FHIR © HL7.org  |  FHIRsmith 4.0.1  |  Server Home  |  XIG Home  |  XIG Stats  | 

FHIR IG analytics

Packagehl7.fhir.uv.sdc
Resource TypeQuestionnaire
IdQuestionnaire-CardiologyForm.json
FHIR VersionR4
Sourcehttps://build.fhir.org/ig/HL7/sdc/Questionnaire-CardiologyForm.html
URLhttp://hl7.org/fhir/uv/sdc/Questionnaire/CardiologyForm
Version4.0.0-ci-build
Statusactive
Date2026-01-20T15:05:51.993+00:00
TitleCardiology Form
Realmuv
Authorityhl7

Resources that use this resource

No resources found


Resources that this resource uses

No resources found


Narrative

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

Generated Narrative: Questionnaire CardiologyForm

Language: en

Structure
LinkIDTextCardinalityTypeFlagsDescription & Constraintsdoco
.. Questionnairehttp://hl7.org/fhir/uv/sdc/Questionnaire/CardiologyForm#4.0.0-ci-build
... patient_headerPatient Information0..1group
.... patient_surnameSurname:1..1string
.... patient_firstnameFirst Name:1..1string
.... patient_date_of_birthDOB:1..1date
.... patient_genderGender:1..1choiceOptions: 3 options
.... patient_hc_pcHN PC:0..1stringMax Length: 2
..... patient_hc_numberHN:0..1stringMax Length: 10
..... patient_hc_vcHN VC:0..1string
.... patient_address_line1Address (Line 1):1..1string
..... patient_address_line2Address (Line 2):0..1string
..... patient_address_cityCity:1..1string
..... patient_address_provinceProvince:1..1stringMax Length: 2
..... patient_address_postalcodePostal Code:1..1string
.... patient_phone_mobileMobile #:0..1string
.... patient_phone_homeHome #:0..1string
.... patient_phone_businessBusiness #:0..1string
.... patient_emailEmail:0..1string
... additionalinfo_header[Optional] Additional Patient Information0..1group
.... additionalinfo_sexassignedatbirthSex assigned at birth:0..1choiceiconiconOptions: 4 options
.... additionalinfo_pronounsPronouns:0..1choiceOptions: 4 options
..... additionalinfo_pronouns_otherOther pronouns:1..1stringEnable When: additionalinfo_pronouns = other (NullFlavor#OTH)
.... additionalinfo_preferredlanguagePreferred language:0..1choiceiconiconOptions: 3 options
..... additionalinfo_preferredlanguage_specifySpecify:1..1stringEnable When: additionalinfo_preferredlanguage = other (NullFlavor#OTH)
..... additionalinfo_preferredlanguage_translatorrequiredTranslator required0..*stringEnable When: additionalinfo_preferredlanguage = other (NullFlavor#OTH)
Options: 1 option
.... additionalinfo_bestmethodofcontactBest method of contact:0..1choiceOptions: 4 options
..... additionalinfo_bestmethodofcontact_voicemailsVoicemails acceptable0..*stringEnable When: additionalinfo_bestmethodofcontact = Mobile (ContactPointUse#mobile)
Options: 1 option
.... additionalinfo_preferredname_selectPreferred name0..*stringOptions: 1 option
.... additionalinfo_preferrednamePrefered name String0..1stringEnable When: additionalinfo_preferredname_select = Preferred Name
.... additionalinfo_alternatecontact_selectAlternate contact0..*stringOptions: 1 option
.... additionalinfo_alternatecontact_nameName:1..1stringEnable When: additionalinfo_alternatecontact_select = Alternate contact
.... additionalinfo_alternatecontact_phoneAlternate contact phone #:0..1stringEnable When: additionalinfo_alternatecontact_select = Alternate contact
.... additionalinfo_alternatecontact_relationshipRelationship:0..1stringEnable When: additionalinfo_alternatecontact_select = Alternate contact
.... additionalinfo_alternatecontact_bookingcontactIs Alternate contact the appointment booking contact?:0..1choiceiconiconEnable When: additionalinfo_alternatecontact_select = Alternate contact
Options: 2 options
.... additionalinfo_unsafecontacts_selectUnsafe contact persons (do not speak with)0..*stringOptions: 1 option
.... additionalinfo_unsafecontacts_speakwithpatientdirectlyOnly speak with patient directly0..*stringEnable When: additionalinfo_unsafecontacts_select = Unsafe contact persons (do not speak with)
Options: 1 option
.... additionalinfo_unsafecontacts_donotspeakwithDo not speak with:0..1stringEnable When: additionalinfo_unsafecontacts_select = Unsafe contact persons (do not speak with)
.... additionalinfo_accessibilityconcernsordisability_selecttAccessibility concerns or disability0..*stringOptions: 1 option
.... additionalinfo_accessibilityconcernsordisabilityAccessibility concerns Options0..*choiceiconiconEnable When: additionalinfo_accessibilityconcernsordisability_selectt = Accessibility concerns or disability
Options: 4 options
.... additionalinfo_specialconsiderations_selectSpecial considerations (e.g. barriers, tips for care delivery, 3rd party insurance, patient requires escort, cognitive issues)0..*stringOptions: 1 option
.... additionalinfo_specialconsiderationsDetails of special considerations:1..1textEnable When: additionalinfo_specialconsiderations_select = Special considerations (e.g. barriers, tips for care delivery, 3rd party insurance, patient requires escort, cognitive issues)
.... additionalinfo_sendcopiestoadditionalprovidersSend copies of reports to additional providers0..*stringOptions: 1 option
.... additionalinfo_sendcopiestoadditionalproviders_namesName(s):1..1stringEnable When: additionalinfo_sendcopiestoadditionalproviders = Send copies of reports to additional providers
..... additionalinfo_sendcopiestoadditionalproviders_contactinfoContact information:1..1stringEnable When: additionalinfo_sendcopiestoadditionalproviders = Send copies of reports to additional providers
..... additionalinfo_sendcopiestoadditionalproviders_ispcpThis is the Primary Care Provider0..*stringEnable When: additionalinfo_sendcopiestoadditionalproviders = Send copies of reports to additional providers
Options: 1 option
... 102173268919Referral Details0..1group
.... cardio_triageconsTriage Considerations0..1group
..... referral_requestedpriorityRequested Priority:1..1choiceiconiconOptions: 2 options
...... referral_requestedpriority_urgentreasonReason for urgent triage1..1stringEnable When: referral_requestedpriority = Urgent (RequestPriority#urgent)
..... referral_secondopinionSecond Opinion0..*choiceiconiconOptions: 1 option
..... referral_secondopinion_reasonReason for second opinion:0..1textEnable When: referral_secondopinion = Second or third medical opinion (SNOMED CT#77406008)
.... 695991571585Service(s) Requested Select all that apply:1..1group
..... referralServiceHSCs Assigned:0..1stringiconiconiconicon
..... 223886162384Cardiac Testing0..*choiceiconiconOptions: 1 option
..... 660331267409Exam(s) Requested0..1groupEnable When: 223886162384 = Cardiac Testing (standardized-referral-form-codes#20001)
...... 72040932687824 Hour Ambulatory Blood Pressure Monitoring0..*choiceiconiconOptions: 1 option
...... 960455115596Coronary Angiogram0..*choiceiconiconOptions: 1 option
...... 297634898828Echocardiogram - Resting0..*choiceiconiconOptions: 1 option
...... 443484577720sub Echocardiogram - Resting0..1groupEnable When: 297634898828 = Echocardiogram - Resting (standardized-referral-form-codes#20005)
....... 165530569567Echocardiogram (2D)0..*choiceOptions: 1 option
....... 286552421895Echocardiogram with Contrast0..*choiceiconiconOptions: 1 option
....... 910527687300Echocardiogram with Saline (Bubble)0..*choiceiconiconOptions: 1 option
....... 657824763133Pediatric Echocardiogram0..*choiceiconiconOptions: 1 option
....... 992743200182Transesophageal Echocardiogram (TEE)0..*choiceiconiconOptions: 1 option
...... 894277763438Electrocardiogram (ECG)0..*choiceiconiconOptions: 1 option
...... 279226023495Holter Monitoring0..*choiceiconiconOptions: 1 option
...... 440449731882sub holter monitoring0..1groupEnable When: 279226023495 = Holter Monitoring (standardized-referral-form-codes#20007)
....... 67132870385124 Hours0..*choiceiconiconOptions: 1 option
....... 42399226184148 Hours0..*choiceiconiconOptions: 1 option
....... 41992423918772 Hours0..*choiceiconiconOptions: 1 option
....... 7310544172707 Days0..*choiceiconiconOptions: 1 option
....... 23587642104414 Days0..*choiceiconiconOptions: 1 option
...... 374742834400Loop / Event Monitor0..*choiceiconiconOptions: 1 option
...... 159161544747Cardiovascular stress testing0..*choiceiconiconOptions: 1 option
...... 370275060390Sub Stress Testing0..1groupEnable When: 159161544747 = Stress Testing (standardized-referral-form-codes#20009)
....... 814218498309ECG - Exercise Stress Test0..*choiceiconiconOptions: 1 option
....... 307107493993ECG - Dobutamine/Persantine Stress Test0..*choiceiconiconOptions: 1 option
....... 805303414102Echocardiogram - Exercise Stress Test0..*choiceiconiconOptions: 1 option
....... 193586908489Echocardiogram - Dobutamine/Persantine Stress Test0..*choiceiconiconOptions: 1 option
...... 918517139023Nuclear Medicine0..*choiceiconiconOptions: 1 option
...... 222686221935sub Nuclear Medicine0..1groupEnable When: 918517139023 = Nuclear Medicine (standardized-referral-form-codes#20010)
....... 924189648184MUGA - Resting0..*choiceiconiconOptions: 1 option
....... 857163514910Cardiac Pyrophosphate0..*choiceiconiconOptions: 1 option
....... 892165959617Myocardial perfusion scan0..*choiceiconiconOptions: 1 option
....... 538288549138sub MIBI0..1groupEnable When: 892165959617 = MIBI Scans / Myocardial Perfusion Imaging (MPI): (standardized-referral-form-codes#20028)
........ 373435981917MIBI Scan - Exercise Stress Test0..*stringOptions: 1 option
........ 434394942688MIBI Scan - Dobutamine/Persantine Stress Test0..*stringOptions: 1 option
........ 913594478162Thallium Viability Test0..*stringOptions: 1 option
...... 992682216482Tilt Table Testing0..*choiceiconiconOptions: 1 option
...... cardiology_referral_services_cardiactesting_otherOther0..*choiceiconiconOptions: 1 option
...... cardiology_referral_services_cardiactesting_other_specifySpecify1..1textEnable When: cardiology_referral_services_cardiactesting_other = other (NullFlavor#OTH)
..... 785727177547Cardiology Consultation0..*choiceiconiconOptions: 1 option
.... 186952778859Concern(s) / Indication(s) Triggering Referral Select all that apply:1..1group
..... 219569805461Arrhythmias or Palpitations0..*choiceiconiconOptions: 1 option
..... 571934328499Cardiovascular Risk Assessment0..*choiceiconiconOptions: 1 option
..... 459737733395Chest Pain or Angina0..*choiceiconiconOptions: 1 option
..... 929919815516Congenital Heart Disease0..*choiceiconiconOptions: 1 option
..... 832263816528Congestive Heart Failure0..*choiceiconiconOptions: 1 option
..... 803760213460Coronary Artery Disease0..*choiceiconiconOptions: 1 option
..... 129767162379Dyspnea0..*choiceiconiconOptions: 1 option
..... 116150628533Hypertension0..*choiceiconiconOptions: 1 option
..... 513825527027Murmur0..*choiceiconiconOptions: 1 option
..... 975075898688Pericardial Disease0..*choiceiconiconOptions: 1 option
..... 704148928571Peripheral Edema0..*choiceiconiconOptions: 1 option
..... 886489617115Post-Myocardial Infarction0..*choiceiconiconOptions: 1 option
..... 621745958993Pre-operative Consultation0..*choiceiconiconOptions: 1 option
..... 873024527134Procedure Date (if known)0..1dateEnable When: 621745958993 = Pre-operative Consultation (standardized-referral-form-codes#20044)
..... 197975129599Syncope0..*choiceiconiconOptions: 1 option
..... 675849150752Valvular Heart Disease or Prosthetic Heart Valve0..*choiceiconiconOptions: 1 option
..... 721982740516Other0..*choiceiconiconOptions: 1 option
..... 720594942482Specify1..1textEnable When: 721982740516 = other (NullFlavor#OTH)
.... DescriptionofclinicalquestionClinical Question / Goal(s) of Referral with Relevant History, Management and Investigations1..1text
... cpp_headerCumulative Patient Profile Please delete any sensitive information you do not intend to share from the CPP0..1group
.... cpp_separateCPP attached separately (if not entered below)0..*stringOptions: 1 option
.... cpp_currentprobCurrent Problem List:0..1textEnable When: cpp_separate exists false
.... cpp_pastmedicalhistoryPast Medical History:0..1textEnable When: cpp_separate exists false
.... cpp_currentmedicationsCurrent Medications :0..1textEnable When: cpp_separate exists false
.... cpp_familyhistoryFamily History:0..1textEnable When: cpp_separate exists false
.... cpp_allergiesAllergies:0..1textEnable When: cpp_separate exists false
... preferredconsultlocation_headerPreferred Consultant or Location All patients will be triaged to the shortest wait time unless a preferred consultant or location is entered.0..1group
.... preferredconsultlocation_selectorPreferred consultant or location0..*stringOptions: 1 option
.... preferredconsultlocation_specifyPlease specify either a preferred consultant or location0..1groupEnable When: preferredconsultlocation_selector = Preferred consultant or location
..... preferredconsultlocation_consultantConsultant:0..1string
..... preferredconsultlocation_locationLocation:0..1string
.... preferredconsultlocation_willingtotravelPatient willing to travel for shorter wait time0..*stringOptions: 1 option
.... preferredconsultlocation_otherconsiderationsOther considerations:0..1string
... supportingdocumentation_headerSupporting Documentation Please attach all relevant laboratory and diagnostic investigations.0..1group
.... supportingdocumentation_detailsPersonal Health Information that is medically relevant has not been disclosed at the request of the patient.0..*stringOptions: 1 option
... supportingdocumentation_attachmentAdd Attachments0..1attachment
... feedbacksurvey_cardiologyClick here to provide feedback on this form0..1display
... referrer_headerReferrer's Information0..1group
.... referrer_sitenameSite Name:0..1string
.... referrer_address_line1Address (Line 1):1..1string
..... referrer_address_line2Address (Line 2):0..1string
..... referrer_address_cityCity:1..1string
..... referrer_address_provinceProvince:1..1stringMax Length: 2
..... referrer_address_postalcodePostal Code:1..1string
.... referrer_phonePhone #:0..1string
.... referrer_faxFax #:0..1string
.... referrer_billingBilling Number:0..1integer
.... referrer_professionalidProfessional ID:0..1integer
.... referrer_signatureSigned:1..1text
.... referrer_roleRole:0..1choiceOptions: 9 options

