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Source1

{
  "resourceType": "QuestionnaireResponse",
  "id": "clinical-questionnaire-example",
  "meta": {
    "profile": [
      "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-mha-profile-QuestionnaireResponse"
    ]
  },
  "questionnaire": "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-mha-clinical-summary-questionnaire-template",
  "status": "completed",
  "subject": {
    "reference": "urn:uuid:a3fb7d98-a471-42fa-ae94-d655f2393cc0"
  },
  "authored": "2024-03-05T09:30:00-05:00",
  "item": [
    {
      "linkId": "Q1",
      "text": "Symptoms of Clinical Concern",
      "answer": [
        {
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "48694002",
            "display": "Anxiety"
          }
        },
        {
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "225021007",
            "display": "Abnormal grief reaction"
          }
        }
      ]
    },
    {
      "linkId": "Q2",
      "text": "Behavioural Addictions and/or Problematic Substance Use",
      "answer": [
        {
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "18085000",
            "display": "Compulsive gambling"
          }
        },
        {
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "74851005",
            "display": "Hallucinogen abuse"
          }
        }
      ]
    },
    {
      "linkId": "Q3",
      "text": "Other Reasons for Seeking Service",
      "answer": [
        {
          "valueCoding": {
            "system": "http://ontariohealth.ca/fhir/CodeSystem/help-seeking-reason",
            "code": "housing-p",
            "display": "Housing Problems"
          }
        },
        {
          "valueCoding": {
            "system": "http://ontariohealth.ca/fhir/CodeSystem/help-seeking-reason",
            "code": "economic-p",
            "display": "Economic Problems"
          }
        }
      ]
    },
    {
      "linkId": "Q4",
      "text": "Prescribed pharmacotherapy or anti-craving medication for alcohol use disorder",
      "item": [
        {
          "linkId": "Q4-a",
          "text": "Are you receiving prescribed pharmacotherapy or anti-craving medication for alcohol use disorder?",
          "answer": [
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "373066001",
                "display": "Yes"
              }
            }
          ]
        },
        {
          "linkId": "Q4-b",
          "text": "What anti-craving medication prescribed?",
          "answer": [
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "373546002",
                "display": "Naltrexone"
              }
            }
          ]
        }
      ]
    },
    {
      "linkId": "Q5",
      "text": "Prescribed pharmacotherapy or Opioid agonist therapy for Opioid Use Disorder",
      "item": [
        {
          "linkId": "Q5-a",
          "text": "Are you receiving prescribed pharmacotherapy or Opioid agonist therapy for Opioid Use Disorder?",
          "answer": [
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "373066001",
                "display": "Yes"
              }
            }
          ]
        },
        {
          "linkId": "Q5-b",
          "text": "What opioid Agonist therapy is prescribed?",
          "answer": [
            {
              "valueCoding": {
                "system": "http://ontariohealth.ca/fhir/CodeSystem/opioid-agonist-medication",
                "code": "c",
                "display": "Methadone"
              }
            }
          ]
        }
      ]
    },
    {
      "linkId": "Q6",
      "text": "Gambing Problem Identified",
      "answer": [
        {
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "373066001",
            "display": "Yes"
          }
        }
      ]
    },
    {
      "linkId": "Q7",
      "text": "Reason for Non-completion of Gambling Data Form",
      "answer": [
        {
          "valueCoding": {
            "system": "http://ontariohealth.ca/fhir/CodeSystem/gambling-form-non-completion-reason",
            "code": "declined",
            "display": "Client declined treatment"
          }
        }
      ]
    },
    {
      "linkId": "Q8",
      "text": "Gambling Treatment Plan Status",
      "answer": [
        {
          "valueCoding": {
            "system": "http://ontariohealth.ca/fhir/CodeSystem/gambling-treatment-plan-status",
            "code": "treated",
            "display": "Treated within this agency"
          }
        }
      ]
    }
  ]
}