Structured Data Capture
4.0.0 - STU 4 International flag

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

Questionnaire: Questionnaire - ANC Quick Check (Experimental)

Official URL: http://hl7.org/fhir/uv/sdc/Questionnaire/anc-quick-check Version: 4.0.0
Standards status: Informative Active as of 2026-03-24 Computable Name: ANC_Quick_Check
Other Identifiers: OID:2.16.840.1.113883.4.642.40.17.35.2

A sample questionnaire using itemMedia and itemAnswerMedia extensions

Structure
LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. ANC_Quick_Check A sample questionnaire using itemMedia and itemAnswerMedia extensions Questionnaire http://hl7.org/fhir/uv/sdc/Questionnaire/anc-quick-check#4.0.0
... reason-for-visit Why did you come? 0..1 choice Value Set:
Options: 5 options

doco Documentation for this format

Options Sets

Answer options for reason-for-visit

  • For a scheduled (routine) visit
  • For specific complaints about you or your baby
  • First visit
  • Follow-up visit
  • Do you want to include your companion or other family member (parent if adolescent) in the examination and discussion?

Why did you come?

Test this Questionnaire

Try this questionnaire out:

Responses for this Questionnaire

There are currently no QuestionnaireResponse instances for this Questionnaire defined in this IG.