doco Documentation for this format

Options Sets

Answer options for patient_gender

  • http://hl7.org/fhir/administrative-gender#male ("Male")
  • http://hl7.org/fhir/administrative-gender#female ("Female")
  • http://hl7.org/fhir/administrative-gender#other ("Other")

Answer options for additionalinfo_sexassignedatbirth

  • http://loinc.org#LA3-6 ("Female")
  • http://loinc.org#LA2-8 ("Male")
  • http://example.com/CodeSystem/exampleCS#Intersex ("Intersex")
  • http://loinc.org#LA4489-6 ("Unknown")

Answer options for additionalinfo_pronouns

  • http://loinc.org#LA29519-8 ("She/Her")
  • http://loinc.org#LA29518-0 ("He/Him")
  • http://loinc.org#LA29519-8 ("They/Them")
  • http://terminology.hl7.org/CodeSystem/v3-NullFlavor#OTH ("other")

Answer options for additionalinfo_preferredlanguage

  • urn:ietf:bcp:47#en ("English")
  • urn:ietf:bcp:47#fr ("French")
  • http://terminology.hl7.org/CodeSystem/v3-NullFlavor#OTH ("other")

Answer options for additionalinfo_preferredlanguage_translatorrequired

  • Translator Required

Answer options for additionalinfo_bestmethodofcontact

  • http://hl7.org/fhir/contact-point-use#mobile ("Mobile")
  • http://hl7.org/fhir/contact-point-use#home ("Home")
  • http://hl7.org/fhir/contact-point-use#work ("Work")
  • http://hl7.org/fhir/contact-point-system#email ("Email")

Answer options for additionalinfo_bestmethodofcontact_voicemails

  • Voicemails acceptable

Answer options for additionalinfo_preferredname_select

  • Preferred Name

Answer options for additionalinfo_alternatecontact_select

  • Alternate contact

Answer options for additionalinfo_alternatecontact_bookingcontact

  • http://terminology.hl7.org/CodeSystem/v2-0532#Y ("Yes")
  • http://terminology.hl7.org/CodeSystem/v2-0532#N ("No")

Answer options for additionalinfo_unsafecontacts_select

  • Unsafe contact persons (do not speak with)

Answer options for additionalinfo_unsafecontacts_speakwithpatientdirectly

  • Only speak with patient directly

Answer options for additionalinfo_accessibilityconcernsordisability_selectt

  • Accessibility concerns or disability

Answer options for additionalinfo_accessibilityconcernsordisability

  • http://snomed.info/sct#129839007 ("Falls risk")
  • http://snomed.info/sct#301621006 ("Patient requires lift")
  • http://snomed.info/sct#105503008 ("Wheelchair")
  • http://snomed.info/sct#15188001 ("Hearing impaired")

Answer options for additionalinfo_specialconsiderations_select

  • Special considerations (e.g. barriers, tips for care delivery, 3rd party insurance, patient requires escort, cognitive issues)

Answer options for additionalinfo_sendcopiestoadditionalproviders

  • Send copies of reports to additional providers

Answer options for additionalinfo_sendcopiestoadditionalproviders_ispcp

  • This is the Primary Care Provider

Answer options for referral_requestedpriority

  • http://hl7.org/fhir/request-priority#routine ("Routine")
  • http://hl7.org/fhir/request-priority#urgent ("Urgent")

Answer options for referral_secondopinion

  • http://snomed.info/sct#77406008 ("Second or third medical opinion")

