XIG: Questionnaire/order-referral-form

FHIR IG Statistics: Questionnaire/order-referral-form

Package	ch.fhir.ig.ch-orf
Resource Type	Questionnaire
Id	order-referral-form
FHIR Version	R4
Source	http://fhir.ch/ig/ch-orf/https://build.fhir.org/ig/hl7ch/ch-orf/Questionnaire-order-referral-form.html
URL	http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form
Version	3.0.2-ci-build
Status	active
Date	2022-07-07
Name	OrderReferralForm
Title	Order Referral Form
Realm	ch
Authority	hl7
Copyright	CC0-1.0

Resources that use this resource

No resources found

Resources that this resource uses

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Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: Questionnaire order-referral-form

Language: de-CH

Profiles: CH ORF Questionnaire, SDCBaseQuestionnaire, Extractable Questionnaire - StructureMap, Populatable Questionnaire - Expression

Structure

LinkID	Text	Cardinality	Type	Description & Constraints
OrderReferralForm			Questionnaire	http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form#3.0.2-ci-build
order	Auftrag	1..1	group
order.authoredOn	Datum/Zeit der Auftragserteilung	0..1	dateTime	Definition: ServiceRequest.authoredOn
order.placerOrderIdentifier	Auftragsnummer des Auftraggebers	0..1	string	Definition: ServiceRequest.identifier
order.placerOrderIdentifierDomain	Identifier Domain der Auftragsnummer des Auftraggebers	0..1	string	Definition: ServiceRequest.identifier
order.fillerOrderIdentifier	Auftragsnummer des Auftragsempfängers	0..1	string	Definition: ServiceRequest.identifier
order.fillerOrderIdentifierDomain	Identifier Domain der Auftragsnummer des Auftragsempfängers	0..1	string	Definition: ServiceRequest.identifier
order.precedentDocumentIdentifier	Identifier des Vorgängerdokuments	0..1	string	Definition: Composition.extension
order.notificationContactDocument	Dringender Benachrichtigungskontakt für dieses Dokument	0..1	group	Definition: Composition.extension
order.notificationContactDocument.practitioner	Zu benachrichtigende Person	0..1	group	Definition: PractitionerRole.practitioner
order.notificationContactDocument.practitioner.title	Titel	0..1	string	Definition: Practitioner.name.prefix
order.notificationContactDocument.practitioner.familyName	Name	0..1	string	Definition: Practitioner.name.family
order.notificationContactDocument.practitioner.givenName	Vorname	0..1	string	Definition: Practitioner.name.given
order.notificationContactDocument.practitioner.phone	Telefon	0..1	string	Definition: Practitioner.telecom.value
order.notificationContactDocument.practitioner.email	E-Mail	0..1	string	Definition: Practitioner.telecom.value
order.notificationContactDocumentResponse	Dringender Benachrichtigungskontakt für die Antwort auf dieses Dokument	0..1	group	Definition: Composition.extension
order.notificationContactDocumentResponse.practitioner	Zu benachrichtigende Person	0..1	group	Definition: PractitionerRole.practitioner
order.notificationContactDocumentResponse.practitioner.title	Titel	0..1	string	Definition: Practitioner.name.prefix
order.notificationContactDocumentResponse.practitioner.familyName	Name	0..1	string	Definition: Practitioner.name.family
order.notificationContactDocumentResponse.practitioner.givenName	Vorname	0..1	string	Definition: Practitioner.name.given
order.notificationContactDocumentResponse.practitioner.phone	Telefon	0..1	string	Definition: Practitioner.telecom.value
order.notificationContactDocumentResponse.practitioner.email	E-Mail	0..1	string	Definition: Practitioner.telecom.value
order.priority	Auftragspriorität	0..1	choice	Definition: ServiceRequest.priority Options: 4 options
receiver	Empfänger	0..1	group	Definition: Composition.extension
receiver.practitioner	Empfangende Person	0..1	group	Definition: PractitionerRole.practitioner
receiver.practitioner.title	Titel	0..1	string	Definition: Practitioner.name.prefix
receiver.practitioner.familyName	Name	0..1	string	Definition: Practitioner.name.family
receiver.practitioner.givenName	Vorname	0..1	string	Definition: Practitioner.name.given
receiver.practitioner.gln	GLN	0..1	string	Definition: Practitioner.identifier:GLN.value
receiver.practitioner.zsr	ZSR (fr/it: RCC)	0..1	string	Definition: Practitioner.identifier:ZSR.value
receiver.practitioner.phone	Telefon	0..1	string	Definition: Practitioner.telecom.value
receiver.practitioner.email	E-Mail	0..1	string	Definition: Practitioner.telecom.value
receiver.organization	Empfangende Organisation	0..1	group	Definition: PractitionerRole.organization
receiver.organization.name	Name der Organisation	0..1	string	Definition: Organization.name
receiver.organization.gln	GLN	0..1	string	Definition: Organization.identifier:GLN
receiver.organization.streetAddressLine	Strasse, Hausnummer, Postfach etc.	0..*	string
receiver.organization.postalCode	PLZ	0..1	string
receiver.organization.city	Ort	0..1	string
receiver.organization.country	Land	0..1	string
initiator	Initiant dieser Anmeldung	0..1	group	Definition: Composition.extension
initiator.legalrelation	Juristische Beziehung zum Patienten	0..1	choice	Definition: Extension.extension Options: 2 options
initiator.personalrelation	Persönliche Beziehung zum Patienten?	0..1	choice	Definition: Extension.extension Options: 10 options
initiator.practitionerRole	Gesundheitsfachperson oder -organisation	0..1	group	Definition: PractitionerRole.practitioner
initiator.practitionerRole.practitioner	Gesundheitsfachperson	0..1	group	Definition: PractitionerRole.practitioner
initiator.practitionerRole.practitioner.title	Titel	0..1	string	Definition: Practitioner.name.prefix
initiator.practitionerRole.practitioner.familyName	Name	0..1	string	Definition: Practitioner.name.family
initiator.practitionerRole.practitioner.givenName	Vorname	0..1	string	Definition: Practitioner.name.given
initiator.practitionerRole.practitioner.phone	Telefon	0..1	string	Definition: Practitioner.telecom.value
initiator.practitionerRole.practitioner.email	E-Mail	0..1	string	Definition: Practitioner.telecom.value
initiator.practitionerRole.organization	Gesundheitsorganisatiton	0..1	group	Definition: PractitionerRole.organization
initiator.practitionerRole.organization.name	Name der Organisation	0..1	string	Definition: Organization.name
initiator.practitionerRole.organization.streetAddressLine	Strasse, Hausnummer, Postfach etc.	0..*	string
initiator.practitionerRole.organization.postalCode	PLZ	0..1	string
initiator.practitionerRole.organization.city	Ort	0..1	string
initiator.practitionerRole.organization.country	Land	0..1	string
initiator.relatedPerson	Andere Person	0..1	group	Definition: RelatedPerson
initiator.relatedPerson.familyName	Name	0..1	string	Definition: RelatedPerson.name.family
initiator.relatedPerson.givenName	Vorname	0..1	string	Definition: RelatedPerson.name.given
initiator.relatedPerson.phone	Telefon	0..*	string	Definition: RelatedPerson.telecom.value
initiator.relatedPerson.email	E-Mail	0..1	string	Definition: RelatedPerson.telecom.value
initiator.relatedPerson.streetAddressLine	Strasse, Hausnummer, Postfach etc.	0..*	string
initiator.relatedPerson.postalCode	PLZ	0..1	string
initiator.relatedPerson.city	Ort	0..1	string
initiator.relatedPerson.country	Land	0..1	string
patient	Patient	1..1	group	Definition: Composition.subject
patient.familyName	Name	0..1	string	Definition: Patient.name.family
patient.maidenName	Ledigname	0..1	string	Definition: Patient.name.family
patient.givenName	Vorname	0..1	string	Definition: Patient.name.given
patient.localPid	Lokale Patienten-ID	0..1	string	Definition: Patient.identifier:LocalPid.value
patient.localPidDomain	Lokale Patienten-ID Domain	0..1	string	Definition: Patient.identifier:LocalPid.system
patient.birthDate	Geburtsdatum	0..1	date	Definition: Patient.birthDate
patient.gender	Geschlecht	0..1	choice	Definition: Patient.gender Options: 3 options
patient.maritalStatus	Zivilstand	0..1	choice	Definition: Patient.maritalStatus Options: 8 options
patient.phone	Telefon	0..*	string	Definition: Patient.telecom.value
patient.email	E-Mail	0..1	string	Definition: Patient.telecom.value
patient.streetAddressLine	Strasse, Hausnummer, Postfach etc.	0..*	string
patient.postalCode	PLZ	0..1	string
patient.city	Ort	0..1	string
patient.country	Land	0..1	string
patient.languageOfCorrespondence	Korrespondenzsprache	0..1	choice	Definition: Patient.communication:languageOfCorrespondence Value Set: DocumentEntry.languageCode
patient.contactperson	Kontaktperson	0..*	group	Definition: Patient.contact
patient.contactperson.relationship	Beziehung	0..1	string	Definition: Patient.contact.relationship.text
patient.contactperson.familyName	Name	0..1	string	Definition: Patient.contact.name.family
patient.contactperson.givenName	Vorname	0..1	string	Definition: Patient.contact.name.given
patient.contactperson.phone	Telefon	0..*	string	Definition: Patient.contact.telecom.value
patient.contactperson.email	E-Mail	0..1	string	Definition: Patient.contact.telecom.value
familydoctor	Hausarzt	0..1	group	Definition: Patient.generalPractitioner
familydoctor.practitioner	Hausarzt Person	0..1	group	Definition: PractitionerRole.practitioner
familydoctor.practitioner.title	Titel	0..1	string	Definition: Practitioner.name.prefix
familydoctor.practitioner.familyName	Name	0..1	string	Definition: Practitioner.name.family
familydoctor.practitioner.givenName	Vorname	0..1	string	Definition: Practitioner.name.given
familydoctor.practitioner.gln	GLN	0..1	string	Definition: Practitioner.identifier:GLN.value
familydoctor.practitioner.zsr	ZSR (fr/it: RCC)	0..1	string	Definition: Practitioner.identifier:ZSR.value
familydoctor.practitioner.phone	Telefon	0..1	string	Definition: Practitioner.telecom.value
familydoctor.practitioner.email	E-Mail	0..1	string	Definition: Practitioner.telecom.value
familydoctor.organization	Hausarzt Organisation	0..1	group	Definition: PractitionerRole.organization
familydoctor.organization.name	Name der Organisation	0..1	string	Definition: Organization.name
familydoctor.organization.gln	GLN	0..1	string	Definition: Organization.identifier:GLN
