." style="background-color: white; background-color: inherit" title="String" class="hierarchy"/> 4.6.3</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">City</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-string">string</a></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">Definition: <a href="http://hl7.org/fhir/R4/patient.html#Patient.address.city">Patient.address.city</a><br/>Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">Initial Value</a>: <code>city</code></li></ul></td></tr>
<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.4.6.4" 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_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"/> 4.6.4</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Province</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"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Definition: <a href="http://hl7.org/fhir/R4/patient.html#Patient.address.state">Patient.address.state</a><br/>Options: <a href="#opt-item.4.6.4">10 options</a><br/>Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">Initial Value</a>: <code>state</code></li></ul></td></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_bck0000.png)" id="item.4.6.5" 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_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-string.png" alt="." style="background-color: white; background-color: inherit" title="String" class="hierarchy"/> 4.6.5</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Postal Code</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-string">string</a></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">Definition: <a href="http://hl7.org/fhir/R4/patient.html#Patient.address.postalCode">Patient.address.postalCode</a><br/>Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">Initial Value</a>: <code>postalCode</code></li></ul></td></tr>
<tr><td colspan="6" 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.2.1"> </a><p><b>Answer options for 2.1</b></p><ul><li style="font-size: 11px"><a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html">LOINC</a>: LA28397-0 ("Often true")</li><li style="font-size: 11px"><a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html">LOINC</a>: LA6729-3 ("Sometimes true")</li><li style="font-size: 11px"><a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html">LOINC</a>: LA28398-8 ("Never true")</li><li style="font-size: 11px"><a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html">LOINC</a>: LA15775-2 ("Don't know/refused")</li></ul><a name="opt-item.2.8"> </a><p><b>Answer options for 2.8</b></p><ul><li style="font-size: 11px">http://example.org/CodeSystem/procedures#U1 ("Heart attack")</li><li style="font-size: 11px">http://example.org/CodeSystem/procedures#U2 ("Heart surgery")</li><li style="font-size: 11px">http://example.org/CodeSystem/procedures#U3 ("Cardiac catheterization")</li><li style="font-size: 11px">http://example.org/CodeSystem/procedures#U4 ("Coronary angioplasty (PTCA)")</li><li style="font-size: 11px">http://example.org/CodeSystem/procedures#U5 ("Cardiac pacemaker")</li></ul><a name="opt-item.2.9"> </a><p><b>Answer options for 2.9</b></p><ul><li style="font-size: 11px">http://example.org/CodeSystem/procedures#U1 ("Heart attack")</li><li style="font-size: 11px">http://example.org/CodeSystem/procedures#U2 ("Heart surgery")</li><li style="font-size: 11px">http://example.org/CodeSystem/procedures#U3 ("Cardiac catheterization")</li><li style="font-size: 11px">http://example.org/CodeSystem/procedures#U4 ("Coronary angioplasty (PTCA)")</li><li style="font-size: 11px">http://example.org/CodeSystem/procedures#U5 ("Cardiac pacemaker")</li></ul><a name="opt-item.2.10"> </a><p><b>Answer options for 2.10</b></p><ul><li style="font-size: 11px">http://example.org/CodeSystem/procedures#U1 ("Heart attack")</li><li style="font-size: 11px">http://example.org/CodeSystem/procedures#U2 ("Heart surgery")</li><li style="font-size: 11px">http://example.org/CodeSystem/procedures#U3 ("Cardiac catheterization")</li><li style="font-size: 11px">http://example.org/CodeSystem/procedures#U4 ("Coronary angioplasty (PTCA)")</li><li style="font-size: 11px">http://example.org/CodeSystem/procedures#U5 ("Cardiac pacemaker")</li></ul><a name="opt-item.2.11"> </a><p><b>Answer options for 2.11</b></p><ul><li