Answer options for 223886162384

  • http://example.com/CodeSystem/standardized-referral-form-codes#20001 ("Cardiac Testing")

Answer options for 720409326878

  • http://example.com/CodeSystem/standardized-referral-form-codes#20003 ("24 Hour Ambulatory Blood Pressure Monitoring")

Answer options for 960455115596

  • http://example.com/CodeSystem/standardized-referral-form-codes#20004 ("Coronary Angiogram")

Answer options for 297634898828

  • http://example.com/CodeSystem/standardized-referral-form-codes#20005 ("Echocardiogram - Resting")

Answer options for 165530569567

  • http://example.com/CodeSystem/standardized-referral-form-codes#20012 ("Echocardiogram (2D)")

Answer options for 286552421895

  • http://example.com/CodeSystem/standardized-referral-form-codes#20013 ("Echocardiogram with Contrast")

Answer options for 910527687300

  • http://example.com/CodeSystem/standardized-referral-form-codes#20014 ("Echocardiogram with Saline (Bubble)")

Answer options for 657824763133

  • http://example.com/CodeSystem/standardized-referral-form-codes#20015 ("Pediatric Echocardiogram")

Answer options for 992743200182

  • http://example.com/CodeSystem/standardized-referral-form-codes#20016 ("Transesophageal Echocardiogram (TEE)")

Answer options for 894277763438

  • http://example.com/CodeSystem/standardized-referral-form-codes#20006 ("Electrocardiogram (ECG)")

Answer options for 279226023495

  • http://example.com/CodeSystem/standardized-referral-form-codes#20007 ("Holter Monitoring")

Answer options for 671328703851

  • http://example.com/CodeSystem/standardized-referral-form-codes#20017 ("24 Hours")

Answer options for 423992261841

  • http://example.com/CodeSystem/standardized-referral-form-codes#20018 ("48 Hours")

Answer options for 419924239187

  • http://example.com/CodeSystem/standardized-referral-form-codes#20019 ("72 Hours")

Answer options for 731054417270

  • http://example.com/CodeSystem/standardized-referral-form-codes#20020 ("7 Days")

Answer options for 235876421044

  • http://example.com/CodeSystem/standardized-referral-form-codes#20021 ("14 Days")

Answer options for 374742834400

  • http://example.com/CodeSystem/standardized-referral-form-codes#20008 ("Loop / Event Monitor")

Answer options for 159161544747

  • http://example.com/CodeSystem/standardized-referral-form-codes#20009 ("Stress Testing")

Answer options for 814218498309

  • http://example.com/CodeSystem/standardized-referral-form-codes#20022 ("ECG - Exercise Stress Test")

Answer options for 307107493993

  • http://example.com/CodeSystem/standardized-referral-form-codes#20023 ("ECG - Dobutamine/Persantine Stress Test")

Answer options for 805303414102

  • http://example.com/CodeSystem/standardized-referral-form-codes#20024 ("Echocardiogram - Exercise Stress Test")

Answer options for 193586908489

  • http://example.com/CodeSystem/standardized-referral-form-codes#20025 ("Echocardiogram - Dobutamine/Persantine Stress Test")

Answer options for 918517139023

  • http://example.com/CodeSystem/standardized-referral-form-codes#20010 ("Nuclear Medicine")

Answer options for 924189648184

  • http://example.com/CodeSystem/standardized-referral-form-codes#20026 ("MUGA - Resting")

Answer options for 857163514910

  • http://example.com/CodeSystem/standardized-referral-form-codes#20027 ("Cardiac Pyrophosphate")

Answer options for 892165959617

  • http://example.com/CodeSystem/standardized-referral-form-codes#20028 ("MIBI Scans / Myocardial Perfusion Imaging (MPI):")

Answer options for 373435981917

  • MIBI Scan - Exercise Stress Test

Answer options for 434394942688

  • MIBI Scan - Dobutamine/Persantine Stress Test

Answer options for 913594478162

  • Thallium Viability Test

Answer options for 992682216482

  • http://example.com/CodeSystem/standardized-referral-form-codes#20011 ("Tilt Table Testing")

Answer options for cardiology_referral_services_cardiactesting_other

  • http://terminology.hl7.org/CodeSystem/v3-NullFlavor#OTH ("other")

Answer options for 785727177547

  • http://example.com/CodeSystem/standardized-referral-form-codes#20002 ("Cardiology Consultation")

Answer options for 219569805461

  • http://snomed.info/sct#698247007 ("Arrhythmias or Palpitations")

Answer options for 571934328499

  • http://example.com/CodeSystem/standardized-referral-form-codes#20033 ("Cardiovascular Risk Assessment")

Answer options for 459737733395

  • http://example.com/CodeSystem/standardized-referral-form-codes#20034 ("Chest Pain or Angina")

Answer options for 929919815516

  • http://example.com/CodeSystem/standardized-referral-form-codes#20035 ("Congenital Heart Disease")

Answer options for 832263816528

  • http://example.com/CodeSystem/standardized-referral-form-codes#20036 ("Congestive Heart Failure")

Answer options for 803760213460

  • http://example.com/CodeSystem/standardized-referral-form-codes#20037 ("Coronary Artery Disease")

Answer options for 129767162379

  • http://example.com/CodeSystem/standardized-referral-form-codes#20038 ("Dyspnea")

Answer options for 116150628533

  • http://example.com/CodeSystem/standardized-referral-form-codes#20039 ("Hypertension")

Answer options for 513825527027

  • http://example.com/CodeSystem/standardized-referral-form-codes#20040 ("Murmur")

Answer options for 975075898688

  • http://example.com/CodeSystem/standardized-referral-form-codes#20041 ("Pericardial Disease")

Answer options for 704148928571

  • http://example.com/CodeSystem/standardized-referral-form-codes#20042 ("Peripheral Edema")

Answer options for 886489617115

  • http://example.com/CodeSystem/standardized-referral-form-codes#20043 ("Post-Myocardial Infarction")

Answer options for 621745958993

  • http://example.com/CodeSystem/standardized-referral-form-codes#20044 ("Pre-operative Consultation")

Answer options for 197975129599

  • http://example.com/CodeSystem/standardized-referral-form-codes#20045 ("Syncope")

Answer options for 675849150752

  • http://snomed.info/sct#368009 ("Valvular Heart Disease or Prosthetic Heart Valve")

Answer options for 721982740516

  • http://terminology.hl7.org/CodeSystem/v3-NullFlavor#OTH ("other")

Answer options for cpp_separate

  • CPP attached separately (if not entered below)

Answer options for preferredconsultlocation_selector

  • Preferred consultant or location

Answer options for preferredconsultlocation_willingtotravel

  • Patient willing to travel for shorter wait time

Answer options for supportingdocumentation_details

  • Personal Health Information that is medically relevant has not been disclosed at the request of the patient.

Answer options for referrer_role

  • http://snomed.info/sct#309398001 ("Allied Health Professional")
  • http://snomed.info/sct#62247001 ("Family Physician")
  • http://snomed.info/sct#449161006 ("Physician Assistant")
  • http://snomed.info/sct#398130009 ("Medical Student")
  • http://snomed.info/sct#106292003 ("Nurse")
  • http://snomed.info/sct#224571005 ("Nurse Practitioner")
  • http://snomed.info/sct#405277009 ("Resident")
  • http://snomed.info/sct#69280009 ("Specialist")
  • http://terminology.hl7.org/CodeSystem/v3-NullFlavor#OTH ("other")

Contained Resources


Metadata
Description HTML with embedded [FHIRPath Liquid](https://confluence.hl7.org/spaces/FHIR/pages/66938964/FHIR+Liquid+Profile) that is intended to be executed against QuestionnaireResponses based on this Questionnaire.
Type logic-library from http://hl7.terminology.org/CodeSystem/library-types
Parameters
Parameter None
Library Content
text/htmlContent
Encoded data 
Generated using version 0.5.4 of the sample-content-ig Liquid templates