familydoctor.organization.streetAddressLine	Strasse, Hausnummer, Postfach etc.	0..*	string
familydoctor.organization.postalCode	PLZ	0..1	string
familydoctor.organization.city	Ort	0..1	string
familydoctor.organization.country	Land	0..1	string
requestedEncounter	Patientenaufnahme	0..1	group	Definition: ServiceRequest.extension
requestedEncounter.class	Voraussichtlich: Ambulant / Stationär / Notfall	0..1	choice	Definition: Encounter.class Options: 3 options
requestedEncounter.desiredAccommodation	Zimmerkategorie	0..1	choice	Definition: Encounter.extension Options: 3 options
coverage	Kostenträger	0..1	group	Definition: ServiceRequest.insurance
coverage.beneficiary	Begünstigter (Patient)	0..1	group	Definition: Coverage.beneficiary
coverage.beneficiary.ahvn13	AHV-Nr. des Patienten (fr/it: AVS)	0..1	string	Definition: Patient.identifier:AHVN13
coverage.kvg	Krankenkasse nach KVG (fr/it: LAMal)	0..1	group	Definition: Coverage.type
coverage.kvg.name	Name der Versicherung	0..1	string	Definition: Coverage.payor
coverage.kvg.insuranceCardNumber	Kennnummer der Versichertenkarte	0..1	string	Definition: Coverage.identifier
coverage.uvg	Unfallversicherung nach UVG (fr: LAA, it: LAINF)	0..1	group	Definition: Coverage.type
coverage.uvg.name	Name der Versicherung	0..1	string	Definition: Coverage.payor
coverage.uvg.claimNumber	Schadennummer	0..1	string	Definition: Coverage.identifier
coverage.vvg	Zusatzversicherung nach VVG (fr/it: LCA)	0..1	group	Definition: Coverage.type
coverage.vvg.name	Name der Versicherung	0..1	string	Definition: Coverage.payor
coverage.vvg.insuranceCardNumber	Kennnummer der Versichertenkarte	0..1	string	Definition: Coverage.identifier
coverage.iv	Invalidenversicherung IV (fr/it: AI)	0..1	group	Definition: Coverage.type
coverage.iv.verfuegungsnummer	IV-Verfügungsnummer	0..1	string	Definition: Coverage.identifier
coverage.mv	Militärversicherung MV (fr/it: AM)	0..1	group	Definition: Coverage.type
coverage.mv.versichertennummer	MV-Versichertennummer	0..1	string	Definition: Coverage.identifier
coverage.self	Selbstzahler	0..1	group	Definition: Coverage.type
coverage.self.patient	Patient selbst	0..1	boolean	Definition: Coverage.payor
coverage.self.patientRelatedPerson	Andere Person	0..1	boolean	Definition: Coverage.payor Enable When: coverage.self.patient =
coverage.self.relatedPerson	Andere Person	0..1	group	Definition: Coverage.payor Enable When: coverage.self.patientRelatedPerson =
coverage.self.relatedPerson.familyName	Name	0..1	string	Definition: RelatedPerson.name.family
coverage.self.relatedPerson.givenName	Vorname	0..1	string	Definition: RelatedPerson.name.given
coverage.self.relatedPerson.phone	Telefon	0..*	string	Definition: RelatedPerson.telecom.value
coverage.self.relatedPerson.email	E-Mail	0..1	string	Definition: RelatedPerson.telecom.value
coverage.self.relatedPerson.streetAddressLine	Strasse, Hausnummer, Postfach etc.	0..*	string
coverage.self.relatedPerson.postalCode	PLZ	0..1	string
coverage.self.relatedPerson.city	Ort	0..1	string
coverage.self.relatedPerson.country	Land	0..1	string
coverage.other	Anderer Kostenträger	0..1	group	Definition: Coverage.type
coverage.other.name	Name des Kostenträgers	0..1	string	Definition: Coverage.payor
coverage.other.id	Beliebige ID	0..1	string	Definition: Coverage.identifier
coverage.other.id.note	Bemerkung zur ID	0..1	string	Definition: Coverage.identifier.type.text
sender	Absender	1..1	group
sender.author	Verantwortlicher	1..1	group	Definition: Composition.author
sender.author.practitioner	Verantwortliche Person	0..1	group	Definition: PractitionerRole.practitioner
sender.author.practitioner.title	Titel	0..1	string	Definition: Practitioner.name.prefix
sender.author.practitioner.familyName	Name	0..1	string	Definition: Practitioner.name.family
sender.author.practitioner.givenName	Vorname	0..1	string	Definition: Practitioner.name.given
sender.author.practitioner.gln	GLN	0..1	string	Definition: Practitioner.identifier:GLN.value
sender.author.practitioner.zsr	ZSR (fr/it: RCC)	0..1	string	Definition: Practitioner.identifier:ZSR.value
sender.author.practitioner.phone	Telefon	0..1	string	Definition: Practitioner.telecom.value
sender.author.practitioner.email	E-Mail	0..1	string	Definition: Practitioner.telecom.value
sender.author.organization	Verantwortliche Organisation	0..1	group	Definition: PractitionerRole.organization
sender.author.organization.name	Name der Organisation	0..1	string	Definition: Organization.name
sender.author.organization.gln	GLN	0..1	string	Definition: Organization.identifier:GLN
sender.author.organization.streetAddressLine	Strasse, Hausnummer, Postfach etc.	0..*	string
sender.author.organization.postalCode	PLZ	0..1	string
sender.author.organization.city	Ort	0..1	string
sender.author.organization.country	Land	0..1	string
sender.dataenterer	Erfasser	0..1	group	Definition: Composition.extension
sender.dataenterer.practitioner	Erfassende Person	0..1	group	Definition: PractitionerRole.practitioner
sender.dataenterer.practitioner.title	Titel	0..1	string	Definition: Practitioner.name.prefix
sender.dataenterer.practitioner.familyName	Name	0..1	string	Definition: Practitioner.name.family
sender.dataenterer.practitioner.givenName	Vorname	0..1	string	Definition: Practitioner.name.given
sender.dataenterer.practitioner.phone	Telefon	0..1	string	Definition: Practitioner.telecom.value
sender.dataenterer.practitioner.email	E-Mail	0..1	string	Definition: Practitioner.telecom.value
receiverCopy	Kopieempfänger (Kopie dieses Auftrags und aller daraus resultierenden Resultate)	0..1	group	Definition: Composition.extension
receiverCopy.practitionerRole	Gesundheitsfachperson oder -organisation	0..*	group	Definition: PractitionerRole
receiverCopy.practitionerRole.practitioner	Gesundheitsfachperson	0..1	group	Definition: PractitionerRole.practitioner
receiverCopy.practitionerRole.practitioner.title	Titel	0..1	string	Definition: Practitioner.name.prefix
receiverCopy.practitionerRole.practitioner.familyName	Name	0..1	string	Definition: Practitioner.name.family
receiverCopy.practitionerRole.practitioner.givenName	Vorname	0..1	string	Definition: Practitioner.name.given
receiverCopy.practitionerRole.practitioner.phone	Telefon	0..1	string	Definition: Practitioner.telecom.value
receiverCopy.practitionerRole.practitioner.email	E-Mail	0..1	string	Definition: Practitioner.telecom.value
receiverCopy.practitionerRole.organization	Gesundheitsorganisatiton	0..1	group	Definition: PractitionerRole.organization
receiverCopy.practitionerRole.organization.name	Name der Organisation	0..1	string	Definition: Organization.name
receiverCopy.practitionerRole.organization.streetAddressLine	Strasse, Hausnummer, Postfach etc.	0..*	string
receiverCopy.practitionerRole.organization.postalCode	PLZ	0..1	string
receiverCopy.practitionerRole.organization.city	Ort	0..1	string
receiverCopy.practitionerRole.organization.country	Land	0..1	string
receiverCopy.patient	Patient selbst	0..1	boolean	Definition: Patient
receiverCopy.relatedPerson	Andere Person	0..*	group	Definition: RelatedPerson
receiverCopy.relatedPerson.familyName	Name	0..1	string	Definition: RelatedPerson.name.family
receiverCopy.relatedPerson.givenName	Vorname	0..1	string	Definition: RelatedPerson.name.given
receiverCopy.relatedPerson.phone	Telefon	0..*	string	Definition: RelatedPerson.telecom.value
receiverCopy.relatedPerson.email	E-Mail	0..1	string	Definition: RelatedPerson.telecom.value
receiverCopy.relatedPerson.streetAddressLine	Strasse, Hausnummer, Postfach etc.	0..*	string
receiverCopy.relatedPerson.postalCode	PLZ	0..1	string
receiverCopy.relatedPerson.city	Ort	0..1	string
receiverCopy.relatedPerson.country	Land	0..1	string
antecedentEpisodeOfCare	Vorgängiger Aufenthalt in Spital / Heim	0..1	group	Definition: Composition.extension
antecedentEpisodeOfCare.start	Von	0..1	dateTime	Definition: EpisodeOfCare.period
antecedentEpisodeOfCare.end	Bis	0..1	dateTime	Definition: EpisodeOfCare.period
antecedentEpisodeOfCare.managingOrganization	Spital /Heim	0..1	group	Definition: EpisodeOfCare.managingOrganization
antecedentEpisodeOfCare.managingOrganization.name	Name der Organisation	0..1	string	Definition: Organization.name
antecedentEpisodeOfCare.managingOrganization.streetAddressLine	Strasse, Hausnummer, Postfach etc.	0..*	string
antecedentEpisodeOfCare.managingOrganization.postalCode	PLZ	0..1	string
antecedentEpisodeOfCare.managingOrganization.city	Ort	0..1	string
antecedentEpisodeOfCare.managingOrganization.country	Land	0..1	string
appointment	Ort und Zeit der Durchführung der angeforderten Leistung	0..*	group	Definition: ServiceRequest.extension
appointment.location	Ort der Durchführung	0..1	group	Definition: Appointment.participant.actor
appointment.location.name	Name	1..1	string	Definition: Location.name
appointment.location.phone	Telefon	0..1	string	Definition: Location.telecom
appointment.location.email	E-Mail	0..1	string	Definition: Location.telecom
appointment.location.streetAddressLine	Strasse, Hausnummer, Postfach etc.	0..*	string
appointment.location.postalCode	PLZ	0..1	string
appointment.location.city	Ort	0..1	string
appointment.location.country	Land	0..1	string
appointment.requestedPeriod	Datum und Zeit, wann der Termin bevorzugt geplant werden soll	0..1	group	Definition: Appointment.requestedPeriod
appointment.requestedPeriod.start	Von	0..1	dateTime	Definition: Appointment.requestedPeriod.start
appointment.requestedPeriod.end	Bis	0..1	dateTime	Definition: Appointment.requestedPeriod.end
appointment.status	Status	1..1	choice	Definition: Appointment.status Options: 3 options
appointment.patientInstruction	Patienteninformation für diesen Termin	0..1	string	Definition: Appointment.patientInstruction
consent	Einverständniserklärung	0..1	group	Definition: Composition.extension
patient.consent.statement	Ist der Patient über die Anmeldung informiert und explizit einverstanden?	0..1	choice	Options: 2 options
patient.consent.statement.note	Anmerkung	0..1	string
note	Bemerkungen	0..*	group
note.text	Kommentar	0..1	string	Definition: ServiceRequest.note.text
Documentation for this format

