Electronic Long-Term Services and Supports (eLTSS) Release 1 - US Realm
2.0.0 - STU2 United States of America flag

This page is part of the electronic Long-Term Services and Supports Implementation Guide (v2.0.0: STU2) 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

Example Contract: contract1

Page standards status: Informative

Generated Narrative: Contract

ResourceContract "contract1" Version"1" Updated"2020-09-03 10:16:03-0400"

Information Source: #KZ0jzPjXDrhCiMif!

Profile: Contract_eltss

signer

type: Patient (Details: Contract Signer Type Codes code PAT = ' Patient ', stated as ' null ')

party: Patient/patientBSJ1 " SMITH-JOHNSON"

Signatures

-TypeWhenWhoData
*Consent Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.7 = ' Consent Signature ', stated as ' null ')Apr 2, 2020, 3:00:00 AMPatient/patientBSJ1 " SMITH-JOHNSON"(base64 data - 187 bytes)

signer

type: Guardian (Details: Contract Signer Type Codes code GUARD = ' Guardian ', stated as ' null ')

party: RelatedPerson/guardian1 " CHARLES"

Signatures

-TypeWhenWhoData
*Consent Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.7 = ' Consent Signature ', stated as ' null ')Apr 2, 2020, 3:00:00 AMRelatedPerson/guardian1 " CHARLES"(base64 data - 187 bytes)

signer

type: Author (Details: Contract Signer Type Codes code AUT = ' Author ', stated as ' null ')

party: Practitioner/planner1 " PLANNER"

Signatures

-TypeWhenWhoData
*Author's Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.1 = ' Author's Signature ', stated as ' null ')Apr 2, 2020, 3:00:00 AMPractitioner/planner1 " PLANNER"(base64 data - 187 bytes)

signer

type: Co-Author (Details: Contract Signer Type Codes code COAUTH = ' Co-Author ', stated as ' null ')

party: Practitioner/caremgr1 " MONITOR"

Signatures

-TypeWhenWhoData
*Author's Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.1 = ' Author's Signature ', stated as ' null ')Apr 2, 2020, 3:00:00 AMPractitioner/caremgr1 " MONITOR"(base64 data - 187 bytes)

signer

type: Healthcare Provider (Details: Contract Signer Type Codes code HPROV = ' Healthcare Provider ', stated as ' null ')

party: Practitioner/provider3 " EDUCATOR"

Signatures

-TypeWhenWhoData
*Consent Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.7 = ' Consent Signature ', stated as ' null ')Apr 2, 2020, 3:00:00 AMPractitioner/provider3 " EDUCATOR"(base64 data - 187 bytes)

signer

type: Healthcare Provider (Details: Contract Signer Type Codes code HPROV = ' Healthcare Provider ', stated as ' null ')

party: Practitioner/provider2b " DRIVER"

Signatures

-TypeWhenWhoData
*Consent Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.7 = ' Consent Signature ', stated as ' null ')Apr 2, 2020, 3:00:00 AMPractitioner/provider2b " DRIVER"(base64 data - 187 bytes)

signer

type: Healthcare Provider (Details: Contract Signer Type Codes code HPROV = ' Healthcare Provider ', stated as ' null ')

party: RelatedPerson/son1 " CHARLES"

Signatures

-TypeWhenWhoData
*Consent Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.7 = ' Consent Signature ', stated as ' null ')Apr 2, 2020, 3:00:00 AMRelatedPerson/son1 " CHARLES"(base64 data - 187 bytes)

signer

type: Healthcare Provider (Details: Contract Signer Type Codes code HPROV = ' Healthcare Provider ', stated as ' null ')

party: Practitioner/provider4 " TRAINER"

Signatures

-TypeWhenWhoData
*Consent Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.7 = ' Consent Signature ', stated as ' null ')Apr 2, 2020, 3:00:00 AMPractitioner/provider4 " TRAINER"(base64 data - 187 bytes)