style="font-size: 11px">http://example.org/CodeSystem/treatments#noTreatment ("NoTreatment")</li><li style="font-size: 11px">http://example.org/CodeSystem/treatments#aspirin ("Aspirin")</li><li style="font-size: 11px">http://example.org/CodeSystem/treatments#otherMeds ("Other medicines, tablets, or pills")</li><li style="font-size: 11px">http://example.org/CodeSystem/treatments#diet ("Diet")</li><li style="font-size: 11px">http://example.org/CodeSystem/treatments#exercise ("Exercise")</li><li style="font-size: 11px">http://example.org/CodeSystem/treatments#none ("None of the above")</li></ul><a name="opt-item.4.6.4"> </a><p><b>Answer options for 4.6.4</b></p><ul><li style="font-size: 11px">http://example.org/CodeSystem/provinces#Alberta ("Alberta")</li><li style="font-size: 11px">http://example.org/CodeSystem/provinces#BritishColumbia ("British Columbia")</li><li style="font-size: 11px">http://example.org/CodeSystem/provinces#Manitoba ("Manitoba")</li><li style="font-size: 11px">http://example.org/CodeSystem/provinces#NewBrunswick ("New Brunswick")</li><li style="font-size: 11px">http://example.org/CodeSystem/provinces#NewfoundlandAndLabrador ("Newfoundland and Labrador")</li><li style="font-size: 11px">http://example.org/CodeSystem/provinces#NovaScotia ("Nova Scotia")</li><li style="font-size: 11px">http://example.org/CodeSystem/provinces#Ontario ("Ontario")</li><li style="font-size: 11px">http://example.org/CodeSystem/provinces#PrinceEdwardIsland ("Prince Edward Island")</li><li style="font-size: 11px">http://example.org/CodeSystem/provinces#Quebec ("Quebec")</li><li style="font-size: 11px">http://example.org/CodeSystem/provinces#Saskatchewan ("Saskatchewan")</li></ul></div>
</text>
<extension url="http://hl7.org/fhir/StructureDefinition/variable">
<valueExpression>
<name value="weight"/>
<language value="text/fhirpath"/>
<expression
value="%resource.repeat(item).where(linkId='3.3.1').item.answer.valueDecimal"/>
</valueExpression>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/variable">
<valueExpression>
<name value="height"/>
<language value="text/fhirpath"/>
<expression
value="%resource.repeat(item).where(linkId='3.3.2').item.answer.valueDecimal*0.0254"/>
</valueExpression>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/cqf-library">
<valueCanonical value="http://example.org/Library/MeasurementLimits"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext">
<extension url="name">
<valueCoding>
<system value="http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext"/>
<code value="patient"/>
<display value="Patient"/>
</valueCoding>
</extension>
<extension url="type">
<valueCode value="Patient"/>
</extension>
<extension url="description">
<valueString
value="The patient that is to be used to pre-populate the form"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-endpoint">
<valueUri value="http://example.org/QuestionnaireResponse/create"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-entryMode">
<valueCode value="sequential"/>
</extension>
<url
value="http://build.fhir.org/ig/HL7/sdc/questionnaire-sdc-profile-example-form-behavior"/>
<version value="3.0.0"/>
<name value="SDCAdvancedRenderingExample"/>
<status value="draft"/>
<date value="2022-03-08T18:33:14+00:00"/>
<publisher value="HL7 International - FHIR Infrastructure Work Group"/>
<contact>
<telecom>
<system value="url"/>
<value value="http://hl7.org/Special/committees/fiwg"/>
</telecom>
</contact>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
</coding>
</jurisdiction>
<item>
<linkId value="1"/>
<text value="Value constraints"/>
<type value="group"/>
<item>
<linkId value="1.1"/>
<text value="First Name"/>
<type value="string"/>
<maxLength value="50"/>
</item>
<item>
<extension url="http://hl7.org/fhir/StructureDefinition/minLength">
<valueInteger value="2"/>
</extension>
<linkId value="1.2"/>
<text value="Last Name"/>
<type value="string"/>
</item>
<item>
<extension url="http://hl7.org/fhir/StructureDefinition/regex">
<valueString value="[A-Z][0-9][A-Z] [0-9][A-Z][0-9]"/>
</extension>
<linkId value="1.3"/>
<text value="Postal Code (A1A 1A1)"/>
<type value="string"/>
</item>
<item>
<extension url="http://hl7.org/fhir/StructureDefinition/minValue">
<valueDecimal value="1"/>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/maxValue">