Options Sets

Answer options for order.priority

http://hl7.org/fhir/request-priority#routine ("Die Anfrage hat normale Priorität.")
http://hl7.org/fhir/request-priority#urgent ("Die Anfrage sollte dringend bearbeitet werden - höhere Priorität als normal.")
http://hl7.org/fhir/request-priority#asap ("Die Anfrage sollte so schnell wie möglich bearbeitet werden - höhere Priorität als dringend.")
http://hl7.org/fhir/request-priority#stat ("Die Anfrage sollte sofort bearbeitet werden - höchstmögliche Priorität. Z.B. bei einem Notfall.")

Answer options for initiator.legalrelation

http://snomed.info/sct#373068000 ("Nicht definiert")
http://snomed.info/sct#58626002 ("Gesetzlicher Vertreter")

Answer options for initiator.personalrelation

http://snomed.info/sct#66089001 ("Tochter")
http://snomed.info/sct#65616008 ("Sohn")
http://snomed.info/sct#127849001 ("Ehemann")
http://snomed.info/sct#127850001 ("Ehefrau")
http://snomed.info/sct#394921008 ("Partner (eingetragene Partnerschaft)")
http://snomed.info/sct#70924004 ("Bruder")
http://snomed.info/sct#27733009 ("Schwester")
http://snomed.info/sct#72705000 ("Mutter")
http://snomed.info/sct#66839005 ("Vater")
http://snomed.info/sct#48385004 ("Bekannt")

Answer options for patient.gender

http://hl7.org/fhir/administrative-gender#male ("Männlich")
http://hl7.org/fhir/administrative-gender#female ("Weiblich")
http://hl7.org/fhir/administrative-gender#other ("Anderes")

Answer options for patient.maritalStatus

http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus#1 ("ledig")
http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus#2 ("verheiratet")
http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus#3 ("verwitwet")
http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus#4 ("geschieden")
http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus#5 ("unverheiratet")
http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus#6 ("in eingetragener Partnerschaft")
http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus#7 ("aufgelöste Partnerschaft")
http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus#9 ("unbekannt")

Answer options for requestedEncounter.class

http://terminology.hl7.org/CodeSystem/v3-ActCode#AMB ("Ambulant")
http://terminology.hl7.org/CodeSystem/v3-ActCode#IMP ("Stationär")
http://terminology.hl7.org/CodeSystem/v3-ActCode#EMER ("Notfall")

Answer options for requestedEncounter.desiredAccommodation

http://fhir.ch/ig/ch-core/CodeSystem/bfs-medstats-21-encountertype#1 ("allgemein")
http://fhir.ch/ig/ch-core/CodeSystem/bfs-medstats-21-encountertype#2 ("halbprivat")
http://fhir.ch/ig/ch-core/CodeSystem/bfs-medstats-21-encountertype#3 ("privat")

Answer options for appointment.status

http://hl7.org/fhir/appointmentstatus#proposed ("Wunsch des Patienten (vorgeschlagen)")
http://hl7.org/fhir/appointmentstatus#pending ("Vom Patienten bestätigt, aber vom Leistungserbringer noch nicht (ausstehend)")
http://hl7.org/fhir/appointmentstatus#booked ("Vom Patienten und Leistungserbringer bestätigt (gebucht)")

Answer options for patient.consent.statement

http://fhir.ch/ig/ch-orf/CodeSystem/ch-orf-cs-consentstatus#ExplicitAgreement ("Patient is informed and has explicitly agreed")
http://fhir.ch/ig/ch-orf/CodeSystem/ch-orf-cs-consentstatus#Other ("Other situation such as 'implicit agreement', 'agreed by legal guardian' etc.")

