US Core Implementation Guide
7.0.0 - STU7
US Core Implementation Guide
7.0.0 - STU7
This page is part of the US Core (v7.0.0: STU7) 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. Page versions: STU6.1 STU6
| Page standards status: Informative |
{
"resourceType" : "Questionnaire",
"id" : "prapare-example",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><b>Structure</b><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The linkId for the item\">LinkId</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the the itemcan appear in the instance\">Cardinality</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Type</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the item\">Description & Constraints</a><span style=\"float: right\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3goXBCwdPqAP0wAAAldJREFUOMuNk0tIlFEYhp9z/vE2jHkhxXA0zJCMitrUQlq4lnSltEqCFhFG2MJFhIvIFpkEWaTQqjaWZRkp0g26URZkTpbaaOJkDqk10szoODP//7XIMUe0elcfnPd9zsfLOYplGrpRwZaqTtw3K7PtGem7Q6FoidbGgqHVy/HRb669R+56zx7eRV1L31JGxYbBtjKK93cxeqfyQHbehkZbUkK20goELEuIzEd+dHS+qz/Y8PTSif0FnGkbiwcAjHaU1+QWOptFiyCLp/LnKptpqIuXHx6rbR26kJcBX3yLgBfnd7CxwJmflpP2wUg0HIAoUUpZBmKzELGWcN8nAr6Gpu7tLU/CkwAaoKTWRSQyt89Q8w6J+oVQkKnBoblH7V0PPvUOvDYXfopE/SJmALsxnVm6LbkotrUtNowMeIrVrBcBpaMmdS0j9df7abpSuy7HWehwJdt1lhVwi/J58U5beXGAF6c3UXLycw1wdFklArBn87xdh0ZsZtArghBdAA3+OEDVubG4UEzP6x1FOWneHh2VDAHBAt80IbdXDcesNoCvs3E5AFyNSU5nbrDPZpcUEQQTFZiEVx+51fxMhhyJEAgvlriadIJZZksRuwBYMOPBbO3hePVVqgEJhFeUuFLhIPkRP6BQLIBrmMenujm/3g4zc398awIe90Zb5A1vREALqneMcYgP/xVQWlG+Ncu5vgwwlaUNx+3799rfe96u9K0JSDXcOzOTJg4B6IgmXfsygc7/Bvg9g9E58/cDVmGIBOP/zT8Bz1zqWqpbXIsd0O9hajXfL6u4BaOS6SeWAAAAAElFTkSuQmCC\" 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\"/> PRAPAREExample</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">http://hl7.org/fhir/us/core/Questionnaire/prapare-example#7.0.0</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)\" id=\"item./93025-5\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> /93025-5</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)\" id=\"item./93043-8\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> /93043-8</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Personal characteristics</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93043-8/56051-6\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93043-8/56051-6</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Do you consider yourself Hispanic/Latino?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93043-8/56051-6\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93043-8/32624-9\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93043-8/32624-9</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Race</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93043-8/32624-9\">8 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93043-8/93035-4\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93043-8/93035-4</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93043-8/93035-4\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93043-8/93034-7\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93043-8/93034-7</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Have you been discharged from the armed forces of the United States?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93043-8/93034-7\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0100.png)\" id=\"item./93043-8/54899-0\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93043-8/54899-0</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Preferred language</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93043-8/54899-0\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)\" id=\"item./93042-0\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> /93042-0</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Family and home</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93042-0/63512-8\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Integer\" class=\"hierarchy\"/> /93042-0/63512-8</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">How many people are living or staying at this address?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0111.png)\" id=\"item./93042-0/71802-3\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93042-0/71802-3</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Housing status</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93042-0/71802-3\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01100.png)\" id=\"item./93042-0/71802-3-help\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-display.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Display\" class=\"hierarchy\"/> /93042-0/71802-3-help</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Describes patients living arrangement</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display\">display</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93042-0/93033-9\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93042-0/93033-9</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Are you worried about losing your housing?