<valueDecimal value="100"/>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/maxDecimalPlaces">
<valueInteger value="2"/>
</extension>
<linkId value="1.4"/>
<text value="Enter your weight in kg"/>
<type value="decimal"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-unitValueSet">
<valueCanonical value="http://hl7.org/fhir/ValueSet/ucum-bodyweight"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-minQuantity">
<valueQuantity>
<value value="10"/>
<system value="http://unitsofmeasure.org"/>
<code value="kg"/>
</valueQuantity>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-maxQuantity">
<valueQuantity>
<value value="100"/>
<system value="http://unitsofmeasure.org"/>
<code value="kg"/>
</valueQuantity>
</extension>
<linkId value="1.5"/>
<text value="Body Weight"/>
<type value="quantity"/>
</item>
<item>
<extension url="http://hl7.org/fhir/StructureDefinition/mimeType">
<valueCode value="image/jpeg"/>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/mimeType">
<valueCode value="application/pdf"/>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/maxSize">
<valueDecimal value="1048576"/>
</extension>
<linkId value="1.6"/>
<text value="Attach Proof of Citizenship"/>
<type value="attachment"/>
</item>
</item>
<item>
<linkId value="2"/>
<text value="Value constraints"/>
<type value="group"/>
<item>
<linkId value="2.1"/>
<text
value="(I/We) worried whether (my/our) food would run out before (I/we) got money to buy more."/>
<type value="choice"/>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA28397-0"/>
<display value="Often true"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6729-3"/>
<display value="Sometimes true"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA28398-8"/>
<display value="Never true"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA15775-2"/>
<display value="Don't know/refused"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="2.3"/>
<text value="Activity Level"/>
<type value="choice"/>
<answerValueSet value="http://loinc.org/vs/LL4882-8"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerOptionsToggleExpression">
<extension url="option">
<valueCoding>
<system value="http://example.org/CodeSystem/conditions"/>
<code value="3"/>
</valueCoding>
</extension>
<extension url="expression">
<valueExpression>
<language value="text/fhirpath"/>
<expression value="%patient.gender!='male'"/>
</valueExpression>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerOptionsToggleExpression">
<extension url="option">
<valueCoding>
<system value="http://example.org/CodeSystem/conditions"/>
<code value="4"/>
</valueCoding>
</extension>
<extension url="expression">
<valueExpression>
<language value="text/fhirpath"/>
<expression value="%patient.gender!='female'"/>
</valueExpression>
</extension>
</extension>
<linkId value="2.5"/>
<text value="Applicable health conditions"/>
<type value="choice"/>
<repeats value="true"/>
<answerValueSet value="#vsConditionsAll"/>
</item>
<item>
<linkId value="2.6"/>
<text value="Email*"/>
<type value="string"/>
<required value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<description value="current date"/>
<language value="text/fhirpath"/>
<expression value="today()"/>
</valueExpression>
</extension>
<linkId value="2.7"/>
<text value="Current Date:"/>
<type value="date"/>
<readOnly value="true"/>
</item>
<item>
<linkId value="2.7.1"/>
<text>
<extension url="http://hl7.org/fhir/StructureDefinition/cqf-expression">
<valueExpression>
<description value="Substitute in current date"/>
<language value="text/fhirpath"/>
<expression
value="'Please only enter data that has been validated as of ' + today()"/>
</valueExpression>
</extension>
</text>
<type value="display"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-openLabel">
<valueString value="Other event (specify)"/>
</extension>
<linkId value="2.8"/>
<text value="Heart History (check all that applies)"/>
<type value="open-choice"/>
<repeats value="true"/>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U1"/>
<display value="Heart attack"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U2"/>
<display value="Heart surgery"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U3"/>
<display value="Cardiac catheterization"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U4"/>
