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 Questionnaire: questionnaire1

Page standards status: Informative
LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. Questionnaire1Questionnairehttp://hl7.org/fhir/us/eltss/Questionnaire/questionnaire1#2.0.0
... q1Did you choose the setting in which you reside?0..1boolean
... q2What alternative home and community-based settings were considered?0..1string
... q3Were you given a choice of services outlined in the plan?0..1boolean
... q4Did you participate in the selection of services outlined in the plan?0..1boolean
... q5Do you agree to the services outlined in the plan?0..1boolean
... q6Were you offered a choice of providers for each service?0..1boolean
... q7Do you feel you made an informed choice in selecting the provider for each service?0..1boolean

doco Documentation for this format