Source

{
  "resourceType": "Questionnaire",
  "id": "order-referral-form",
  "meta": {
    "profile": [
      "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-questionnaire",
      "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire",
      "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap",
      "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-pop-exp"
    ]
  },
  "language": "de-CH",
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-targetStructureMap",
      "valueCanonical": "http://fhir.ch/ig/ch-orf/StructureMap/OrfQrToBundle"
    },
    {
      "extension": [
        {
          "url": "name",
          "valueCoding": {
            "system": "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext",
            "code": "patient"
          }
        },
        {
          "url": "type",
          "valueCode": "Patient"
        }
      ],
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"
    },
    {
      "extension": [
        {
          "url": "name",
          "valueCoding": {
            "system": "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext",
            "code": "user",
            "display": "User"
          }
        },
        {
          "url": "type",
          "valueCode": "Practitioner"
        },
        {
          "url": "description",
          "valueString": "The practitioner that is to be used to pre-populate the form"
        }
      ],
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"
    },
    {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
      "valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-order|3.0.1"
    },
    {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
      "valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-practitioner-nametel|3.0.1"
    },
    {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
      "valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-receiver|3.0.1"
    },
    {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
      "valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-address|3.0.1"
    },
    {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
      "valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-initiator|3.0.1"
    },
    {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
      "valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-patient|3.0.1"
    },
    {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
      "valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-familydoctor|3.0.1"
    },
    {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
      "valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-requestedencounter|3.0.1"
    },
    {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
      "valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-coverage|3.0.1"
    },
    {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
      "valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-sender|3.0.1"
    },
    {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
      "valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-receivercopy|3.0.1"
    },
    {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
      "valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-appointment|3.0.1"
    },
    {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
      "valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-consent|3.0.1"
    }
  ],
  "url": "http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form",
  "version": "3.0.2-ci-build",
  "name": "OrderReferralForm",
  "title": "Order Referral Form",
  "status": "active",
  "subjectType": [
    "Patient"
  ],
  "date": "2022-07-07",
  "publisher": "HL7 Switzerland",
  "contact": [
    {
      "name": "HL7 Switzerland",
      "telecom": [
        {
          "system": "url",
          "value": "https://www.hl7.ch/"
        }
      ]
    }
  ],
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "CH"
        }
      ]
    }
  ],
  "copyright": "CC0-1.0",
  "item": [
    {
      "linkId": "order",
      "text": "Auftrag",
      "type": "group",
      "required": true,
      "item": [
        {
          "linkId": "order.authoredOn",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.authoredOn",
          "text": "Datum/Zeit der Auftragserteilung",
          "type": "dateTime"
        },
        {
          "linkId": "order.placerOrderIdentifier",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.identifier",
          "text": "Auftragsnummer des Auftraggebers",
          "type": "string"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
              "valueBoolean": true
            }
          ],
          "linkId": "order.placerOrderIdentifierDomain",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.identifier",
          "text": "Identifier Domain der Auftragsnummer des Auftraggebers",
          "type": "string"
        },
        {
          "linkId": "order.fillerOrderIdentifier",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.identifier",
          "text": "Auftragsnummer des Auftragsempfängers",
          "type": "string"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
              "valueBoolean": true
            }
          ],
          "linkId": "order.fillerOrderIdentifierDomain",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.identifier",
          "text": "Identifier Domain der Auftragsnummer des Auftragsempfängers",
          "type": "string"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
              "valueBoolean": true
            }
          ],
          "linkId": "order.precedentDocumentIdentifier",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension",
          "text": "Identifier des Vorgängerdokuments",
          "type": "string"
        },
        {
          "linkId": "order.notificationContactDocument",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension",
          "text": "Dringender Benachrichtigungskontakt für dieses Dokument",
          "type": "group",
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/variable",
                  "valueExpression": {
                    "name": "linkIdPrefix",
                    "language": "text/fhirpath",
                    "expression": "'order.notificationContactDocument.practitioner.'"
                  }
                }
              ],
              "linkId": "order.notificationContactDocument.practitioner",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner",
              "text": "Zu benachrichtigende Person",
              "type": "group",
              "item": [
                {
                  "linkId": "order.notificationContactDocument.practitioner.title",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.prefix",
                  "text": "Titel",
                  "type": "string"
                },
                {
                  "linkId": "order.notificationContactDocument.practitioner.familyName",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.family",
                  "text": "Name",
                  "type": "string"
                },
                {
                  "linkId": "order.notificationContactDocument.practitioner.givenName",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.given",
                  "text": "Vorname",
                  "type": "string"
                },
                {
                  "linkId": "order.notificationContactDocument.practitioner.phone",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value",
                  "text": "Telefon",
                  "type": "string"
                },
                {
                  "linkId": "order.notificationContactDocument.practitioner.email",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value",
                  "text": "E-Mail",
                  "type": "string"
                }
              ]
            }
          ]
        },
        {
          "linkId": "order.notificationContactDocumentResponse",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension",
          "text": "Dringender Benachrichtigungskontakt für die Antwort auf dieses Dokument",
          "type": "group",
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/variable",
                  "valueExpression": {
                    "name": "linkIdPrefix",
                    "language": "text/fhirpath",
                    "expression": "'order.notificationContactDocumentResponse.practitioner.'"
                  }
                }
              ],
              "linkId": "order.notificationContactDocumentResponse.practitioner",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner",
              "text": "Zu benachrichtigende Person",
              "type": "group",
              "item": [
                {
                  "linkId": "order.notificationContactDocumentResponse.practitioner.title",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.prefix",
                  "text": "Titel",
                  "type": "string"
                },
                {
                  "linkId": "order.notificationContactDocumentResponse.practitioner.familyName",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.family",
                  "text": "Name",
                  "type": "string"
                },
                {
                  "linkId": "order.notificationContactDocumentResponse.practitioner.givenName",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.given",
                  "text": "Vorname",
                  "type": "string"
                },
                {
                  "linkId": "order.notificationContactDocumentResponse.practitioner.phone",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value",
                  "text": "Telefon",
                  "type": "string"
                },
                {
                  "linkId": "order.notificationContactDocumentResponse.practitioner.email",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value",
                  "text": "E-Mail",
                  "type": "string"
                }
              ]
            }
          ]
        },
        {
          "linkId": "order.priority",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.priority",
          "text": "Auftragspriorität",
          "type": "choice",
          "answerOption": [
            {
              "valueCoding": {
                "system": "http://hl7.org/fhir/request-priority",
                "code": "routine",
                "display": "Die Anfrage hat normale Priorität."
              },
              "initialSelected": true
            },
            {
              "valueCoding": {
                "system": "http://hl7.org/fhir/request-priority",
                "code": "urgent",
                "display": "Die Anfrage sollte dringend bearbeitet werden - höhere Priorität als normal."
              }
            },
            {
              "valueCoding": {
                "system": "http://hl7.org/fhir/request-priority",
                "code": "asap",
                "display": "Die Anfrage sollte so schnell wie möglich bearbeitet werden - höhere Priorität als dringend."
              }
            },
            {
              "valueCoding": {
                "system": "http://hl7.org/fhir/request-priority",
                "code": "stat",
                "display": "Die Anfrage sollte sofort bearbeitet werden - höchstmögliche Priorität. Z.B. bei einem Notfall."
              }
            }
          ]
        }
      ]
    },
    {
      "linkId": "receiver",
      "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension",
      "text": "Empfänger",
      "type": "group",
      "item": [
        {
          "linkId": "receiver.practitioner",
          "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner",
          "text": "Empfangende Person",
          "type": "group",
          "item": [
            {
              "linkId": "receiver.practitioner.title",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.prefix",
              "text": "Titel",
              "type": "string"
            },
            {
              "linkId": "receiver.practitioner.familyName",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.family",
              "text": "Name",
              "type": "string"
            },
            {
              "linkId": "receiver.practitioner.givenName",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.given",
              "text": "Vorname",
              "type": "string"
            },
            {
              "linkId": "receiver.practitioner.gln",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.identifier:GLN.value",
              "text": "GLN",
              "type": "string"
            },
            {
              "linkId": "receiver.practitioner.zsr",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.identifier:ZSR.value",
              "text": "ZSR (fr/it: RCC)",
              "type": "string"
            },
            {
              "linkId": "receiver.practitioner.phone",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value",
              "text": "Telefon",
              "type": "string"
            },
            {
              "linkId": "receiver.practitioner.email",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value",
              "text": "E-Mail",
              "type": "string"
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/variable",
              "valueExpression": {
                "name": "linkIdPrefix",
                "language": "text/fhirpath",
                "expression": "'receiver.organization.'"
              }
            }
          ],
          "linkId": "receiver.organization",
          "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.organization",
          "text": "Empfangende Organisation",
          "type": "group",
          "item": [
            {
              "linkId": "receiver.organization.name",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.name",
              "text": "Name der Organisation",
              "type": "string"
            },
            {
              "linkId": "receiver.organization.gln",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.identifier:GLN",
              "text": "GLN",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.line"
                  }
                }
              ],
              "linkId": "receiver.organization.streetAddressLine",
              "text": "Strasse, Hausnummer, Postfach etc.",
              "type": "string",
              "repeats": true
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.postalCode"