<display value="Coronary angioplasty (PTCA)"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U5"/>
<display value="Cardiac pacemaker"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs">
<valueInteger value="2"/>
</extension>
<linkId value="2.9"/>
<text value="Heart History (check at least 2):"/>
<type value="choice"/>
<required value="true"/>
<repeats value="true"/>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U1"/>
<display value="Heart attack"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U2"/>
<display value="Heart surgery"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U3"/>
<display value="Cardiac catheterization"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U4"/>
<display value="Coronary angioplasty (PTCA)"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U5"/>
<display value="Cardiac pacemaker"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
<valueInteger value="3"/>
</extension>
<linkId value="2.10"/>
<text value="Heart History (check no more than 3):"/>
<type value="choice"/>
<required value="true"/>
<repeats value="true"/>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U1"/>
<display value="Heart attack"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U2"/>
<display value="Heart surgery"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U3"/>
<display value="Cardiac catheterization"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U4"/>
<display value="Coronary angioplasty (PTCA)"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U5"/>
<display value="Cardiac pacemaker"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="check-box"/>
<display value="Check-box"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="2.11"/>
<text
value="What treatments do you now have for heart disease? (select all that applies)"/>
<type value="choice"/>
<repeats value="true"/>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/treatments"/>
<code value="noTreatment"/>
<display value="NoTreatment"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/treatments"/>
<code value="aspirin"/>
<display value="Aspirin"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/treatments"/>
<code value="otherMeds"/>
<display value="Other medicines, tablets, or pills"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/treatments"/>
<code value="diet"/>
<display value="Diet"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/treatments"/>
<code value="exercise"/>
<display value="Exercise"/>
</valueCoding>
</answerOption>
<answerOption>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionExclusive">
<valueBoolean value="true"/>
</extension>
<valueCoding>
<system value="http://example.org/CodeSystem/treatments"/>
<code value="none"/>
<display value="None of the above"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption">
<valueCoding>
<system value="http://unitsofmeasure.org"/>
<code value="mL"/>
<display value="mL"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption">
<valueCoding>
<system value="http://unitsofmeasure.org"/>
<code value="L"/>
<display value="L"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption">
<valueCoding>
<system value="http://unitsofmeasure.org"/>
<code value="g"/>
<display value="g"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption">
<valueCoding>
<system value="http://unitsofmeasure.org"/>
<code value="mg"/>
<display value="mg"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-unitOpen">
<valueCode value="optionsOrType"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-unitSupplementalSystem">
<valueCanonical value="http://example.org/SomeUnitCodeSystem"/>
</extension>
<linkId value="2.12"/>
<text value="Dosage"/>
<type value="quantity"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-unitValueSet">
<valueCanonical value="http://hl7.org/fhir/ValueSet/age-units"/>
</extension>
<linkId value="2.13"/>
<text value="Specify age:"/>
<type value="quantity"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceResource">
<valueCode value="Practitioner"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile">
<valueCanonical
value="http://example.org/fhir/StructureDefinition/my-practitioner"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-lookupQuestionnaire">
<valueCanonical value="http://example.org/Questionnaire/1234"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression">