Source1

{
  "resourceType": "Questionnaire",
  "id": "CardiologyForm",
  "language": "en",
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "contained": [
    {
      "resourceType": "Library",
      "id": "liquid",
      "status": "active",
      "experimental": false,
      "type": {
        "coding": [
          {
            "system": "http://hl7.terminology.org/CodeSystem/library-types",
            "code": "logic-library"
          }
        ]
      },
      "description": "HTML with embedded [FHIRPath Liquid](https://confluence.hl7.org/spaces/FHIR/pages/66938964/FHIR+Liquid+Profile) that is intended to be executed against QuestionnaireResponses based on this Questionnaire.",
      "content": [
        {
          "contentType": "text/html",
          "data": "<div><!--ReleaseHeader--><p id="publish-box">Structured Data Capture - Local Development build (v4.0.0-ci-build) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the <a href='http://hl7.org/fhir/uv/sdc/history.html'>Directory of published versions</a></p><!--EndReleaseHeader-->{% for currentItem in QuestionnaireResponse.item.where((linkId = '102173268919') or (linkId = 'patient_header') or (linkId = 'additionalinfo_header') or (linkId = 'cpp_header') or (linkId = 'preferredconsultlocation_header') or (linkId = 'supportingdocumentation_header') or (linkId = 'supportingdocumentation_attachment' and answer.exists()) or (linkId = 'referrer_header')) %}{% if currentItem.linkId = '102173268919' %}<br/>Referral Details<br/> {% for currentItem in currentItem.item.where((linkId = 'cardio_triagecons') or (linkId = '695991571585') or (linkId = '186952778859') or (linkId = 'Descriptionofclinicalquestion' and answer.exists())) %}{% if currentItem.linkId = 'cardio_triagecons' %}Triage Considerations {% for currentItem in currentItem.item.where((linkId = 'referral_requestedpriority' and answer.exists()) or (linkId = 'referral_secondopinion' and answer.exists()) or (linkId = 'referral_secondopinion_reason' and answer.exists())) %}{% if currentItem.linkId = 'referral_requestedpriority' %}{% if currentItem.answer.exists() %}Requested Priority: <br/><span style="font-weight:bold;color:#EE6B00;">{% for answer in currentItem.answer %}{% if answer.value.code = 'routine' %}Routine<br/>{% endif %}{% if answer.value.code = 'urgent' %}Urgent{% endif %}{% endfor %}</span>{% endif %}{% endif %}{% if currentItem.linkId = 'referral_secondopinion' %}{% if currentItem.answer.exists() %}Second Opinion {% for answer in currentItem.answer %}{% if answer.value.code = '77406008' %}Second or third medical opinion{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'referral_secondopinion_reason' %}{% if currentItem.answer.exists() %}Reason for second opinion: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = '695991571585' %}Service(s) Requested {% for currentItem in currentItem.item.where((linkId = 'referralService' and answer.exists()) or (linkId = '223886162384' and answer.exists()) or (linkId = '660331267409') or (linkId = '785727177547' and answer.exists())) %}{% if currentItem.linkId = 'referralService' %}{% if currentItem.answer.exists() %}<span style="font-weight:bold;">HSCs Assigned:</span> {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '223886162384' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20001' %}Cardiac Testing{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '660331267409' %}Exam(s) Requested<br/><br/><br/> {% for currentItem in currentItem.item.where((linkId = '720409326878' and answer.exists()) or (linkId = '960455115596' and answer.exists()) or (linkId = '297634898828' and answer.exists()) or (linkId = '443484577720') or (linkId = '894277763438' and answer.exists()) or (linkId = '279226023495' and answer.exists()) or (linkId = '440449731882') or (linkId = '374742834400' and answer.exists()) or (linkId = '159161544747' and answer.exists()) or (linkId = '370275060390') or (linkId = '918517139023' and answer.exists()) or (linkId = '222686221935') or (linkId = '992682216482' and answer.exists()) or (linkId = 'cardiology_referral_services_cardiactesting_other' and answer.exists()) or (linkId = 'cardiology_referral_services_cardiactesting_other_specify' and answer.exists())) %}{% if currentItem.linkId = '720409326878' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20003' %}24 Hour Ambulatory Blood Pressure Monitoring (Not OHIP Covered){% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '960455115596' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20004' %}Coronary Angiogram{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '297634898828' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20005' %}Echocardiogram - Resting{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '443484577720' %}<br/><br/> {% for currentItem in currentItem.item.where((linkId = '165530569567' and answer.exists()) or (linkId = '286552421895' and answer.exists()) or (linkId = '910527687300' and answer.exists()) or (linkId = '657824763133' and answer.exists()) or (linkId = '992743200182' and answer.exists())) %}{% if currentItem.linkId = '165530569567' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20012' %}Echocardiogram (2D){% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '286552421895' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20013' %}Echocardiogram with Contrast{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '910527687300' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20014' %}Echocardiogram with Saline (Bubble){% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '657824763133' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20015' %}Pediatric Echocardiogram{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '992743200182' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20016' %}Transesophageal Echocardiogram (TEE){% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = '894277763438' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20006' %}Electrocardiogram (ECG){% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '279226023495' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20007' %}Holter Monitoring{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '440449731882' %}<br/><br/> {% for currentItem in currentItem.item.where((linkId = '671328703851' and answer.exists()) or (linkId = '423992261841' and answer.exists()) or (linkId = '419924239187' and answer.exists()) or (linkId = '731054417270' and answer.exists()) or (linkId = '235876421044' and answer.exists())) %}{% if currentItem.linkId = '671328703851' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20017' %}24 Hours{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '423992261841' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20018' %}48 Hours{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '419924239187' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20019' %}72 Hours{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '731054417270' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20020' %}7 Days{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '235876421044' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20021' %}14 Days{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = '374742834400' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20008' %}Loop / Event Monitor{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '159161544747' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20009' %}Stress Testing{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '370275060390' %}<br/><br/> {% for currentItem in currentItem.item.where((linkId = '814218498309' and answer.exists()) or (linkId = '307107493993' and answer.exists()) or (linkId = '805303414102' and answer.exists()) or (linkId = '193586908489' and answer.exists())) %}{% if currentItem.linkId = '814218498309' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20022' %}ECG - Exercise Stress Test{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '307107493993' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20023' %}ECG - Dobutamine/Persantine Stress Test{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '805303414102' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20024' %}Echocardiogram - Exercise Stress Test{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '193586908489' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20025' %}Echocardiogram - Dobutamine/Persantine Stress Test{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = '918517139023' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20010' %}Nuclear Medicine{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '222686221935' %}<br/><br/> {% for currentItem in currentItem.item.where((linkId = '924189648184' and answer.exists()) or (linkId = '857163514910' and answer.exists()) or (linkId = '892165959617' and answer.exists()) or (linkId = '538288549138')) %}{% if currentItem.linkId = '924189648184' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20026' %}MUGA - Resting{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '857163514910' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20027' %}Cardiac Pyrophosphate{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '892165959617' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20028' %}MIBI Scans / Myocardial Perfusion Imaging (MPI):{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '538288549138' %}<br/><br/> {% for currentItem in currentItem.item.where((linkId = '373435981917' and answer.exists()) or (linkId = '434394942688' and answer.exists()) or (linkId = '913594478162' and answer.exists())) %}{% if currentItem.linkId = '373435981917' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'MIBI Scan - Exercise Stress Test' %}MIBI Scan - Exercise Stress Test{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '434394942688' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'MIBI Scan - Dobutamine/Persantine Stress Test' %}MIBI Scan - Dobutamine/Persantine Stress Test{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '913594478162' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Thallium Viability Test' %}Thallium Viability Test{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = '992682216482' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20011' %}Tilt Table Testing{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'cardiology_referral_services_cardiactesting_other' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = 'OTH' %}other{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'cardiology_referral_services_cardiactesting_other_specify' %}{% if currentItem.answer.exists() %}Specify {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = '785727177547' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20002' %}Cardiology Consultation{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = '186952778859' %}<b>Concern(s) / Indication(s) Triggering Referral</b><br/><i>Select all that apply:</i><br/><br/> {% for currentItem in currentItem.item.where((linkId = '219569805461' and answer.exists()) or (linkId = '571934328499' and answer.exists()) or (linkId = '459737733395' and answer.exists()) or (linkId = '929919815516' and answer.exists()) or (linkId = '832263816528' and answer.exists()) or (linkId = '803760213460' and answer.exists()) or (linkId = '129767162379' and answer.exists()) or (linkId = '116150628533' and answer.exists()) or (linkId = '513825527027' and answer.exists()) or (linkId = '975075898688' and answer.exists()) or (linkId = '704148928571' and answer.exists()) or (linkId = '886489617115' and answer.exists()) or (linkId = '621745958993' and answer.exists()) or (linkId = '873024527134' and answer.exists()) or (linkId = '197975129599' and answer.exists()) or (linkId = '675849150752' and answer.exists()) or (linkId = '721982740516' and answer.exists()) or (linkId = '720594942482' and answer.exists())) %}{% if currentItem.linkId = '219569805461' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '698247007' %}Arrhythmias or Palpitations{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '571934328499' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20033' %}Cardiovascular Risk Assessment{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '459737733395' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20034' %}Chest Pain or Angina{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '929919815516' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20035' %}Congenital Heart Disease{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '832263816528' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20036' %}Congestive Heart Failure{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '803760213460' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20037' %}Coronary Artery