                  }
                }
              ],
              "linkId": "receiver.organization.postalCode",
              "text": "PLZ",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.city"
                  }
                }
              ],
              "linkId": "receiver.organization.city",
              "text": "Ort",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.country"
                  }
                }
              ],
              "linkId": "receiver.organization.country",
              "text": "Land",
              "type": "string"
            }
          ]
        }
      ]
    },
    {
      "linkId": "initiator",
      "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension",
      "text": "Initiant dieser Anmeldung",
      "type": "group",
      "item": [
        {
          "linkId": "initiator.legalrelation",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-initiator#Extension.extension",
          "text": "Juristische Beziehung zum Patienten",
          "type": "choice",
          "answerOption": [
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "373068000",
                "display": "Nicht definiert"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "58626002",
                "display": "Gesetzlicher Vertreter"
              }
            }
          ]
        },
        {
          "linkId": "initiator.personalrelation",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-initiator#Extension.extension",
          "text": "Persönliche Beziehung zum Patienten?",
          "type": "choice",
          "answerOption": [
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "66089001",
                "display": "Tochter"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "65616008",
                "display": "Sohn"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "127849001",
                "display": "Ehemann"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "127850001",
                "display": "Ehefrau"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "394921008",
                "display": "Partner (eingetragene  Partnerschaft)"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "70924004",
                "display": "Bruder"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "27733009",
                "display": "Schwester"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "72705000",
                "display": "Mutter"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "66839005",
                "display": "Vater"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "48385004",
                "display": "Bekannt"
              }
            }
          ]
        },
        {
          "linkId": "initiator.practitionerRole",
          "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner",
          "text": "Gesundheitsfachperson oder -organisation",
          "type": "group",
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/variable",
                  "valueExpression": {
                    "name": "linkIdPrefix",
                    "language": "text/fhirpath",
                    "expression": "'initiator.practitionerRole.practitioner.'"
                  }
                }
              ],
              "linkId": "initiator.practitionerRole.practitioner",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner",
              "text": "Gesundheitsfachperson",
              "type": "group",
              "item": [
                {
                  "linkId": "initiator.practitionerRole.practitioner.title",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.prefix",
                  "text": "Titel",
                  "type": "string"
                },
                {
                  "linkId": "initiator.practitionerRole.practitioner.familyName",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.family",
                  "text": "Name",
                  "type": "string"
                },
                {
                  "linkId": "initiator.practitionerRole.practitioner.givenName",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.given",
                  "text": "Vorname",
                  "type": "string"
                },
                {
                  "linkId": "initiator.practitionerRole.practitioner.phone",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value",
                  "text": "Telefon",
                  "type": "string"
                },
                {
                  "linkId": "initiator.practitionerRole.practitioner.email",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value",
                  "text": "E-Mail",
                  "type": "string"
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/variable",
                  "valueExpression": {
                    "name": "linkIdPrefix",
                    "language": "text/fhirpath",
                    "expression": "'initiator.practitionerRole.organization.'"
                  }
                }
              ],
              "linkId": "initiator.practitionerRole.organization",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.organization",
              "text": "Gesundheitsorganisatiton",
              "type": "group",
              "item": [
                {
                  "linkId": "initiator.practitionerRole.organization.name",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.name",
                  "text": "Name der Organisation",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.line"
                      }
                    }
                  ],
                  "linkId": "initiator.practitionerRole.organization.streetAddressLine",
                  "text": "Strasse, Hausnummer, Postfach etc.",
                  "type": "string",
                  "repeats": true
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.postalCode"
                      }
                    }
                  ],
                  "linkId": "initiator.practitionerRole.organization.postalCode",
                  "text": "PLZ",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.city"
                      }
                    }
                  ],
                  "linkId": "initiator.practitionerRole.organization.city",
                  "text": "Ort",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.country"
                      }
                    }
                  ],
                  "linkId": "initiator.practitionerRole.organization.country",
                  "text": "Land",
                  "type": "string"
                }
              ]
            }
          ]
        },
        {
          "linkId": "initiator.relatedPerson",
          "definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson",
          "text": "Andere Person",
          "type": "group",
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/variable",
                  "valueExpression": {
                    "name": "linkIdPrefix",
                    "language": "text/fhirpath",
                    "expression": "'initiator.relatedPerson.'"
                  }
                }
              ],
              "linkId": "initiator.relatedPerson.familyName",
              "definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.name.family",
              "text": "Name",
              "type": "string"
            },
            {
              "linkId": "initiator.relatedPerson.givenName",
              "definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.name.given",
              "text": "Vorname",
              "type": "string"
            },
            {
              "linkId": "initiator.relatedPerson.phone",
              "definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.telecom.value",
              "text": "Telefon",
              "type": "string",
              "repeats": true
            },
            {
              "linkId": "initiator.relatedPerson.email",
              "definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.telecom.value",
              "text": "E-Mail",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.line"
                  }
                }
              ],
              "linkId": "initiator.relatedPerson.streetAddressLine",
              "text": "Strasse, Hausnummer, Postfach etc.",
              "type": "string",
              "repeats": true
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.postalCode"
                  }
                }
              ],
              "linkId": "initiator.relatedPerson.postalCode",
              "text": "PLZ",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.city"
                  }
                }
              ],
              "linkId": "initiator.relatedPerson.city",
              "text": "Ort",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.country"
                  }
                }
              ],
              "linkId": "initiator.relatedPerson.country",
              "text": "Land",
              "type": "string"
            }
          ]
        }
      ]
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/variable",
          "valueExpression": {
            "name": "linkIdPrefix",
            "language": "text/fhirpath",
            "expression": "'patient.'"
          }
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/variable",
          "valueExpression": {
            "name": "address",
            "language": "text/fhirpath",
            "expression": "%patient.address"
          }
        }
      ],
      "linkId": "patient",
      "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.subject",
      "text": "Patient",
      "type": "group",
      "required": true,
      "item": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/fhirpath",
                "expression": "%patient.name.where(use='official').family"
              }
            }
          ],
          "linkId": "patient.familyName",
          "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.name.family",
          "text": "Name",
          "type": "string"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/fhirpath",
                "expression": "%patient.name.where(use='maiden').family"
              }
            }
          ],
          "linkId": "patient.maidenName",
          "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.name.family",
          "text": "Ledigname",
          "type": "string"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/fhirpath",
                "expression": "%patient.name.where(use='official').given"
              }
            }
          ],
          "linkId": "patient.givenName",
          "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.name.given",
          "text": "Vorname",
          "type": "string"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/fhirpath",
                "expression": "%patient.identifier.where(type.coding.where(system='http://terminology.hl7.org/CodeSystem/v2-0203' and code='MR').exists()).value"
              }
            }
          ],
          "linkId": "patient.localPid",
          "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.identifier:LocalPid.value",
          "text": "Lokale Patienten-ID",
          "type": "string"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
              "valueBoolean": true
            }
          ],
          "linkId": "patient.localPidDomain",
          "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.identifier:LocalPid.system",
          "text": "Lokale Patienten-ID Domain",
          "type": "string"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/fhirpath",
                "expression": "%patient.birthDate"
              }
            }
          ],
          "linkId": "patient.birthDate",
          "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.birthDate",
          "text": "Geburtsdatum",
          "type": "date"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/fhirpath",
                "expression": "%questionnaire.repeat(item).where(linkId='patient.gender').answerOption.valueCoding.where(code=%patient.gender)"
              }
            }
          ],
          "linkId": "patient.gender",
          "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.gender",
          "text": "Geschlecht",
          "type": "choice",
          "answerOption": [
            {
              "valueCoding": {
                "system": "http://hl7.org/fhir/administrative-gender",
                "code": "male",
                "display": "Männlich"
              },
              "initialSelected": true
            },
            {
              "valueCoding": {
                "system": "http://hl7.org/fhir/administrative-gender",
                "code": "female",
                "display": "Weiblich"
              }
            },
            {
              "valueCoding": {
                "system": "http://hl7.org/fhir/administrative-gender",
                "code": "other",
                "display": "Anderes"
              }
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/fhirpath",
                "expression": "%patient.maritalStatus"
              }
            }
          ],
          "linkId": "patient.maritalStatus",
          "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.maritalStatus",
          "text": "Zivilstand",
          "type": "choice",
          "answerOption": [
            {
              "valueCoding": {
                "system": "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
                "code": "1",
                "display": "ledig"
              }
            },
            {
              "valueCoding": {
                "system": "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
                "code": "2",
                "display": "verheiratet"
              }
            },
            {
              "valueCoding": {
                "system": "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
                "code": "3",
                "display": "verwitwet"
              }
            },
            {
              "valueCoding": {
                "system": "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
                "code": "4",
                "display": "geschieden"
              }
            },
            {
              "valueCoding": {
                "system": "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
                "code": "5",
                "display": "unverheiratet"
              }
            },
            {
              "valueCoding": {
