2nd DSTU Draft For Comment

This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Questionnaire-example-f201-lifelines.xml

Raw XML (canonical form)

Real-world lifelines questionnaire (fictively taken from the patient) (id = "f201")

Raw XML

<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="f201"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><!-- Snipped for brevity --></div>
  </text>
  <identifier>
    <use value="temp"/>
    <label value="Roel's VL 1-1, 18-65_1.2.2"/>
  </identifier>
  <status value="published"/>
  <date value="2010"/>
  <group>
    <concept>
      <system value="http://example.org/system/code/lifelines/nl"/>
      <code value="VL 1-1, 18-65_1.2.2"/>
      <display value="Lifelines Questionnaire 1 part 1"/>
    </concept>
    <group>
      <question><!--   Separate answer   -->
        <text value="Do you have allergies?"/>
      </question>
    </group>
    <group><!--   Answers to general questions   -->
      <text value="General questions"/>
      <question>
        <text value="What is your gender?"/>
      </question>
      <question>
        <text value="What is your date of birth?"/>
      </question>
      <question>
        <text value="What is your country of birth?"/>
      </question>
      <question>
        <text value="What is your marital status?"/>
      </question>
    </group>
    <group><!--   Answers to intoxications   -->
      <title value="Intoxications"/>
      <question>
        <text value="Do you smoke?"/>
      </question>
      <question>
        <text value="Do you drink alchohol?"/>
      </question>
    </group>
  </group>
</Questionnaire>

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.