Disease{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '129767162379' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20038' %}Dyspnea{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '116150628533' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20039' %}Hypertension{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '513825527027' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20040' %}Murmur{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '975075898688' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20041' %}Pericardial Disease{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '704148928571' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20042' %}Peripheral Edema{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '886489617115' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20043' %}Post-Myocardial Infarction{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '621745958993' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20044' %}Pre-operative Consultation{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '873024527134' %}{% if currentItem.answer.exists() %}Procedure Date (if known) {% for answer in currentItem.answer %}{{ answer.value.ofType(date) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '197975129599' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20045' %}Syncope{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '675849150752' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '368009' %}Valvular Heart Disease or Prosthetic Heart Valve{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '721982740516' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = 'OTH' %}other{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '720594942482' %}{% if currentItem.answer.exists() %}Specify {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = 'Descriptionofclinicalquestion' %}{% if currentItem.answer.exists() %}<span style="font-weight:bold;">Clinical Question / Goal(s) of Referral with Relevant History, Management and Investigations<br/></span> {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = 'patient_header' %}Patient Information<br/> {% for currentItem in currentItem.item.where((linkId = 'patient_surname' and answer.exists()) or (linkId = 'patient_firstname' and answer.exists()) or (linkId = 'patient_date_of_birth' and answer.exists()) or (linkId = 'patient_gender' and answer.exists()) or (linkId = 'patient_hc_pc' and answer.exists()) or (linkId = 'patient_address_line1' and answer.exists()) or (linkId = 'patient_phone_mobile' and answer.exists()) or (linkId = 'patient_phone_home' and answer.exists()) or (linkId = 'patient_phone_business' and answer.exists()) or (linkId = 'patient_email' and answer.exists())) %}{% if currentItem.linkId = 'patient_surname' %}{% if currentItem.answer.exists() %}Surname: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'patient_firstname' %}{% if currentItem.answer.exists() %}First Name: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'patient_date_of_birth' %}{% if currentItem.answer.exists() %}DOB: {% for answer in currentItem.answer %}{{ answer.value.ofType(date) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'patient_gender' %}{% if currentItem.answer.exists() %}Gender: {% for answer in currentItem.answer %}{% if answer.value.code = 'male' %}Male{% endif %}{% if answer.value.code = 'female' %}Female{% endif %}{% if answer.value.code = 'other' %}Other{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'patient_hc_pc' %}{% if currentItem.answer.exists() %}HN PC: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'patient_address_line1' %}{% if currentItem.answer.exists() %}Address (Line 1): {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'patient_phone_mobile' %}{% if currentItem.answer.exists() %}Mobile #: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'patient_phone_home' %}{% if currentItem.answer.exists() %}Home #: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'patient_phone_business' %}{% if currentItem.answer.exists() %}Business #: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'patient_email' %}{% if currentItem.answer.exists() %}Email: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = 'additionalinfo_header' %}[Optional] Additional Patient Information<br/><br/> {% for currentItem in currentItem.item.where((linkId = 'additionalinfo_sexassignedatbirth' and answer.exists()) or (linkId = 'additionalinfo_pronouns' and answer.exists()) or (linkId = 'additionalinfo_preferredlanguage' and answer.exists()) or (linkId = 'additionalinfo_bestmethodofcontact' and answer.exists()) or (linkId = 'additionalinfo_preferredname_select' and answer.exists()) or (linkId = 'additionalinfo_preferredname' and answer.exists()) or (linkId = 'additionalinfo_alternatecontact_select' and answer.exists()) or (linkId = 'additionalinfo_alternatecontact_name' and answer.exists()) or (linkId = 'additionalinfo_alternatecontact_phone' and answer.exists()) or (linkId = 'additionalinfo_alternatecontact_relationship' and answer.exists()) or (linkId = 'additionalinfo_alternatecontact_bookingcontact' and answer.exists()) or (linkId = 'additionalinfo_unsafecontacts_select' and answer.exists()) or (linkId = 'additionalinfo_unsafecontacts_speakwithpatientdirectly' and answer.exists()) or (linkId = 'additionalinfo_unsafecontacts_donotspeakwith' and answer.exists()) or (linkId = 'additionalinfo_accessibilityconcernsordisability_selectt' and answer.exists()) or (linkId = 'additionalinfo_accessibilityconcernsordisability' and answer.exists()) or (linkId = 'additionalinfo_specialconsiderations_select' and answer.exists()) or (linkId = 'additionalinfo_specialconsiderations' and answer.exists()) or (linkId = 'additionalinfo_sendcopiestoadditionalproviders' and answer.exists()) or (linkId = 'additionalinfo_sendcopiestoadditionalproviders_names' and answer.exists())) %}{% if currentItem.linkId = 'additionalinfo_sexassignedatbirth' %}{% if currentItem.answer.exists() %}Sex assigned at birth: {% for answer in currentItem.answer %}{% if answer.value.code = 'LA3-6' %}Female{% endif %}{% if answer.value.code = 'LA2-8' %}Male{% endif %}{% if answer.value.code = 'Intersex' %}Intersex{% endif %}{% if answer.value.code = 'LA4489-6' %}Unknown{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_pronouns' %}{% if currentItem.answer.exists() %}Pronouns: {% for answer in currentItem.answer %}{% if answer.value.code = 'LA29519-8' %}She/Her{% endif %}{% if answer.value.code = 'LA29518-0' %}He/Him{% endif %}{% if answer.value.code = 'LA29519-8' %}They/Them{% endif %}{% if answer.value.code = 'OTH' %}other{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_preferredlanguage' %}{% if currentItem.answer.exists() %}Preferred language: {% for answer in currentItem.answer %}{% if answer.value.code = 'en' %}English{% endif %}{% if answer.value.code = 'fr' %}French{% endif %}{% if answer.value.code = 'OTH' %}other{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_bestmethodofcontact' %}{% if currentItem.answer.exists() %}Best method of contact: {% for answer in currentItem.answer %}{% if answer.value.code = 'mobile' %}Mobile{% endif %}{% if answer.value.code = 'home' %}Home{% endif %}{% if answer.value.code = 'work' %}Work{% endif %}{% if answer.value.code = 'email' %}Email{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_preferredname_select' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Preferred Name' %}Preferred Name{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_preferredname' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_alternatecontact_select' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Alternate contact' %}Alternate contact{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_alternatecontact_name' %}{% if currentItem.answer.exists() %}Name: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_alternatecontact_phone' %}{% if currentItem.answer.exists() %}Alternate contact phone #: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_alternatecontact_relationship' %}{% if currentItem.answer.exists() %}Relationship: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_alternatecontact_bookingcontact' %}{% if currentItem.answer.exists() %}Is Alternate contact the appointment booking contact?: {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_unsafecontacts_select' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Unsafe contact persons (do not speak with)' %}Unsafe contact persons (do not speak with){% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_unsafecontacts_speakwithpatientdirectly' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Only speak with patient directly' %}Only speak with patient directly{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_unsafecontacts_donotspeakwith' %}{% if currentItem.answer.exists() %}Do not speak with: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_accessibilityconcernsordisability_selectt' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Accessibility concerns or disability' %}Accessibility concerns or disability{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_accessibilityconcernsordisability' %}{% if currentItem.answer.exists() %}<br/>{% for answer in currentItem.answer %}{% if answer.value.code = '129839007' %}Falls risk{% endif %}{% if answer.value.code = '301621006' %}Patient requires lift{% endif %}{% if answer.value.code = '105503008' %}Wheelchair{% endif %}{% if answer.value.code = '15188001' %}Hearing impaired{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_specialconsiderations_select' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Special considerations (e.g. barriers, tips for care delivery, 3rd party insurance, patient requires escort, cognitive issues)' %}Special considerations (e.g. barriers, tips for care delivery, 3rd party insurance, patient requires escort, cognitive issues){% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_specialconsiderations' %}{% if currentItem.answer.exists() %}Details of special considerations: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_sendcopiestoadditionalproviders' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Send copies of reports to additional providers' %}Send copies of reports to additional providers{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_sendcopiestoadditionalproviders_names' %}{% if currentItem.answer.exists() %}Name(s): {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = 'cpp_header' %}Cumulative Patient Profile<br/><br/><i>Please delete any sensitive information you do not intend to share from the CPP</i><br/> {% for currentItem in currentItem.item.where((linkId = 'cpp_separate' and answer.exists()) or (linkId = 'cpp_currentprob' and answer.exists()) or (linkId = 'cpp_pastmedicalhistory' and answer.exists()) or (linkId = 'cpp_currentmedications' and answer.exists()) or (linkId = 'cpp_familyhistory' and answer.exists()) or (linkId = 'cpp_allergies' and answer.exists())) %}{% if currentItem.linkId = 'cpp_separate' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'CPP attached separately (if not entered below)' %}CPP attached separately (if not entered below){% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'cpp_currentprob' %}{% if currentItem.answer.exists() %}Current Problem List: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'cpp_pastmedicalhistory' %}{% if currentItem.answer.exists() %}Past Medical History: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'cpp_currentmedications' %}{% if currentItem.answer.exists() %}Current Medications : {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'cpp_familyhistory' %}{% if currentItem.answer.exists() %}Family History: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'cpp_allergies' %}{% if currentItem.answer.exists() %}Allergies: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = 'preferredconsultlocation_header' %}<b>Preferred Consultant or Location</b><br/><br/>All patients will be triaged to the shortest wait time unless a preferred consultant or location is entered.<br/> {% for currentItem in currentItem.item.where((linkId = 'preferredconsultlocation_selector' and answer.exists()) or (linkId = 'preferredconsultlocation_specify') or (linkId = 'preferredconsultlocation_willingtotravel' and answer.exists()) or (linkId = 'preferredconsultlocation_otherconsiderations' and answer.exists())) %}{% if currentItem.linkId = 'preferredconsultlocation_selector' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Preferred consultant or location' %}Preferred consultant or location{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'preferredconsultlocation_specify' %}Please specify either a <b>preferred</b> consultant or location<br/> {% for currentItem in currentItem.item.where((linkId = 'preferredconsultlocation_consultant' and answer.exists()) or (linkId = 'preferredconsultlocation_location' and answer.exists())) %}{% if currentItem.linkId = 'preferredconsultlocation_consultant' %}{% if currentItem.answer.exists() %}Consultant: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'preferredconsultlocation_location' %}{% if currentItem.answer.exists() %}Location: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = 'preferredconsultlocation_willingtotravel' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Patient willing to travel for shorter wait time' %}Patient willing to travel for shorter wait time{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'preferredconsultlocation_otherconsiderations' %}{% if currentItem.answer.exists() %}Other considerations: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = 'supportingdocumentation_header' %}<b>Supporting Documentation</b><br/>Please attach all <b><span style="text-decoration: underline">relevant</span></b> laboratory and diagnostic investigations.