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Packagehl7.fhir.us.davinci-pdex
Resource TypeDocumentReference
IdDocumentReference-treatment-attestation-form-002.json
FHIR VersionR4

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Narrative

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

Signed Treatment Relationship Attestation Form for Sarah Williams


Source1

{
  "resourceType": "DocumentReference",
  "id": "treatment-attestation-form-002",
  "meta": {
    "lastUpdated": "2024-12-16T10:00:00Z"
  },
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "status": "current",
  "docStatus": "final",
  "type": {
    "coding": [
      {
        "system": "http://loinc.org",
        "code": "64292-6",
        "display": "Release of information consent Document"
      }
    ]
  },
  "category": [
    {
      "coding": [
        {
          "system": "http://loinc.org",
          "code": "64292-6",
          "display": "Release of information consent Document"
        }
      ]
    }
  ],
  "subject": {
    "reference": "Patient/patient-prov-002",
    "display": "Sarah Elizabeth Williams"
  },
  "date": "2024-12-16T09:45:00Z",
  "author": [
    {
      "reference": "Practitioner/provider-002",
      "display": "Dr. Mary Jones"
    }
  ],
  "custodian": {
    "reference": "Organization/provider-org-002",
    "display": "Second Example Provider Organization"
  },
  "description": "Signed attestation form documenting active treatment relationship between Dr. Jones and patient Sarah Williams",
  "content": [
    {
      "attachment": {
        "contentType": "application/pdf",
        "language": "en-US",
        "title": "Treatment Relationship Attestation Form",
        "creation": "2024-12-16T09:45:00Z"
      }
    }
  ],
  "context": {
    "period": {
      "start": "2024-02-15"
    }
  }
}