<valueExpression>
<description value="all active practitioners"/>
<language value="application/x-fhir-query"/>
<expression value="Practitioner?active=true&_sort=family,given"/>
</valueExpression>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn">
<extension url="path">
<valueString
value="name.where(use='official').family + ', ' + name.where(use='official').given.first()"/>
</extension>
<extension url="forDisplay">
<valueBoolean value="true"/>
</extension>
</extension>
<linkId value="2.14"/>
<text value="Select your preferred practitioner:"/>
<type value="reference"/>
</item>
</item>
<item>
<linkId value="3"/>
<text value="Calculation"/>
<type value="group"/>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<description value="deadline for submission"/>
<language value="text/fhirpath"/>
<expression value="today() + 7 days"/>
</valueExpression>
</extension>
<linkId value="3.1"/>
<text value="Deadline for submission (7 days from now)"/>
<type value="date"/>
<readOnly value="true"/>
</item>
<item>
<linkId value="3.2"/>
<type value="group"/>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<description value="patient's last name"/>
<language value="text/fhirpath"/>
<expression
value="%patient.name.where(use='official').given.first()"/>
</valueExpression>
</extension>
<linkId value="3.2.1"/>
<text value="Last Name:"/>
<type value="string"/>
<readOnly value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<description value="patient's first name"/>
<language value="text/fhirpath"/>
<expression
value="%patient.name.where(use='official').family()"/>
</valueExpression>
</extension>
<linkId value="3.2.2"/>
<text value="First Name:"/>
<type value="string"/>
<readOnly value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<description value="patient's gender"/>
<language value="text/fhirpath"/>
<expression value="%patient.gender"/>
</valueExpression>
</extension>
<linkId value="3.2.3"/>
<text value="Gender:"/>
<type value="string"/>
<readOnly value="true"/>
</item>
</item>
<item>
<linkId value="3.3"/>
<text value="Calculated Expression"/>
<type value="group"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-unit">
<valueCoding>
<system value="http://unitsofmeasure.org"/>
<code value="kg"/>
</valueCoding>
</extension>
<linkId value="3.3.1"/>
<text value="Weight (kg)"/>
<type value="decimal"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-unit">
<valueCoding>
<system value="http://unitsofmeasure.org"/>
<code value="[in_i]"/>
</valueCoding>
</extension>
<linkId value="3.3.2"/>
<text value="Body Height (inches)"/>
<type value="decimal"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression">
<valueExpression>
<description value="BMI Calculation"/>
<language value="text/fhirpath"/>
<expression value="(%weight/(%height.power(2))).round(1)"/>
</valueExpression>
</extension>
<linkId value="3.3.3"/>
<text value="Your Body Mass Index (BMI) is"/>
<type value="decimal"/>
<readOnly value="true"/>
</item>
</item>
<item>
<linkId value="3.4"/>
<text value="CQF-related Example"/>
<type value="group"/>
<item>
<extension url="http://hl7.org/fhir/StructureDefinition/minValue">
<valueDecimal value="1">
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue">
<valueString value="min_weight"/>
</extension>
</valueDecimal>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/maxValue">
<valueDecimal value="100">
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue">
<valueString value="max_weight"/>
</extension>
</valueDecimal>
</extension>
<linkId value="3.4.1"/>
<text value="Enter weight in kg"/>
<type value="decimal"/>
</item>
<item>
<linkId value="3.4.2"/>
<text value="Enter email address"/>
<type value="string"/>
<required value="false">
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-expression">
<valueExpression>
<description value="current date"/>
<language value="text/fhirpath"/>
<expression value="%patient.active"/>
</valueExpression>
</extension>
</required>
</item>
</item>
<item>
<linkId value="3.5"/>
<text>
<extension url="http://hl7.org/fhir/StructureDefinition/cqf-expression">
<valueExpression>
<description value="last immunization date"/>
<language value="text/fhirpath"/>
<expression
value="'Your last immunization was on '+ %Immunization.occurrenceDateTime.substring(0,10) + '.'"/>
</valueExpression>
</extension>