<br/><br/> {% for currentItem in currentItem.item.where((linkId = 'supportingdocumentation_details' and answer.exists())) %}{% if currentItem.linkId = 'supportingdocumentation_details' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Personal Health Information that is medically relevant has not been disclosed at the request of the patient.' %}Personal Health Information that is medically relevant has not been disclosed at the request of the patient.{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = 'supportingdocumentation_attachment' %}{% if currentItem.answer.exists() %}Add Attachments {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'referrer_header' %}Referrer's Information<br/> {% for currentItem in currentItem.item.where((linkId = 'referrer_sitename' and answer.exists()) or (linkId = 'referrer_address_line1' and answer.exists()) or (linkId = 'referrer_phone' and answer.exists()) or (linkId = 'referrer_fax' and answer.exists()) or (linkId = 'referrer_billing' and answer.exists()) or (linkId = 'referrer_professionalid' and answer.exists()) or (linkId = 'referrer_signature' and answer.exists()) or (linkId = 'referrer_role' and answer.exists())) %}{% if currentItem.linkId = 'referrer_sitename' %}{% if currentItem.answer.exists() %}Site Name: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'referrer_address_line1' %}{% if currentItem.answer.exists() %}Address (Line 1): {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'referrer_phone' %}{% if currentItem.answer.exists() %}Phone #: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'referrer_fax' %}{% if currentItem.answer.exists() %}Fax #: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'referrer_billing' %}{% if currentItem.answer.exists() %}Billing Number: {% for answer in currentItem.answer %}{{ answer.value.ofType(integer) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'referrer_professionalid' %}{% if currentItem.answer.exists() %}Professional ID: {% for answer in currentItem.answer %}{{ answer.value.ofType(integer) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'referrer_signature' %}{% if currentItem.answer.exists() %}Signed: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'referrer_role' %}{% if currentItem.answer.exists() %}Role: {% for answer in currentItem.answer %}{% if answer.value.code = '309398001' %}Allied Health Professional{% endif %}{% if answer.value.code = '62247001' %}Family Physician{% endif %}{% if answer.value.code = '449161006' %}Physician Assistant{% endif %}{% if answer.value.code = '398130009' %}Medical Student{% endif %}{% if answer.value.code = '106292003' %}Nurse{% endif %}{% if answer.value.code = '224571005' %}Nurse Practitioner{% endif %}{% if answer.value.code = '405277009' %}Resident{% endif %}{% if answer.value.code = '69280009' %}Specialist{% endif %}{% if answer.value.code = 'OTH' %}other{% endif %}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}</div>"
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm",
      "valueCoding": {
        "system": "http://hl7.org/fhir/version-algorithm",
        "code": "semver"
      }
    },
    {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-entryMode",
      "valueCode": "random"
    },
    {
      "extension": [
        {
          "url": "purpose",
          "valueCoding": {
            "system": "http://terminology.hl7.org/CodeSystem/rendering-purpose",
            "code": "narrative"
          }
        },
        {
          "url": "template",
          "valueReference": {
            "reference": "#liquid"
          }
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/instance-rendering"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "fhir"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 4,
      "_valueInteger": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical": "http://hl7.org/fhir/uv/sdc/ImplementationGuide/hl7.fhir.uv.sdc"
          }
        ]
      }
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode": "trial-use",
      "_valueCode": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical": "http://hl7.org/fhir/uv/sdc/ImplementationGuide/hl7.fhir.uv.sdc"
          }
        ]
      }
    }
  ],
  "url": "http://hl7.org/fhir/uv/sdc/Questionnaire/CardiologyForm",
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.16.840.1.113883.4.642.40.17.35.43"
    }
  ],
  "version": "4.0.0-ci-build",
  "title": "Cardiology Form",
  "status": "active",
  "experimental": false,
  "subjectType": [
    "Patient"
  ],
  "date": "2026-01-20T15:05:51.993+00:00",
  "publisher": "HL7 International / FHIR Infrastructure",
  "contact": [
    {
      "name": "HL7 International / FHIR Infrastructure",
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/fiwg"
        }
      ]
    },
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/fiwg"
        }
      ]
    }
  ],
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001",
          "display": "World"
        }
      ]
    }
  ],
  "effectivePeriod": {
    "start": "2025-02-03"
  },
  "code": [
    {
      "system": "http://snomed.info/sct",
      "code": "789718008",
      "display": "Cardiology service"
    }
  ],
  "item": [
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://hl7.org/fhir/questionnaire-item-control",
                "code": "list",
                "display": "List"
              }
            ]
          }
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
          "valueString": "background-color:grey;border-style:solid;"
        }
      ],
      "linkId": "patient_header",
      "text": "Patient Information",
      "_text": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
            "valueString": "font-weight:bold;"
          }
        ]
      },
      "type": "group",
      "item": [
        {
          "linkId": "patient_surname",
          "text": "Surname:",
          "type": "string",
          "required": true
        },
        {
          "linkId": "patient_firstname",
          "text": "First Name:",
          "type": "string",
          "required": true
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/entryFormat",
              "valueString": "yyyy/MM/dd"
            }
          ],
          "linkId": "patient_date_of_birth",
          "text": "DOB:",
          "type": "date",
          "required": true
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "radio-button",
                    "display": "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId": "patient_gender",
          "text": "Gender:",
          "type": "choice",
          "required": true,
          "answerOption": [
            {
              "valueCoding": {
                "system": "http://hl7.org/fhir/administrative-gender",
                "code": "male",
                "display": "Male"
              }
            },
            {
              "valueCoding": {
                "system": "http://hl7.org/fhir/administrative-gender",
                "code": "female",
                "display": "Female"
              }
            },
            {
              "valueCoding": {
                "system": "http://hl7.org/fhir/administrative-gender",
                "code": "other",
                "display": "Other"
              }
            }
          ]
        },
        {
          "linkId": "patient_hc_pc",
          "text": "HN PC:",
          "type": "string",
          "maxLength": 2,
          "item": [
            {
              "linkId": "patient_hc_number",
              "text": "HN:",
              "type": "string",
              "maxLength": 10
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/minLength",
                  "valueInteger": 2
                }
              ],
              "linkId": "patient_hc_vc",
              "text": "HN VC:",
              "type": "string"
            }
          ]
        },
        {
          "linkId": "patient_address_line1",
          "text": "Address (Line 1):",
          "type": "string",
          "required": true,
          "item": [
            {
              "linkId": "patient_address_line2",
              "text": "Address (Line 2):",
              "type": "string"
            },
            {
              "linkId": "patient_address_city",
              "text": "City:",
              "type": "string",
              "required": true
            },
            {
              "linkId": "patient_address_province",
              "text": "Province:",
              "type": "string",
              "required": true,
              "maxLength": 2
            },
            {
              "extension": [
                {
                  "extension": [
                    {
                      "url": "key",
                      "valueId": "pat-pcode"
                    },
                    {
                      "url": "severity",
                      "valueCode": "error"
                    },
                    {
                      "url": "expression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%resource.repeat(item).where(linkId='patient_address_postalcode').answer.all(value.matches('^(?!.*[DFIOQU])[A-VXY][0-9][A-Z] ?[0-9][A-Z][0-9][%content%]#39;))"
                      }
                    },
                    {
                      "url": "human",
                      "valueString": "Must be a valid Canadian postal-code"
                    }
                  ],
                  "url": "http://hl7.org/fhir/StructureDefinition/targetConstraint"
                }
              ],
              "linkId": "patient_address_postalcode",
              "text": "Postal Code:",
              "type": "string",
              "required": true
            }
          ]
        },
        {
          "extension": [
            {
              "extension": [
                {
                  "url": "key",
                  "valueId": "mobilephone"
                },
                {
                  "url": "severity",
                  "valueCode": "error"
                },
                {
                  "url": "expression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%resource.repeat(item).where(linkId='patient_phone_mobile').answer.all(value.matches('^(\\+\\d{1,2}\\s?)?\\(?\\d{3}\\)?[\\s.-]?\\d{3}[\\s.-]?\\d{4}[%content%]#39;))"
                  }
                },
                {
                  "url": "human",
                  "valueString": "Must be a valid phone number"
                }
              ],
              "url": "http://hl7.org/fhir/StructureDefinition/targetConstraint"
            }
          ],
          "linkId": "patient_phone_mobile",
          "text": "Mobile #:",
          "type": "string"
        },
        {
          "extension": [
            {
              "extension": [
                {
                  "url": "key",
                  "valueId": "homephone"
                },
                {
                  "url": "severity",
                  "valueCode": "error"
                },
                {
                  "url": "expression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%resource.repeat(item).where(linkId='patient_phone_home').answer.all(value.matches('^(\\+\\d{1,2}\\s?)?\\(?\\d{3}\\)?[\\s.-]?\\d{3}[\\s.-]?\\d{4}[%content%]#39;))"
                  }
                },
                {
                  "url": "human",
                  "valueString": "Must be a valid phone number"
                }
              ],
              "url": "http://hl7.org/fhir/StructureDefinition/targetConstraint"
            }
          ],
          "linkId": "patient_phone_home",
          "text": "Home #:",
          "type": "string"
        },
        {
          "extension": [
            {
              "extension": [
                {
                  "url": "key",
                  "valueId": "busphone"
                },
                {
                  "url": "severity",
                  "valueCode": "error"
                },
                {
                  "url": "expression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%resource.repeat(item).where(linkId='patient_phone_business').answer.all(value.matches('^(\\+\\d{1,2}\\s?)?\\(?\\d{3}\\)?[\\s.-]?\\d{3}[\\s.-]?\\d{4}[%content%]#39;))"
                  }
                },
                {
                  "url": "human",