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93042-0/93033-9\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0100.png)\" id=\"item./93042-0/56799-0\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"String\" class=\"hierarchy\"/> /93042-0/56799-0</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Address</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)\" id=\"item./93041-2\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> /93041-2</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Money and resources</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93041-2/82589-3\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93041-2/82589-3</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Highest level of educ</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93041-2/82589-3\">4 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93041-2/67875-5\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93041-2/67875-5</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Employment status current</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93041-2/67875-5\">5 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93041-2/76437-3\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93041-2/76437-3</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Primary insurance</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93041-2/76437-3\">7 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93041-2/63586-2\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-decimal.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Decimal\" class=\"hierarchy\"/> /93041-2/63586-2</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">What was your best estimate of the total income of all family members from all sources, before taxes, in last year?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal\">decimal</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93041-2/93031-3\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93041-2/93031-3</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93041-2/93031-3\">8 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0100.png)\" id=\"item./93041-2/93030-5\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93041-2/93030-5</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93041-2/93030-5\">4 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)\" id=\"item./93040-4\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> /93040-4</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Social and emotional health</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item./93040-4/93029-7\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93040-4/93029-7</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93040-4/93029-7\">5 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0100.png)\" id=\"item./93040-4/93038-8\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93040-4/93038-8</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Stress is when someone feels tense, nervous, anxious or can't sleep at night because their mind is troubled. How stressed are you?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93040-4/93038-8\">6 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck001.png)\" id=\"item./93039-6\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> /93039-6</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Optional additional questions</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" id=\"item./93039-6/93028-9\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93039-6/93028-9</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93039-6/93028-9\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" id=\"item./93039-6/93027-1\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93039-6/93027-1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Are you a refugee?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93039-6/93027-1\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" id=\"item./93039-6/93026-3\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93039-6/93026-3</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Do you feel physically and emotionally safe where you currently live?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93039-6/93026-3\">4 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0000.png)\" id=\"item./93039-6/76501-6\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /93039-6/76501-6</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Within the last year, have you been afraid of your partner or ex-partner?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./93039-6/76501-6\">2 options</a></td></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table><hr/><p><b>Option Sets</b></p><a name=\"opt-item./93043-8/56051-6\"> </a><p><b>Answer options for /93043-8/56051-6</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 ("Yes")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 ("No")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93043-8/32624-9\"> </a><p><b>Answer options for /93043-8/32624-9</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA6156-9 ("Asian")</li><li style=\"font-size: 11px\">http://loinc.org#LA14045-1 ("Native Hawaiian")</li><li style=\"font-size: 11px\">http://loinc.org#LA30187-1 ("Pacific Islander")</li><li style=\"font-size: 11px\">http://loinc.org#LA14042-8 ("Black/African American")</li><li style=\"font-size: 11px\">http://loinc.org#LA4457-3 ("White")</li><li style=\"font-size: 11px\">http://loinc.org#LA4-4 ("American Indian/Alaskan Native")</li><li style=\"font-size: 11px\">http://loinc.org#LA46-8 ("Other")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93043-8/93035-4\"> </a><p><b>Answer options for /93043-8/93035-4</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 ("Yes")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 ("No")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93043-8/93034-7\"> </a><p><b>Answer options for /93043-8/93034-7</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 ("Yes")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 ("No")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93043-8/54899-0\"> </a><p><b>Answer options for /93043-8/54899-0</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA43-5 ("English")</li><li style=\"font-size: 11px\">http://loinc.org#LA30188-9 ("Language other than English")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93042-0/71802-3\"> </a><p><b>Answer options for /93042-0/71802-3</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA30189-7 ("I have housing")</li><li style=\"font-size: 11px\">http://loinc.org#LA30190-5 ("I do not have housing (staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, or in a park)")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93042-0/93033-9\"> </a><p><b>Answer options for /93042-0/93033-9</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 ("Yes")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 ("No")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93041-2/82589-3\"> </a><p><b>Answer options for /93041-2/82589-3</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA30191-3 ("Less than high school degree")</li><li style=\"font-size: 11px\">http://loinc.org#LA30192-1 ("High school diploma or GED")</li><li style=\"font-size: 11px\">http://loinc.org#LA30193-9 ("More than high school")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93041-2/67875-5\"> </a><p><b>Answer options for /93041-2/67875-5</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA17956-6 ("Unemployed")</li><li style=\"font-size: 11px\">http://loinc.org#LA30138-4 ("Part-time or temporary work")</li><li style=\"font-size: 11px\">http://loinc.org#LA30136-8 ("Full-time work")</li><li style=\"font-size: 11px\">http://loinc.org#LA30137-6 ("Otherwise unemployed but not seeking work (ex: student, retired, disabled, unpaid primary care giver)")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93041-2/76437-3\"> </a><p><b>Answer options for /93041-2/76437-3</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA30194-7 ("None/uninsured")</li><li style=\"font-size: 11px\">http://loinc.org#LA17849-3 ("Medicaid")</li><li style=\"font-size: 11px\">http://loinc.org#LA30195-4 ("CHIP Medicaid")</li><li style=\"font-size: 11px\">http://loinc.org#LA15652-3 ("Medicare")</li><li style=\"font-size: 11px\">http://loinc.org#LA30196-2 ("Other public insurance (not CHIP)")</li><li style=\"font-size: 11px\">http://loinc.org#LA30197-0 ("Other public insurance (CHIP)")</li><li style=\"font-size: 11px\">http://loinc.org#LA6350-8 ("Private insurance")</li></ul><a name=\"opt-item./93041-2/93031-3\"> </a><p><b>Answer options for /93041-2/93031-3</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA30125-1 ("Food")</li><li style=\"font-size: 11px\">http://loinc.org#LA30126-9 ("Clothing")</li><li style=\"font-size: 11px\">http://loinc.org#LA30124-4 ("Utilities")</li><li style=\"font-size: 11px\">http://loinc.org#LA30127-7 ("Child care")</li><li style=\"font-size: 11px\">http://loinc.org#LA30128-5 ("Medicine or Any Health Care (Medical, Dental, Mental Health, Vision)")</li><li style=\"font-size: 11px\">http://loinc.org#LA30129-3 ("Phone")</li><li style=\"font-size: 11px\">http://loinc.org#LA46-8 ("Other")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93041-2/93030-5\"> </a><p><b>Answer options for /93041-2/93030-5</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA30133-5 ("Yes, it has kept me from medical appointments or from getting my medications")</li><li style=\"font-size: 11px\">http://loinc.org#LA30134-3 ("Yes, it has kept me from non-medical meetings, appointments, work, or from getting things that I need")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 ("No")</li><li style=\"font-size: 11px\">http://loinc.org#LA30257-2 ("Patient unable to respond")</li></ul><a name=\"opt-item./93040-4/93029-7\"> </a><p><b>Answer options for /93040-4/93029-7</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA27722-0 ("Less than once a week")</li><li style=\"font-size: 11px\">http://loinc.org#LA30130-1 ("1 or 2 times a week")</li><li style=\"font-size: 11px\">http://loinc.org#LA30131-9 ("3 to 5 times a week")</li><li style=\"font-size: 11px\">http://loinc.org#LA30132-7 ("5 or more times a week")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93040-4/93038-8\"> </a><p><b>Answer options for /93040-4/93038-8</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA6568-5 ("Not at all")</li><li style=\"font-size: 11px\">http://loinc.org#LA13863-8 ("A little bit")</li><li style=\"font-size: 11px\">http://loinc.org#LA13909-9 ("Somewhat")</li><li style=\"font-size: 11px\">http://loinc.org#LA13902-4 ("Quite a bit")</li><li style=\"font-size: 11px\">http://loinc.org#LA13914-9 ("Very much")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93039-6/93028-9\"> </a><p><b>Answer options for /93039-6/93028-9</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 ("Yes")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 ("No")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93039-6/93027-1\"> </a><p><b>Answer options for /93039-6/93027-1</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 ("Yes")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 ("No")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93039-6/93026-3\"> </a><p><b>Answer options for /93039-6/93026-3</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 ("Yes")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 ("No")</li><li style=\"font-size: 11px\">http://loinc.org#LA14072-5 ("Unsure")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 ("I choose not to answer this question")</li></ul><a name=\"opt-item./93039-6/76501-6\"> </a><p><b>Answer options for /93039-6/76501-6</b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 ("Yes")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 ("No")</li></ul></div>"