</text>
<type value="display"/>
</item>
</item>
<item>
<linkId value="4"/>
<text value="Other Controls"/>
<type value="group"/>
<item>
<linkId value="4.1"/>
<text value="Marital Status"/>
<type value="choice"/>
<answerValueSet value="http://hl7.org/fhir/ValueSet/marital-status"/>
<initial>
<valueCoding>
<system value="http://terminology.hl7.org/CodeSystem/v3-MaritalStatus"/>
<code value="D"/>
<display value="Divorced"/>
</valueCoding>
</initial>
</item>
<item>
<linkId value="4.2"/>
<type value="group"/>
<item>
<linkId value="4.2.1"/>
<text value="Choose Gender"/>
<type value="choice"/>
<answerValueSet
value="http://hl7.org/fhir/ValueSet/administrative-gender"/>
</item>
<item>
<linkId value="4.2.2"/>
<text value="Are you pregnant? (enableWhen = gender is Female)"/>
<type value="choice"/>
<enableWhen>
<question value="4.2.1"/>
<operator value="="/>
<answerCoding>
<system value="http://hl7.org/fhir/administrative-gender"/>
<code value="female"/>
</answerCoding>
</enableWhen>
<answerValueSet value="http://hl7.org/fhir/ValueSet/yesnodontknow"/>
</item>
<item>
<linkId value="4.2.3"/>
<text value="Are you diabetic? (enableWhen = gender is Female)"/>
<type value="choice"/>
<enableWhen>
<question value="4.2.1"/>
<operator value="="/>
<answerCoding>
<system value="http://hl7.org/fhir/administrative-gender"/>
<code value="female"/>
</answerCoding>
</enableWhen>
<answerValueSet value="http://hl7.org/fhir/ValueSet/yesnodontknow"/>
</item>
<item>
<linkId value="4.2.4"/>
<text
value="Have you been diagnosed with Gestational Diabetes? (enableBehavior = only when pregnant and diabetic)"/>
<type value="choice"/>
<enableWhen>
<question value="4.2.2"/>
<operator value="="/>
<answerCoding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0136"/>
<code value="Y"/>
</answerCoding>
</enableWhen>
<enableWhen>
<question value="4.2.3"/>
<operator value="="/>
<answerCoding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0136"/>
<code value="Y"/>
</answerCoding>
</enableWhen>
<enableBehavior value="all"/>
<answerValueSet value="http://hl7.org/fhir/ValueSet/yesnodontknow"/>
</item>
<item>
<extension url="http://hl7.org/fhir/StructureDefinition/entryFormat">
<valueString value="MM/DD/YYYY"/>
</extension>
<linkId value="4.2.5"/>
<text value="Enter your birthdate (MM/DD/YYYY)"/>
<type value="date"/>
<answerValueSet
value="http://hl7.org/fhir/ValueSet/administrative-gender"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression">
<valueExpression>
<description value="if last 2 questions were answered"/>
<language value="text/fhirpath"/>
<expression
value="%resource.repeat(item).where(linkId='4.2.b.1').answer.value.code ='female' and today().toString().substring(0, 4).toInteger() - %resource.repeat(item).where(linkId='4.2.b.5').answer.value.toString().substring(0, 4).toInteger() >= 40"/>
</valueExpression>
</extension>
<linkId value="4.2.6"/>
<text
value="Have you had mammogram before?(enableWhenExpression = only when gender is female and age > 40)"/>
<type value="choice"/>
<answerValueSet value="http://hl7.org/fhir/ValueSet/yesnodontknow"/>
</item>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-signatureRequired">
<valueCodeableConcept>
<coding>
<system value="urn:iso-astm:E1762-95:2013"/>
<code value="1.2.840.10065.1.12.1.8"/>
<display value="Signature Witness Signature"/>
</coding>
<text value="the signature of a witness to any other signature."/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-usageMode">
<valueCode value="capture"/>
</extension>
<linkId value="4.4"/>
<text value="Signature of Patient"/>
<type value="attachment"/>
<required value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-candidateExpression">
<valueExpression>
<description
value="active practitioners that speak at least one of the patient's language"/>
<language value="application/x-fhir-query"/>
<expression value="Practitioner?communication=&active=true"/>
</valueExpression>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn">
<extension url="path">
<valueString value="name.first().family"/>
</extension>
<extension url="label">
<valueString value="LAST NAME"/>
</extension>
<extension url="width">
<valueQuantity>
<value value="40"/>
<system value="http://unitsofmeasure.org"/>
<code value="%"/>
</valueQuantity>
</extension>
<extension url="forDisplay">