                  "valueString": "Must be a valid phone number"
                }
              ],
              "url": "http://hl7.org/fhir/StructureDefinition/targetConstraint"
            }
          ],
          "linkId": "patient_phone_business",
          "text": "Business #:",
          "type": "string"
        },
        {
          "extension": [
            {
              "extension": [
                {
                  "url": "key",
                  "valueId": "patemail"
                },
                {
                  "url": "severity",
                  "valueCode": "error"
                },
                {
                  "url": "expression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%resource.repeat(item).where(linkId='patient_email').answer.all(value.matches('(?:[a-z0-9!#$%&'*+/=?^_`{|}~-]+(?:\\.[a-z0-9!#$%&'*+/=?^_`{|}~-]+)*|\"(?:[\\x01-\\x08\\x0b\\x0c\\x0e-\\x1f\\x21\\x23-\\x5b\\x5d-\\x7f]|\\\\[\\x01-\\x09\\x0b\\x0c\\x0e-\\x7f])*\")@(?:(?:[a-z0-9](?:[a-z0-9-]*[a-z0-9])?\\.)+[a-z0-9](?:[a-z0-9-]*[a-z0-9])?|\\[(?:(?:(2(5[0-5]|[0-4][0-9])|1[0-9][0-9]|[1-9]?[0-9]))\\.){3}(?:(2(5[0-5]|[0-4][0-9])|1[0-9][0-9]|[1-9]?[0-9])|[a-z0-9-]*[a-z0-9]:(?:[\\x01-\\x08\\x0b\\x0c\\x0e-\\x1f\\x21-\\x5a\\x53-\\x7f]|\\\\[\\x01-\\x09\\x0b\\x0c\\x0e-\\x7f])+)\\])'))"
                  }
                },
                {
                  "url": "human",
                  "valueString": "Must be a valid email address"
                }
              ],
              "url": "http://hl7.org/fhir/StructureDefinition/targetConstraint"
            }
          ],
          "linkId": "patient_email",
          "text": "Email:",
          "type": "string"
        }
      ]
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
          "valueString": "background-color:grey;border-style:solid;"
        }
      ],
      "linkId": "additionalinfo_header",
      "text": "[Optional] Additional Patient Information",
      "_text": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
            "valueString": "[Optional]&#xa0;Additional&#xa0;Patient&#xa0;Information<br/>"
          },
          {
            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
            "valueString": "font-weight:bold;"
          }
        ]
      },
      "type": "group",
      "item": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
              "valueCode": "horizontal"
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://example.com/CodeSystem/item-controls",
                    "code": "push-button",
                    "display": "Push Button"
                  }
                ]
              }
            }
          ],
          "linkId": "additionalinfo_sexassignedatbirth",
          "text": "Sex assigned at birth:",
          "type": "choice",
          "answerOption": [
            {
              "valueCoding": {
                "system": "http://loinc.org",
                "code": "LA3-6",
                "display": "Female"
              }
            },
            {
              "valueCoding": {
                "system": "http://loinc.org",
                "code": "LA2-8",
                "display": "Male"
              }
            },
            {
              "valueCoding": {
                "system": "http://example.com/CodeSystem/exampleCS",
                "code": "Intersex",
                "display": "Intersex"
              }
            },
            {
              "valueCoding": {
                "system": "http://loinc.org",
                "code": "LA4489-6",
                "display": "Unknown"
              }
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://example.com/CodeSystem/item-controls",
                    "code": "push-button",
                    "display": "Push Button"
                  }
                ]
              }
            }
          ],
          "linkId": "additionalinfo_pronouns",
          "text": "Pronouns:",
          "type": "choice",
          "answerOption": [
            {
              "valueCoding": {
                "system": "http://loinc.org",
                "code": "LA29519-8",
                "display": "She/Her"
              }
            },
            {
              "valueCoding": {
                "system": "http://loinc.org",
                "code": "LA29518-0",
                "display": "He/Him"
              }
            },
            {
              "valueCoding": {
                "system": "http://loinc.org",
                "code": "LA29519-8",
                "display": "They/Them"
              }
            },
            {
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
                "code": "OTH",
                "display": "other"
              }
            }
          ],
          "item": [
            {
              "linkId": "additionalinfo_pronouns_other",
              "text": "Other pronouns:",
              "type": "string",
              "enableWhen": [
                {
                  "question": "additionalinfo_pronouns",
                  "operator": "=",
                  "answerCoding": {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
                    "code": "OTH",
                    "display": "other"
                  }
                }
              ],
              "enableBehavior": "all",
              "required": true
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
              "valueCode": "horizontal"
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://example.com/CodeSystem/item-controls",
                    "code": "push-button",
                    "display": "Push Button"
                  }
                ]
              }
            }
          ],
          "linkId": "additionalinfo_preferredlanguage",
          "text": "Preferred language:",
          "type": "choice",
          "required": false,
          "answerOption": [
            {
              "valueCoding": {
                "system": "urn:ietf:bcp:47",
                "code": "en",
                "display": "English"
              }
            },
            {
              "valueCoding": {
                "system": "urn:ietf:bcp:47",
                "code": "fr",
                "display": "French"
              }
            },
            {
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
                "code": "OTH",
                "display": "other"
              }
            }
          ],
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                  "valueString": "background-color:white;border-style:solid;"
                }
              ],
              "linkId": "additionalinfo_preferredlanguage_specify",
              "text": "Specify:",
              "type": "string",
              "enableWhen": [
                {
                  "question": "additionalinfo_preferredlanguage",
                  "operator": "=",
                  "answerCoding": {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
                    "code": "OTH",
                    "display": "other"
                  }
                }
              ],
              "enableBehavior": "all",
              "required": true
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                  "valueString": "background-color:white;border-style:solid;"
                }
              ],
              "linkId": "additionalinfo_preferredlanguage_translatorrequired",
              "text": "Translator required",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "string",
              "enableWhen": [
                {
                  "question": "additionalinfo_preferredlanguage",
                  "operator": "=",
                  "answerCoding": {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
                    "code": "OTH",
                    "display": "other"
                  }
                }
              ],
              "repeats": true,
              "answerOption": [
                {
                  "valueString": "Translator Required"
                }
              ]
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://example.com/CodeSystem/item-controls",
                    "code": "push-button",
                    "display": "Push Button"
                  }
                ]
              }
            }
          ],
          "linkId": "additionalinfo_bestmethodofcontact",
          "text": "Best method of contact:",
          "type": "choice",
          "answerOption": [
            {
              "valueCoding": {
                "system": "http://hl7.org/fhir/contact-point-use",
                "code": "mobile",
                "display": "Mobile"
              }
            },
            {
              "valueCoding": {
                "system": "http://hl7.org/fhir/contact-point-use",
                "code": "home",
                "display": "Home"
              }
            },
            {
              "valueCoding": {
                "system": "http://hl7.org/fhir/contact-point-use",
                "code": "work",
                "display": "Work"
              }
            },
            {
              "valueCoding": {
                "system": "http://hl7.org/fhir/contact-point-system",
                "code": "email",
                "display": "Email"
              }
            }
          ],
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                  "valueString": "background-color:white;border-style:solid;"
                }
              ],
              "linkId": "additionalinfo_bestmethodofcontact_voicemails",
              "text": "Voicemails acceptable",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "string",
              "enableWhen": [
                {
                  "question": "additionalinfo_bestmethodofcontact",
                  "operator": "=",
                  "answerCoding": {
                    "system": "http://hl7.org/fhir/contact-point-use",
                    "code": "mobile",
                    "display": "Mobile"
                  }
                }
              ],
              "enableBehavior": "any",
              "repeats": true,
              "answerOption": [
                {
                  "valueString": " Voicemails acceptable"
                }
              ]
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "check-box",
                    "display": "Check-box"
                  }
                ]
              }
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            }
          ],
          "linkId": "additionalinfo_preferredname_select",
          "text": "Preferred name",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "<br/>"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                "valueString": "display:none;"
              }
            ]
          },
          "type": "string",
          "repeats": true,
          "answerOption": [
            {
              "valueString": "Preferred Name"
            }
          ]
        },
        {
          "linkId": "additionalinfo_preferredname",
          "text": "Prefered name String",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "<br/>"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                "valueString": "display:none;"
              }
            ]
          },
          "type": "string",
          "enableWhen": [
            {
              "question": "additionalinfo_preferredname_select",
              "operator": "=",
              "answerString": "Preferred Name"
            }
          ],
          "enableBehavior": "all"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "check-box",
                    "display": "Check-box"
                  }
                ]
              }
            }
          ],
          "linkId": "additionalinfo_alternatecontact_select",
          "text": "Alternate contact",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "<br/>"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                "valueString": "display:none;"
              }
            ]
          },
          "type": "string",
          "repeats": true,
          "answerOption": [
            {
              "valueString": "Alternate contact"
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            }
          ],
          "linkId": "additionalinfo_alternatecontact_name",
          "text": "Name:",
          "type": "string",
          "enableWhen": [
            {
              "question": "additionalinfo_alternatecontact_select",
              "operator": "=",
              "answerString": "Alternate contact"
            }
          ],
          "enableBehavior": "all",
          "required": true
        },
        {
          "extension": [
            {
              "extension": [
                {
                  "url": "key",
                  "valueId": "altphone"
                },
                {
                  "url": "severity",
                  "valueCode": "error"