},
"url" : "http://hl7.org/fhir/us/core/Questionnaire/prapare-example",
"identifier" : [
{
"system" : "urn:ietf:rfc:3986",
"value" : "urn:oid:2.16.840.1.113883.4.642.40.2.35.6"
}
],
"version" : "7.0.0",
"name" : "PRAPAREExample",
"title" : "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]",
"status" : "active",
"experimental" : true,
"date" : "2023-03-31",
"publisher" : "HL7 International / Cross-Group Projects",
"contact" : [
{
"name" : "HL7 International / Cross-Group Projects",
"telecom" : [
{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/cgp"
},
{
"system" : "email",
"value" : "cgp@lists.HL7.org"
}
]
}
],
"useContext" : [
{
"code" : {
"system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code" : "focus"
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/core/CodeSystem/us-core-category",
"code" : "sdoh"
}
]
}
}
],
"jurisdiction" : [
{
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "US"
}
]
}
],
"copyright" : "Used by permission of HL7 International, all rights reserved Creative Commons License",
"code" : [
{
"system" : "http://loinc.org",
"code" : "93025-5",
"display" : "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
}
],
"item" : [
{
"linkId" : "/93025-5",
"text" : "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]",
"type" : "group",
"required" : false,
"item" : [
{
"linkId" : "/93043-8",
"code" : [
{
"system" : "http://loinc.org",
"code" : "93043-8",
"display" : "Personal characteristics [PRAPARE]"
}
],
"text" : "Personal characteristics",
"type" : "group",
"required" : false,
"item" : [
{
"linkId" : "/93043-8/56051-6",
"code" : [
{
"system" : "http://loinc.org",
"code" : "56051-6",
"display" : "Do you consider yourself Hispanic/Latino?"
}
],
"text" : "Do you consider yourself Hispanic/Latino?",
"type" : "choice",
"required" : false,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA33-6",
"display" : "Yes"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA32-8",
"display" : "No"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30122-8",
"display" : "I choose not to answer this question"
}
}
]
},
{
"linkId" : "/93043-8/32624-9",
"code" : [
{
"system" : "http://loinc.org",
"code" : "32624-9",
"display" : "Race"
}
],
"text" : "Race",
"type" : "choice",
"required" : false,
"repeats" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA6156-9",
"display" : "Asian"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA14045-1",
"display" : "Native Hawaiian"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30187-1",
"display" : "Pacific Islander"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA14042-8",
"display" : "Black/African American"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA4457-3",
"display" : "White"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA4-4",
"display" : "American Indian/Alaskan Native"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA46-8",
"display" : "Other"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30122-8",
"display" : "I choose not to answer this question"
}
}
]
},
{
"linkId" : "/93043-8/93035-4",
"code" : [
{
"system" : "http://loinc.org",
"code" : "93035-4",
"display" : "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?"
}
],
"text" : "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?",
"type" : "choice",
"required" : false,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA33-6",
"display" : "Yes"
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},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA32-8",
"display" : "No"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30122-8",
"display" : "I choose not to answer this question"
}
}
]
},
{
"linkId" : "/93043-8/93034-7",
"code" : [
{
"system" : "http://loinc.org",
"code" : "93034-7",
"display" : "Have you been discharged from the armed forces of the United States?"
}
],
"text" : "Have you been discharged from the armed forces of the United States?",
"type" : "choice",
"required" : false,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA33-6",
"display" : "Yes"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA32-8",
"display" : "No"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30122-8",
"display" : "I choose not to answer this question"
}
}
]
},
{
"linkId" : "/93043-8/54899-0",
"code" : [
{
"system" : "http://loinc.org",
"code" : "54899-0",
"display" : "Preferred language"
}
],
"text" : "Preferred language",
"type" : "choice",
"required" : false,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA43-5",
"display" : "English"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30188-9",
"display" : "Language other than English"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30122-8",
"display" : "I choose not to answer this question"
}
}
]
}
]
},
{
"linkId" : "/93042-0",
"code" : [
{
"system" : "http://loinc.org",
"code" : "93042-0",
"display" : "Family and home [PRAPARE]"
}
],
"text" : "Family and home",
"type" : "group",
"required" : false,
"item" : [
{
"linkId" : "/93042-0/63512-8",
"code" : [
{
"system" : "http://loinc.org",
"code" : "63512-8",
"display" : "How many people are living or staying at this address?"
