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 - Demographics Example (Experimental)

Official URL: http://hl7.org/fhir/uv/sdc/Questionnaire/demographics Version: 4.0.0
Standards status: Informative Active as of 2026-03-24 Computable Name: DemographicExample
Other Identifiers: OID:2.16.840.1.113883.4.642.40.17.35.3

A sample questionnaire using context-based population and extraction

LinkIDTextCardinalityTypeFlagsDescription & Constraintsdoco
.. DemographicExample A sample questionnaire using context-based population and extraction Questionnaire http://hl7.org/fhir/uv/sdc/Questionnaire/demographics#4.0.0
... patient.id (internal use) 0..1 string iconiconiconicon Definition: Patient.id
Value Set:
... patient.birthDate Date of birth 1..1 date Definition: Patient.birthDate
Value Set:
... patient.name Name(s) 0..* group Definition: Patient.name
Value Set:
.... patient.name.family Family name 1..1 string Definition: Patient.name.family
Value Set:
.... patient.name.given Given name(s) 1..* string Definition: Patient.name.given
Value Set:
.... relative.id (internal use) 0..1 string iconiconiconicon Definition: RelatedPerson.id
Value Set:
.... relative.relationship Relationship(s) 1..* choice Definition: RelatedPerson.relationship
Value Set: Patient relationship type
.... relative.name Name(s) 0..* group Definition: RelatedPerson.name
Value Set:
..... relative.name.family Family name 1..1 string Definition: RelatedPerson.name.family
Value Set:
..... relative.name.given Given name(s) 1..* string Definition: RelatedPerson.name.given
Value Set:

doco Documentation for this format

(internal use)

  • Flags: icon
  • linkId: patient.id
  • Definition:: Patient.id
  • Answers:

Date of birth*

Name(s)

Family name*

Given name(s)*

Relatives, caregivers and other personal relationships

  • linkId: relative
  • Answers:

(internal use)

Relationship(s)*

Name(s)

Family name*

Given name(s)*

LinkIDDescription & Constraintsdoco
.. patient.id Definition: Patient.id
Value Set:
.. patient.birthDate Definition: Patient.birthDate
Value Set:
.. patient.name Definition: Patient.name
Value Set:
... patient.name.family Definition: Patient.name.family
Value Set:
... patient.name.given Definition: Patient.name.given
Value Set:
.. relative Value Set:
... relative.id Definition: RelatedPerson.id
Value Set:
... relative.relationship Definition: RelatedPerson.relationship
Value Set: Patient relationship type
... relative.name Definition: RelatedPerson.name
Value Set:
.... relative.name.family Definition: RelatedPerson.name.family
Value Set:
.... relative.name.given Definition: RelatedPerson.name.given
Value Set:

doco Documentation for this format

Test this Questionnaire

Try this questionnaire out:

Responses for this Questionnaire

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