                "system": "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
                "code": "6",
                "display": "in eingetragener Partnerschaft"
              }
            },
            {
              "valueCoding": {
                "system": "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
                "code": "7",
                "display": "aufgelöste Partnerschaft"
              }
            },
            {
              "valueCoding": {
                "system": "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
                "code": "9",
                "display": "unbekannt"
              }
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/fhirpath",
                "expression": "%patient.telecom.where(system='phone').value"
              }
            }
          ],
          "linkId": "patient.phone",
          "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.telecom.value",
          "text": "Telefon",
          "type": "string",
          "repeats": true
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/fhirpath",
                "expression": "%patient.telecom.where(system='email').value"
              }
            }
          ],
          "linkId": "patient.email",
          "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.telecom.value",
          "text": "E-Mail",
          "type": "string"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/fhirpath",
                "expression": "%address.line"
              }
            }
          ],
          "linkId": "patient.streetAddressLine",
          "text": "Strasse, Hausnummer, Postfach etc.",
          "type": "string",
          "repeats": true
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/fhirpath",
                "expression": "%address.postalCode"
              }
            }
          ],
          "linkId": "patient.postalCode",
          "text": "PLZ",
          "type": "string"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/fhirpath",
                "expression": "%address.city"
              }
            }
          ],
          "linkId": "patient.city",
          "text": "Ort",
          "type": "string"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/fhirpath",
                "expression": "%address.country"
              }
            }
          ],
          "linkId": "patient.country",
          "text": "Land",
          "type": "string"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/fhirpath",
                "expression": "%patient.communication.where(preferred=true).language.coding"
              }
            }
          ],
          "linkId": "patient.languageOfCorrespondence",
          "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.communication:languageOfCorrespondence",
          "text": "Korrespondenzsprache",
          "type": "choice",
          "answerValueSet": "http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.languageCode"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/variable",
              "valueExpression": {
                "name": "contact",
                "language": "text/fhirpath",
                "expression": "%patient.contact"
              }
            }
          ],
          "linkId": "patient.contactperson",
          "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.contact",
          "text": "Kontaktperson",
          "type": "group",
          "repeats": true,
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%contact.relationship.text"
                  }
                }
              ],
              "linkId": "patient.contactperson.relationship",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.contact.relationship.text",
              "text": "Beziehung",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%contact.name.family"
                  }
                }
              ],
              "linkId": "patient.contactperson.familyName",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.contact.name.family",
              "text": "Name",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%contact.name.given"
                  }
                }
              ],
              "linkId": "patient.contactperson.givenName",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.contact.name.given",
              "text": "Vorname",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%contact.telecom.where(system='phone').value"
                  }
                }
              ],
              "linkId": "patient.contactperson.phone",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.contact.telecom.value",
              "text": "Telefon",
              "type": "string",
              "repeats": true
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%contact.telecom.where(system='email').value"
                  }
                }
              ],
              "linkId": "patient.contactperson.email",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.contact.telecom.value",
              "text": "E-Mail",
              "type": "string"
            }
          ]
        },
        {
          "linkId": "familydoctor",
          "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.generalPractitioner",
          "text": "Hausarzt",
          "type": "group",
          "item": [
            {
              "linkId": "familydoctor.practitioner",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner",
              "text": "Hausarzt Person",
              "type": "group",
              "item": [
                {
                  "linkId": "familydoctor.practitioner.title",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.prefix",
                  "text": "Titel",
                  "type": "string"
                },
                {
                  "linkId": "familydoctor.practitioner.familyName",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.family",
                  "text": "Name",
                  "type": "string"
                },
                {
                  "linkId": "familydoctor.practitioner.givenName",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.given",
                  "text": "Vorname",
                  "type": "string"
                },
                {
                  "linkId": "familydoctor.practitioner.gln",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.identifier:GLN.value",
                  "text": "GLN",
                  "type": "string"
                },
                {
                  "linkId": "familydoctor.practitioner.zsr",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.identifier:ZSR.value",
                  "text": "ZSR (fr/it: RCC)",
                  "type": "string"
                },
                {
                  "linkId": "familydoctor.practitioner.phone",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value",
                  "text": "Telefon",
                  "type": "string"
                },
                {
                  "linkId": "familydoctor.practitioner.email",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value",
                  "text": "E-Mail",
                  "type": "string"
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/variable",
                  "valueExpression": {
                    "name": "linkIdPrefix",
                    "language": "text/fhirpath",
                    "expression": "'familydoctor.organization.'"
                  }
                }
              ],
              "linkId": "familydoctor.organization",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.organization",
              "text": "Hausarzt Organisation",
              "type": "group",
              "item": [
                {
                  "linkId": "familydoctor.organization.name",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.name",
                  "text": "Name der Organisation",
                  "type": "string"
                },
                {
                  "linkId": "familydoctor.organization.gln",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.identifier:GLN",
                  "text": "GLN",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.line"
                      }
                    }
                  ],
                  "linkId": "familydoctor.organization.streetAddressLine",
                  "text": "Strasse, Hausnummer, Postfach etc.",
                  "type": "string",
                  "repeats": true
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.postalCode"
                      }
                    }
                  ],
                  "linkId": "familydoctor.organization.postalCode",
                  "text": "PLZ",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.city"
                      }
                    }
                  ],
                  "linkId": "familydoctor.organization.city",
                  "text": "Ort",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.country"
                      }
                    }
                  ],
                  "linkId": "familydoctor.organization.country",
                  "text": "Land",
                  "type": "string"
                }
              ]
            }
          ]
        }
      ]
    },
    {
      "linkId": "requestedEncounter",
      "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.extension",
      "text": "Patientenaufnahme",
      "type": "group",
      "item": [
        {
          "linkId": "requestedEncounter.class",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-encounter#Encounter.class",
          "text": "Voraussichtlich: Ambulant / Stationär / Notfall",
          "type": "choice",
          "answerOption": [
            {
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                "code": "AMB",
                "display": "Ambulant"
              }
            },
            {
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                "code": "IMP",
                "display": "Stationär"
              }
            },
            {
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                "code": "EMER",
                "display": "Notfall"
              }
            }
          ]
        },
        {
          "linkId": "requestedEncounter.desiredAccommodation",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-encounter#Encounter.extension",
          "text": "Zimmerkategorie",
          "type": "choice",
          "answerOption": [
            {
              "valueCoding": {
                "system": "http://fhir.ch/ig/ch-core/CodeSystem/bfs-medstats-21-encountertype",
                "code": "1",
                "display": "allgemein"
              }
            },
            {
              "valueCoding": {
                "system": "http://fhir.ch/ig/ch-core/CodeSystem/bfs-medstats-21-encountertype",
                "code": "2",
                "display": "halbprivat"
              }
            },
            {
              "valueCoding": {
                "system": "http://fhir.ch/ig/ch-core/CodeSystem/bfs-medstats-21-encountertype",
                "code": "3",
                "display": "privat"
              }
            }
          ]
        }
      ]
    },
    {
      "linkId": "coverage",
      "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.insurance",
      "text": "Kostenträger",
      "type": "group",
      "item": [
        {
          "linkId": "coverage.beneficiary",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.beneficiary",
          "text": "Begünstigter (Patient)",
          "type": "group",
          "item": [
            {
              "linkId": "coverage.beneficiary.ahvn13",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.identifier:AHVN13",
              "text": "AHV-Nr. des Patienten (fr/it: AVS)",
              "type": "string"
            }
          ]
        },
        {
          "linkId": "coverage.kvg",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type",
          "text": "Krankenkasse nach KVG (fr/it: LAMal)",
          "type": "group",
          "item": [
            {
              "linkId": "coverage.kvg.name",
              "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor",
              "text": "Name der Versicherung",
              "type": "string"
            },
            {
              "linkId": "coverage.kvg.insuranceCardNumber",
              "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier",
              "text": "Kennnummer der Versichertenkarte",
              "type": "string"
            }
          ]
        },
        {
          "linkId": "coverage.uvg",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type",
          "text": "Unfallversicherung nach UVG (fr: LAA, it: LAINF)",
          "type": "group",
          "item": [
            {
              "linkId": "coverage.uvg.name",
              "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor",
              "text": "Name der Versicherung",
              "type": "string"
            },
            {
              "linkId": "coverage.uvg.claimNumber",
              "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier",
              "text": "Schadennummer",
              "type": "string"
            }
          ]
        },
        {
          "linkId": "coverage.vvg",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type",
          "text": "Zusatzversicherung nach VVG (fr/it: LCA)",
          "type": "group",
          "item": [
            {
              "linkId": "coverage.vvg.name",
              "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor",
              "text": "Name der Versicherung",
              "type": "string"
            },
            {
              "linkId": "coverage.vvg.insuranceCardNumber",
              "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier",
              "text": "Kennnummer der Versichertenkarte",
              "type": "string"
            }
          ]
        },
        {
          "linkId": "coverage.iv",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type",
          "text": "Invalidenversicherung IV (fr/it: AI)",
          "type": "group",
          "item": [
            {
              "linkId": "coverage.iv.verfuegungsnummer",
              "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier",
              "text": "IV-Verfügungsnummer",
              "type": "string"
            }
          ]
        },
        {
          "linkId": "coverage.mv",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type",