}
],
"text" : "How many people are living or staying at this address?",
"type" : "integer",
"required" : false
},
{
"linkId" : "/93042-0/71802-3",
"code" : [
{
"system" : "http://loinc.org",
"code" : "71802-3",
"display" : "Housing status"
}
],
"text" : "Housing status",
"type" : "choice",
"required" : false,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30189-7",
"display" : "I have housing"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30190-5",
"display" : "I do not have housing (staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, or in a park)"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30122-8",
"display" : "I choose not to answer this question"
}
}
],
"item" : [
{
"linkId" : "/93042-0/71802-3-help",
"text" : "Describes patients living arrangement",
"type" : "display"
}
]
},
{
"linkId" : "/93042-0/93033-9",
"code" : [
{
"system" : "http://loinc.org",
"code" : "93033-9",
"display" : "Are you worried about losing your housing?"
}
],
"text" : "Are you worried about losing your housing?",
"type" : "choice",
"required" : false,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA33-6",
"display" : "Yes"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA32-8",
"display" : "No"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30122-8",
"display" : "I choose not to answer this question"
}
}
]
},
{
"linkId" : "/93042-0/56799-0",
"code" : [
{
"system" : "http://loinc.org",
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}
],
"text" : "Address",
"type" : "string",
"required" : false
}
]
},
{
"linkId" : "/93041-2",
"code" : [
{
"system" : "http://loinc.org",
"code" : "93041-2",
"display" : "Money and resources [PRAPARE]"
}
],
"text" : "Money and resources",
"type" : "group",
"required" : false,
"item" : [
{
"linkId" : "/93041-2/82589-3",
"code" : [
{
"system" : "http://loinc.org",
"code" : "82589-3",
"display" : "Highest level of educ"
}
],
"text" : "Highest level of educ",
"type" : "choice",
"required" : false,
"answerOption" : [
{
"valueCoding" : {
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"code" : "LA30191-3",
"display" : "Less than high school degree"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30192-1",
"display" : "High school diploma or GED"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30193-9",
"display" : "More than high school"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30122-8",
"display" : "I choose not to answer this question"
}
}
]
},
{
"linkId" : "/93041-2/67875-5",
"code" : [
{
"system" : "http://loinc.org",
"code" : "67875-5",
"display" : "Employment status current"
}
],
"text" : "Employment status current",
"type" : "choice",
"required" : false,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA17956-6",
"display" : "Unemployed"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30138-4",
"display" : "Part-time or temporary work"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30136-8",
"display" : "Full-time work"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30137-6",
"display" : "Otherwise unemployed but not seeking work (ex: student, retired, disabled, unpaid primary care giver)"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30122-8",
"display" : "I choose not to answer this question"
}
}
]
},
{
"linkId" : "/93041-2/76437-3",
"code" : [
{
"system" : "http://loinc.org",
"code" : "76437-3",
"display" : "Primary insurance"
}
],
"text" : "Primary insurance",
"type" : "choice",
"required" : false,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30194-7",
"display" : "None/uninsured"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA17849-3",
"display" : "Medicaid"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30195-4",
"display" : "CHIP Medicaid"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA15652-3",
"display" : "Medicare"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30196-2",
"display" : "Other public insurance (not CHIP)"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30197-0",
"display" : "Other public insurance (CHIP)"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA6350-8",
"display" : "Private insurance"
}
}
]
},
{
"linkId" : "/93041-2/63586-2",
"code" : [
{
"system" : "http://loinc.org",
"code" : "63586-2",
"display" : "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?"
}
],
"text" : "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?",
"type" : "decimal",
"required" : false
},
{
"linkId" : "/93041-2/93031-3",
"code" : [
{
"system" : "http://loinc.org",
"code" : "93031-3",
"display" : "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?"