<valueBoolean value="true"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn">
<extension url="path">
<valueString value="name.first().given.first()"/>
</extension>
<extension url="label">
<valueString value="FIRST NAME"/>
</extension>
<extension url="width">
<valueQuantity>
<value value="40"/>
<system value="http://unitsofmeasure.org"/>
<code value="%"/>
</valueQuantity>
</extension>
<extension url="forDisplay">
<valueBoolean value="true"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn">
<extension url="path">
<valueString value="gender"/>
</extension>
<extension url="label">
<valueString value="GENDER"/>
</extension>
<extension url="width">
<valueQuantity>
<value value="20"/>
<system value="http://unitsofmeasure.org"/>
<code value="%"/>
</valueQuantity>
</extension>
<extension url="forDisplay">
<valueBoolean value="false"/>
</extension>
</extension>
<linkId value="4.5"/>
<text
value="All the practitioners below can speak the patient's language. Choose all preferred practioners:"/>
<type value="reference"/>
<repeats value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemPopulationContext">
<valueExpression>
<description value="Home address of the patient"/>
<language value="text/fhirpath"/>
<expression value="%patient.address.where(use='home')[0]"/>
</valueExpression>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemExtractionContext">
<valueExpression>
<description value="Home address of the patient"/>
<language value="text/fhirpath"/>
<expression value="%patient.address.where(use='home')[0]"/>
</valueExpression>
</extension>
<linkId value="4.6"/>
<type value="group"/>
<item>
<linkId value="4.6.1"/>
<text value="Home Address"/>
<type value="display"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<description value="Address Line 1"/>
<language value="text/fhirpath"/>
<expression value="line[0]"/>
</valueExpression>
</extension>
<linkId value="4.6.2"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/Patient#Patient.address.line"/>
<text value="Address"/>
<type value="string"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<description value="City"/>
<language value="text/fhirpath"/>
<expression value="city"/>
</valueExpression>
</extension>
<linkId value="4.6.3"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/Patient#Patient.address.city"/>
<text value="City"/>
<type value="string"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<description value="State"/>
<language value="text/fhirpath"/>
<expression value="state"/>
</valueExpression>
</extension>
<linkId value="4.6.4"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/Patient#Patient.address.state"/>
<text value="Province"/>
<type value="choice"/>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/provinces"/>
<code value="Alberta"/>
<display value="Alberta"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/provinces"/>
<code value="BritishColumbia"/>
<display value="British Columbia"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/provinces"/>
<code value="Manitoba"/>
<display value="Manitoba"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/provinces"/>
<code value="NewBrunswick"/>
<display value="New Brunswick"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/provinces"/>
<code value="NewfoundlandAndLabrador"/>
<display value="Newfoundland and Labrador"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/provinces"/>
<code value="NovaScotia"/>
<display value="Nova Scotia"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/provinces"/>
<code value="Ontario"/>
<display value="Ontario"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/provinces"/>
<code value="PrinceEdwardIsland"/>
<display value="Prince Edward Island"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/provinces"/>
<code value="Quebec"/>
<display value="Quebec"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/provinces"/>
<code value="Saskatchewan"/>
<display value="Saskatchewan"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<description value="Postal Code"/>
<language value="text/fhirpath"/>
<expression value="postalCode"/>
</valueExpression>
</extension>
<linkId value="4.6.5"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/Patient#Patient.address.postalCode"/>
<text value="Postal Code"/>
<type value="string"/>
</item>
</item>
</item>
</Questionnaire>