          "text": "Militärversicherung MV (fr/it: AM)",
          "type": "group",
          "item": [
            {
              "linkId": "coverage.mv.versichertennummer",
              "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier",
              "text": "MV-Versichertennummer",
              "type": "string"
            }
          ]
        },
        {
          "linkId": "coverage.self",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type",
          "text": "Selbstzahler",
          "type": "group",
          "item": [
            {
              "linkId": "coverage.self.patient",
              "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor",
              "text": "Patient selbst",
              "type": "boolean"
            },
            {
              "linkId": "coverage.self.patientRelatedPerson",
              "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor",
              "text": "Andere Person",
              "type": "boolean",
              "enableWhen": [
                {
                  "question": "coverage.self.patient",
                  "operator": "=",
                  "answerBoolean": false
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/variable",
                  "valueExpression": {
                    "name": "linkIdPrefix",
                    "language": "text/fhirpath",
                    "expression": "'coverage.self.relatedPerson.'"
                  }
                }
              ],
              "linkId": "coverage.self.relatedPerson",
              "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor",
              "text": "Andere Person",
              "type": "group",
              "enableWhen": [
                {
                  "question": "coverage.self.patientRelatedPerson",
                  "operator": "=",
                  "answerBoolean": true
                }
              ],
              "item": [
                {
                  "linkId": "coverage.self.relatedPerson.familyName",
                  "definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.name.family",
                  "text": "Name",
                  "type": "string"
                },
                {
                  "linkId": "coverage.self.relatedPerson.givenName",
                  "definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.name.given",
                  "text": "Vorname",
                  "type": "string"
                },
                {
                  "linkId": "coverage.self.relatedPerson.phone",
                  "definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.telecom.value",
                  "text": "Telefon",
                  "type": "string",
                  "repeats": true
                },
                {
                  "linkId": "coverage.self.relatedPerson.email",
                  "definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.telecom.value",
                  "text": "E-Mail",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.line"
                      }
                    }
                  ],
                  "linkId": "coverage.self.relatedPerson.streetAddressLine",
                  "text": "Strasse, Hausnummer, Postfach etc.",
                  "type": "string",
                  "repeats": true
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.postalCode"
                      }
                    }
                  ],
                  "linkId": "coverage.self.relatedPerson.postalCode",
                  "text": "PLZ",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.city"
                      }
                    }
                  ],
                  "linkId": "coverage.self.relatedPerson.city",
                  "text": "Ort",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.country"
                      }
                    }
                  ],
                  "linkId": "coverage.self.relatedPerson.country",
                  "text": "Land",
                  "type": "string"
                }
              ]
            }
          ]
        },
        {
          "linkId": "coverage.other",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type",
          "text": "Anderer Kostenträger",
          "type": "group",
          "item": [
            {
              "linkId": "coverage.other.name",
              "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor",
              "text": "Name des Kostenträgers",
              "type": "string"
            },
            {
              "linkId": "coverage.other.id",
              "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier",
              "text": "Beliebige ID",
              "type": "string"
            },
            {
              "linkId": "coverage.other.id.note",
              "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier.type.text",
              "text": "Bemerkung zur ID",
              "type": "string"
            }
          ]
        }
      ]
    },
    {
      "linkId": "sender",
      "text": "Absender",
      "type": "group",
      "required": true,
      "item": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/variable",
              "valueExpression": {
                "name": "senderPractitionerRoles",
                "language": "application/x-fhir-query",
                "expression": "PractitionerRole?practitioner={{%user.id}}"
              }
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/variable",
              "valueExpression": {
                "name": "senderPractitionerRole",
                "language": "text/fhirpath",
                "expression": "%senderPractitionerRoles.entry[0].resource"
              }
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/variable",
              "valueExpression": {
                "name": "senderOrganizations",
                "language": "application/x-fhir-query",
                "expression": "Organization?_id={{%senderPractitionerRole.organization.reference}}"
              }
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/variable",
              "valueExpression": {
                "name": "senderOrganization",
                "language": "text/fhirpath",
                "expression": "%senderOrganizations.entry[0].resource"
              }
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/variable",
              "valueExpression": {
                "name": "address",
                "language": "text/fhirpath",
                "expression": "%senderOrganization.address"
              }
            }
          ],
          "linkId": "sender.author",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.author",
          "text": "Verantwortlicher",
          "type": "group",
          "required": true,
          "item": [
            {
              "linkId": "sender.author.practitioner",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner",
              "text": "Verantwortliche Person",
              "type": "group",
              "item": [
                {
                  "linkId": "sender.author.practitioner.title",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.prefix",
                  "text": "Titel",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%user.name.family"
                      }
                    }
                  ],
                  "linkId": "sender.author.practitioner.familyName",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.family",
                  "text": "Name",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%user.name.given"
                      }
                    }
                  ],
                  "linkId": "sender.author.practitioner.givenName",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.given",
                  "text": "Vorname",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%user.identifier.where(system='urn:oid:2.51.1.3').value"
                      }
                    }
                  ],
                  "linkId": "sender.author.practitioner.gln",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.identifier:GLN.value",
                  "text": "GLN",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%user.identifier.where(system='urn:oid:2.16.756.5.30.1.123.100.2.1.1').value"
                      }
                    }
                  ],
                  "linkId": "sender.author.practitioner.zsr",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.identifier:ZSR.value",
                  "text": "ZSR (fr/it: RCC)",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%user.telecom.where(system='phone').value"
                      }
                    }
                  ],
                  "linkId": "sender.author.practitioner.phone",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value",
                  "text": "Telefon",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%user.telecom.where(system='email').value"
                      }
                    }
                  ],
                  "linkId": "sender.author.practitioner.email",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value",
                  "text": "E-Mail",
                  "type": "string"
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/variable",
                  "valueExpression": {
                    "name": "linkIdPrefix",
                    "language": "text/fhirpath",
                    "expression": "'sender.author.organization.'"
                  }
                }
              ],
              "linkId": "sender.author.organization",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.organization",
              "text": "Verantwortliche Organisation",
              "type": "group",
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%senderOrganization.name"
                      }
                    }
                  ],
                  "linkId": "sender.author.organization.name",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.name",
                  "text": "Name der Organisation",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%senderOrganization.identifier.where(system='urn:oid:2.51.1.3').value"
                      }
                    }
                  ],
                  "linkId": "sender.author.organization.gln",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.identifier:GLN",
                  "text": "GLN",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.line"
                      }
                    }
                  ],
                  "linkId": "sender.author.organization.streetAddressLine",
                  "text": "Strasse, Hausnummer, Postfach etc.",
                  "type": "string",
                  "repeats": true
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.postalCode"
                      }
                    }
                  ],
                  "linkId": "sender.author.organization.postalCode",
                  "text": "PLZ",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.city"
                      }
                    }
                  ],
                  "linkId": "sender.author.organization.city",
                  "text": "Ort",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.country"
                      }
                    }
                  ],
                  "linkId": "sender.author.organization.country",
                  "text": "Land",
                  "type": "string"
                }
              ]
            }
          ]
        },
        {
          "linkId": "sender.dataenterer",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension",
          "text": "Erfasser",
          "type": "group",
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/variable",
                  "valueExpression": {
                    "name": "linkIdPrefix",
                    "language": "text/fhirpath",
                    "expression": "'sender.dataenterer.practitioner.'"
                  }
                }
              ],
              "linkId": "sender.dataenterer.practitioner",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner",
              "text": "Erfassende Person",
              "type": "group",
              "item": [
                {
                  "linkId": "sender.dataenterer.practitioner.title",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.prefix",
                  "text": "Titel",
                  "type": "string"
                },
                {
                  "linkId": "sender.dataenterer.practitioner.familyName",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.family",
                  "text": "Name",
                  "type": "string"
                },
                {
                  "linkId": "sender.dataenterer.practitioner.givenName",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.given",
                  "text": "Vorname",
                  "type": "string"
                },
                {
                  "linkId": "sender.dataenterer.practitioner.phone",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value",
                  "text": "Telefon",
                  "type": "string"
                },
                {
                  "linkId": "sender.dataenterer.practitioner.email",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value",
                  "text": "E-Mail",
                  "type": "string"
                }
              ]
            }
          ]
        }
      ]
    },
    {
      "linkId": "receiverCopy",
      "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension",
      "text": "Kopieempfänger (Kopie dieses Auftrags und aller daraus resultierenden Resultate)",
      "type": "group",
      "item": [
        {
          "linkId": "receiverCopy.practitionerRole",
          "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole",
          "text": "Gesundheitsfachperson oder -organisation",
          "type": "group",
          "repeats": true,
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/variable",
                  "valueExpression": {
                    "name": "linkIdPrefix",
                    "language": "text/fhirpath",
                    "expression": "'receiverCopy.practitionerRole.practitioner.'"
                  }
                }
              ],
              "linkId": "receiverCopy.practitionerRole.practitioner",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner",
              "text": "Gesundheitsfachperson",
              "type": "group",
              "item": [
                {