}
],
"text" : "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?",
"type" : "choice",
"required" : false,
"repeats" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30125-1",
"display" : "Food"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30126-9",
"display" : "Clothing"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30124-4",
"display" : "Utilities"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30127-7",
"display" : "Child care"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30128-5",
"display" : "Medicine or Any Health Care (Medical, Dental, Mental Health, Vision)"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30129-3",
"display" : "Phone"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA46-8",
"display" : "Other"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30122-8",
"display" : "I choose not to answer this question"
}
}
]
},
{
"linkId" : "/93041-2/93030-5",
"code" : [
{
"system" : "http://loinc.org",
"code" : "93030-5",
"display" : "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
}
],
"text" : "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living",
"type" : "choice",
"required" : false,
"repeats" : true,
"answerOption" : [
{
"extension" : [
{
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"valueString" : "A"
}
],
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30133-5",
"display" : "Yes, it has kept me from medical appointments or from getting my medications"
}
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix",
"valueString" : "B"
}
],
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30134-3",
"display" : "Yes, it has kept me from non-medical meetings, appointments, work, or from getting things that I need"
}
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix",
"valueString" : "C"
}
],
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA32-8",
"display" : "No"
}
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix",
"valueString" : "X"
}
],
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30257-2",
"display" : "Patient unable to respond"
}
}
]
}
]
},
{
"linkId" : "/93040-4",
"code" : [
{
"system" : "http://loinc.org",
"code" : "93040-4",
"display" : "Social and emotional health [PRAPARE]"
}
],
"text" : "Social and emotional health",
"type" : "group",
"required" : false,
"item" : [
{
"linkId" : "/93040-4/93029-7",
"code" : [
{
"system" : "http://loinc.org",
"code" : "93029-7",
"display" : "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?"
}
],
"text" : "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?",
"type" : "choice",
"required" : false,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA27722-0",
"display" : "Less than once a week"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30130-1",
"display" : "1 or 2 times a week"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30131-9",
"display" : "3 to 5 times a week"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30132-7",
"display" : "5 or more times a week"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30122-8",
"display" : "I choose not to answer this question"
}
}
]
},
{
"linkId" : "/93040-4/93038-8",
"code" : [
{
"system" : "http://loinc.org",
"code" : "93038-8",
"display" : "Stress level"
}
],
"text" : "Stress is when someone feels tense, nervous, anxious or can't sleep at night because their mind is troubled. How stressed are you?",
"type" : "choice",
"required" : false,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA6568-5",
"display" : "Not at all"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA13863-8",
"display" : "A little bit"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA13909-9",
"display" : "Somewhat"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA13902-4",
"display" : "Quite a bit"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA13914-9",
"display" : "Very much"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30122-8",
"display" : "I choose not to answer this question"
}
}
]
}
]
},
{
"linkId" : "/93039-6",
"code" : [
{
"system" : "http://loinc.org",
"code" : "93039-6",
"display" : "Optional additional questions [PRAPARE]"
}
],
"text" : "Optional additional questions",
"type" : "group",
"required" : false,
"item" : [
{
"linkId" : "/93039-6/93028-9",
"code" : [
{
"system" : "http://loinc.org",
"code" : "93028-9",
"display" : "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?"
}
],
"text" : "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?",
"type" : "choice",
"required" : false,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA33-6",
"display" : "Yes"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA32-8",
"display" : "No"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30122-8",
"display" : "I choose not to answer this question"
}
}
]
},
{
"linkId" : "/93039-6/93027-1",
"code" : [
{
"system" : "http://loinc.org",
"code" : "93027-1",
"display" : "Are you a refugee?"
}
],
"text" : "Are you a refugee?",
"type" : "choice",
"required" : false,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA33-6",
"display" : "Yes"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA32-8",
"display" : "No"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30122-8",
"display" : "I choose not to answer this question"
}
}
]
},
{
"linkId" : "/93039-6/93026-3",
"code" : [
{
"system" : "http://loinc.org",
"code" : "93026-3",
"display" : "Do you feel physically and emotionally safe where you currently live?"
}
],
"text" : "Do you feel physically and emotionally safe where you currently live?",
"type" : "choice",
"required" : false,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA33-6",
"display" : "Yes"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA32-8",
"display" : "No"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA14072-5",
"display" : "Unsure"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA30122-8",
"display" : "I choose not to answer this question"
}
}
]
},
{
"linkId" : "/93039-6/76501-6",
"code" : [
{
"system" : "http://loinc.org",
"code" : "76501-6",
"display" : "Within the last year, have you been afraid of your partner or ex-partner?"
}
],
"text" : "Within the last year, have you been afraid of your partner or ex-partner?",
"type" : "choice",
"required" : false,
"answerOption" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix",
"valueString" : "1"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal" : 1
}
],
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA33-6",
"display" : "Yes"
}
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix",
"valueString" : "0"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal" : 0
}
],
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA32-8",
"display" : "No"
}
}
]
}
]
}
]
}
]
}
IG © 2024+ HL7 International / Cross-Group Projects. Package hl7.fhir.us.core#7.0.0 based on FHIR 4.0.1. Generated 2024-05-08
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