                  "linkId": "receiverCopy.practitionerRole.practitioner.title",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.prefix",
                  "text": "Titel",
                  "type": "string"
                },
                {
                  "linkId": "receiverCopy.practitionerRole.practitioner.familyName",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.family",
                  "text": "Name",
                  "type": "string"
                },
                {
                  "linkId": "receiverCopy.practitionerRole.practitioner.givenName",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.given",
                  "text": "Vorname",
                  "type": "string"
                },
                {
                  "linkId": "receiverCopy.practitionerRole.practitioner.phone",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value",
                  "text": "Telefon",
                  "type": "string"
                },
                {
                  "linkId": "receiverCopy.practitionerRole.practitioner.email",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value",
                  "text": "E-Mail",
                  "type": "string"
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/variable",
                  "valueExpression": {
                    "name": "linkIdPrefix",
                    "language": "text/fhirpath",
                    "expression": "'receiverCopy.practitionerRole.organization.'"
                  }
                }
              ],
              "linkId": "receiverCopy.practitionerRole.organization",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.organization",
              "text": "Gesundheitsorganisatiton",
              "type": "group",
              "item": [
                {
                  "linkId": "receiverCopy.practitionerRole.organization.name",
                  "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.name",
                  "text": "Name der Organisation",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.line"
                      }
                    }
                  ],
                  "linkId": "receiverCopy.practitionerRole.organization.streetAddressLine",
                  "text": "Strasse, Hausnummer, Postfach etc.",
                  "type": "string",
                  "repeats": true
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.postalCode"
                      }
                    }
                  ],
                  "linkId": "receiverCopy.practitionerRole.organization.postalCode",
                  "text": "PLZ",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.city"
                      }
                    }
                  ],
                  "linkId": "receiverCopy.practitionerRole.organization.city",
                  "text": "Ort",
                  "type": "string"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%address.country"
                      }
                    }
                  ],
                  "linkId": "receiverCopy.practitionerRole.organization.country",
                  "text": "Land",
                  "type": "string"
                }
              ]
            }
          ]
        },
        {
          "linkId": "receiverCopy.patient",
          "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient",
          "text": "Patient selbst",
          "type": "boolean"
        },
        {
          "linkId": "receiverCopy.relatedPerson",
          "definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson",
          "text": "Andere Person",
          "type": "group",
          "repeats": true,
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/variable",
                  "valueExpression": {
                    "name": "linkIdPrefix",
                    "language": "text/fhirpath",
                    "expression": "'receiverCopy.relatedPerson.'"
                  }
                }
              ],
              "linkId": "receiverCopy.relatedPerson.familyName",
              "definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.name.family",
              "text": "Name",
              "type": "string"
            },
            {
              "linkId": "receiverCopy.relatedPerson.givenName",
              "definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.name.given",
              "text": "Vorname",
              "type": "string"
            },
            {
              "linkId": "receiverCopy.relatedPerson.phone",
              "definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.telecom.value",
              "text": "Telefon",
              "type": "string",
              "repeats": true
            },
            {
              "linkId": "receiverCopy.relatedPerson.email",
              "definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.telecom.value",
              "text": "E-Mail",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.line"
                  }
                }
              ],
              "linkId": "receiverCopy.relatedPerson.streetAddressLine",
              "text": "Strasse, Hausnummer, Postfach etc.",
              "type": "string",
              "repeats": true
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.postalCode"
                  }
                }
              ],
              "linkId": "receiverCopy.relatedPerson.postalCode",
              "text": "PLZ",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.city"
                  }
                }
              ],
              "linkId": "receiverCopy.relatedPerson.city",
              "text": "Ort",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.country"
                  }
                }
              ],
              "linkId": "receiverCopy.relatedPerson.country",
              "text": "Land",
              "type": "string"
            }
          ]
        }
      ]
    },
    {
      "linkId": "antecedentEpisodeOfCare",
      "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension",
      "text": "Vorgängiger Aufenthalt in Spital / Heim",
      "type": "group",
      "item": [
        {
          "linkId": "antecedentEpisodeOfCare.start",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-episodeofcare#EpisodeOfCare.period",
          "text": "Von",
          "type": "dateTime"
        },
        {
          "linkId": "antecedentEpisodeOfCare.end",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-episodeofcare#EpisodeOfCare.period",
          "text": "Bis",
          "type": "dateTime"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/variable",
              "valueExpression": {
                "name": "linkIdPrefix",
                "language": "text/fhirpath",
                "expression": "'antecedentEpisodeOfCare.managingOrganization.'"
              }
            }
          ],
          "linkId": "antecedentEpisodeOfCare.managingOrganization",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-episodeofcare#EpisodeOfCare.managingOrganization",
          "text": "Spital /Heim",
          "type": "group",
          "item": [
            {
              "linkId": "antecedentEpisodeOfCare.managingOrganization.name",
              "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.name",
              "text": "Name der Organisation",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.line"
                  }
                }
              ],
              "linkId": "antecedentEpisodeOfCare.managingOrganization.streetAddressLine",
              "text": "Strasse, Hausnummer, Postfach etc.",
              "type": "string",
              "repeats": true
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.postalCode"
                  }
                }
              ],
              "linkId": "antecedentEpisodeOfCare.managingOrganization.postalCode",
              "text": "PLZ",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.city"
                  }
                }
              ],
              "linkId": "antecedentEpisodeOfCare.managingOrganization.city",
              "text": "Ort",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.country"
                  }
                }
              ],
              "linkId": "antecedentEpisodeOfCare.managingOrganization.country",
              "text": "Land",
              "type": "string"
            }
          ]
        }
      ]
    },
    {
      "linkId": "appointment",
      "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.extension",
      "text": "Ort und Zeit der Durchführung der angeforderten Leistung",
      "type": "group",
      "repeats": true,
      "item": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/variable",
              "valueExpression": {
                "name": "linkIdPrefix",
                "language": "text/fhirpath",
                "expression": "'appointment.location.'"
              }
            }
          ],
          "linkId": "appointment.location",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-appointment#Appointment.participant.actor",
          "text": "Ort der Durchführung",
          "type": "group",
          "item": [
            {
              "linkId": "appointment.location.name",
              "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-location#Location.name",
              "text": "Name",
              "type": "string",
              "required": true
            },
            {
              "linkId": "appointment.location.phone",
              "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-location#Location.telecom",
              "text": "Telefon",
              "type": "string"
            },
            {
              "linkId": "appointment.location.email",
              "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-location#Location.telecom",
              "text": "E-Mail",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.line"
                  }
                }
              ],
              "linkId": "appointment.location.streetAddressLine",
              "text": "Strasse, Hausnummer, Postfach etc.",
              "type": "string",
              "repeats": true
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.postalCode"
                  }
                }
              ],
              "linkId": "appointment.location.postalCode",
              "text": "PLZ",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.city"
                  }
                }
              ],
              "linkId": "appointment.location.city",
              "text": "Ort",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%address.country"
                  }
                }
              ],
              "linkId": "appointment.location.country",
              "text": "Land",
              "type": "string"
            }
          ]
        },
        {
          "linkId": "appointment.requestedPeriod",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-appointment#Appointment.requestedPeriod",
          "text": "Datum und Zeit, wann der Termin bevorzugt geplant werden soll",
          "type": "group",
          "item": [
            {
              "linkId": "appointment.requestedPeriod.start",
              "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-appointment#Appointment.requestedPeriod.start",
              "text": "Von",
              "type": "dateTime"
            },
            {
              "linkId": "appointment.requestedPeriod.end",
              "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-appointment#Appointment.requestedPeriod.end",
              "text": "Bis",
              "type": "dateTime"
            }
          ]
        },
        {
          "linkId": "appointment.status",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-appointment#Appointment.status",
          "text": "Status",
          "type": "choice",
          "required": true,
          "answerOption": [
            {
              "valueCoding": {
                "system": "http://hl7.org/fhir/appointmentstatus",
                "code": "proposed",
                "display": "Wunsch des Patienten (vorgeschlagen)"
              },
              "initialSelected": true
            },
            {
              "valueCoding": {
                "system": "http://hl7.org/fhir/appointmentstatus",
                "code": "pending",
                "display": "Vom Patienten bestätigt, aber vom Leistungserbringer noch nicht (ausstehend)"
              }
            },
            {
              "valueCoding": {
                "system": "http://hl7.org/fhir/appointmentstatus",
                "code": "booked",
                "display": "Vom Patienten und Leistungserbringer bestätigt (gebucht)"
              }
            }
          ]
        },
        {
          "linkId": "appointment.patientInstruction",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-appointment#Appointment.patientInstruction",
          "text": "Patienteninformation für diesen Termin",
          "type": "string"
        }
      ]
    },
    {
      "linkId": "consent",
      "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension",
      "text": "Einverständniserklärung",
      "type": "group",
      "item": [
        {
          "linkId": "patient.consent.statement",
          "text": "Ist der Patient über die Anmeldung informiert und explizit einverstanden?",
          "type": "choice",
          "answerOption": [
            {
              "valueCoding": {
                "system": "http://fhir.ch/ig/ch-orf/CodeSystem/ch-orf-cs-consentstatus",
                "code": "ExplicitAgreement",
                "display": "Patient is informed and has explicitly agreed"
              }
            },
            {
              "valueCoding": {
                "system": "http://fhir.ch/ig/ch-orf/CodeSystem/ch-orf-cs-consentstatus",
                "code": "Other",
                "display": "Other situation such as 'implicit agreement', 'agreed by legal guardian' etc."
              }
            }
          ],
          "item": [
            {
              "linkId": "patient.consent.statement.note",
              "text": "Anmerkung",
              "type": "string"
            }
          ]
        }
      ]
    },
    {
      "linkId": "note",
      "text": "Bemerkungen",
      "type": "group",
      "repeats": true,
      "item": [
        {
          "linkId": "note.text",
          "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.note.text",
          "text": "Kommentar",
          "type": "string"
        }
      ]
    }
  ]
}