                },
                {
                  "url": "expression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%resource.repeat(item).where(linkId='additionalinfo_alternatecontact_phone').answer.all(value.matches('^(\\+\\d{1,2}\\s?)?\\(?\\d{3}\\)?[\\s.-]?\\d{3}[\\s.-]?\\d{4}[%content%]#39;))"
                  }
                },
                {
                  "url": "human",
                  "valueString": "Must be a valid phone number"
                }
              ],
              "url": "http://hl7.org/fhir/StructureDefinition/targetConstraint"
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            }
          ],
          "linkId": "additionalinfo_alternatecontact_phone",
          "text": "Alternate contact phone #:",
          "type": "string",
          "enableWhen": [
            {
              "question": "additionalinfo_alternatecontact_select",
              "operator": "=",
              "answerString": "Alternate contact"
            }
          ],
          "enableBehavior": "all"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            }
          ],
          "linkId": "additionalinfo_alternatecontact_relationship",
          "text": "Relationship:",
          "type": "string",
          "enableWhen": [
            {
              "question": "additionalinfo_alternatecontact_select",
              "operator": "=",
              "answerString": "Alternate contact"
            }
          ],
          "enableBehavior": "all"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "radio-button",
                    "display": "Radio Button"
                  }
                ]
              }
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
              "valueCode": "horizontal"
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            }
          ],
          "linkId": "additionalinfo_alternatecontact_bookingcontact",
          "text": "Is Alternate contact the appointment booking contact?:",
          "type": "choice",
          "enableWhen": [
            {
              "question": "additionalinfo_alternatecontact_select",
              "operator": "=",
              "answerString": "Alternate contact"
            }
          ],
          "enableBehavior": "all",
          "answerOption": [
            {
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
                "code": "Y",
                "display": "Yes"
              }
            },
            {
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
                "code": "N",
                "display": "No"
              }
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "check-box",
                    "display": "Check-box"
                  }
                ]
              }
            }
          ],
          "linkId": "additionalinfo_unsafecontacts_select",
          "text": "Unsafe contact persons (do not speak with)",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "<br/>"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                "valueString": "display:none;"
              }
            ]
          },
          "type": "string",
          "repeats": true,
          "answerOption": [
            {
              "valueString": "Unsafe contact persons (do not speak with)"
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "check-box",
                    "display": "Check-box"
                  }
                ]
              }
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            }
          ],
          "linkId": "additionalinfo_unsafecontacts_speakwithpatientdirectly",
          "text": "Only speak with patient directly",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "<br/>"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                "valueString": "display:none;"
              }
            ]
          },
          "type": "string",
          "enableWhen": [
            {
              "question": "additionalinfo_unsafecontacts_select",
              "operator": "=",
              "answerString": "Unsafe contact persons (do not speak with)"
            }
          ],
          "enableBehavior": "all",
          "repeats": true,
          "answerOption": [
            {
              "valueString": "Only speak with patient directly"
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            }
          ],
          "linkId": "additionalinfo_unsafecontacts_donotspeakwith",
          "text": "Do not speak with:",
          "type": "string",
          "enableWhen": [
            {
              "question": "additionalinfo_unsafecontacts_select",
              "operator": "=",
              "answerString": "Unsafe contact persons (do not speak with)"
            }
          ],
          "enableBehavior": "all"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "check-box",
                    "display": "Check-box"
                  }
                ]
              }
            }
          ],
          "linkId": "additionalinfo_accessibilityconcernsordisability_selectt",
          "text": "Accessibility concerns or disability",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "<br/>"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                "valueString": "display:none;"
              }
            ]
          },
          "type": "string",
          "repeats": true,
          "answerOption": [
            {
              "valueString": "Accessibility concerns or disability"
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
              "valueCode": "horizontal"
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://example.com/CodeSystem/item-controls",
                    "code": "push-button",
                    "display": "Push Button"
                  }
                ]
              }
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            }
          ],
          "linkId": "additionalinfo_accessibilityconcernsordisability",
          "text": "Accessibility concerns Options",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "<br/>"
              }
            ]
          },
          "type": "choice",
          "enableWhen": [
            {
              "question": "additionalinfo_accessibilityconcernsordisability_selectt",
              "operator": "=",
              "answerString": "Accessibility concerns or disability"
            }
          ],
          "repeats": true,
          "answerOption": [
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "129839007",
                "display": "Falls risk"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "301621006",
                "display": "Patient requires lift"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "105503008",
                "display": "Wheelchair"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "15188001",
                "display": "Hearing impaired"
              }
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "check-box",
                    "display": "Check-box"
                  }
                ]
              }
            }
          ],
          "linkId": "additionalinfo_specialconsiderations_select",
          "text": "Special considerations (e.g. barriers, tips for care delivery, 3rd party insurance, patient requires escort, cognitive issues)",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "<br/>"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                "valueString": "display:none;"
              }
            ]
          },
          "type": "string",
          "repeats": true,
          "answerOption": [
            {
              "valueString": "Special considerations (e.g. barriers, tips for care delivery, 3rd party insurance, patient requires escort, cognitive issues)"
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            }
          ],
          "linkId": "additionalinfo_specialconsiderations",
          "text": "Details of special considerations:",
          "type": "text",
          "enableWhen": [
            {
              "question": "additionalinfo_specialconsiderations_select",
              "operator": "=",
              "answerString": "Special considerations (e.g. barriers, tips for care delivery, 3rd party insurance, patient requires escort, cognitive issues)"
            }
          ],
          "required": true
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "check-box",
                    "display": "Check-box"
                  }
                ]
              }
            }
          ],
          "linkId": "additionalinfo_sendcopiestoadditionalproviders",
          "text": "Send copies of reports to additional providers",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "<br/>"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                "valueString": "display:none;"
              }
            ]
          },
          "type": "string",
          "repeats": true,
          "answerOption": [
            {
              "valueString": "Send copies of reports to additional providers"
            }
          ]
        },
        {
          "linkId": "additionalinfo_sendcopiestoadditionalproviders_names",
          "text": "Name(s):",
          "type": "string",
          "enableWhen": [
            {
              "question": "additionalinfo_sendcopiestoadditionalproviders",
              "operator": "=",
              "answerString": "Send copies of reports to additional providers"
            }
          ],
          "enableBehavior": "all",
          "required": true,
          "item": [
            {
              "linkId": "additionalinfo_sendcopiestoadditionalproviders_contactinfo",
              "text": "Contact information:",
              "type": "string",
              "enableWhen": [
                {
                  "question": "additionalinfo_sendcopiestoadditionalproviders",
                  "operator": "=",
                  "answerString": "Send copies of reports to additional providers"
                }
              ],
              "enableBehavior": "all",
              "required": true
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                }
              ],
              "linkId": "additionalinfo_sendcopiestoadditionalproviders_ispcp",
              "text": "This is the Primary Care Provider",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "string",
              "enableWhen": [
                {
                  "question": "additionalinfo_sendcopiestoadditionalproviders",
                  "operator": "=",
                  "answerString": "Send copies of reports to additional providers"
                }
              ],
              "enableBehavior": "all",
              "repeats": true,
              "answerOption": [
                {
                  "valueString": "This is the Primary Care Provider"
                }
              ]
            }
          ]
        }
      ]
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
          "valueString": "background-color:grey;border-style:solid;"
        },
        {
          "extension": [
            {
              "url": "sortIndex",
              "valuePositiveInt": 1
            },
            {
              "url": "text",
              "valueString": "Referral Details",
              "_valueString": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>Referral Details<br/>"
                  }
                ]
              }
            },
            {
              "url": "style",
              "valueString": "font-weight:bold;text-decoration:underline;"
            },
            {
              "url": "groupItems",
              "valueBoolean": false
            }
          ],
          "url": "http://example.com/StructureDefinition/group-note-info"
        }
      ],
      "linkId": "102173268919",
      "text": "Referral Details",
      "_text": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
            "valueString": "Referral&#xa0;Details<br/>"
          },
          {
            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
            "valueString": "font-weight:bold;color:#202035;"
          }
        ]
      },
      "type": "group",
      "item": [
        {
          "extension": [
            {
              "extension": [
                {
                  "url": "enableWhenExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "true"
                  }
                },
                {
                  "url": "sortIndex",
                  "valuePositiveInt": 1
                },
                {
                  "url": "text",
                  "valueString": "Triage Considerations"
                },
                {
                  "url": "style",
                  "valueString": "font-weight:bold;"
                }
              ],
              "url": "http://example.com/StructureDefinition/group-note-info"
            }
          ],
          "linkId": "cardio_triagecons",
          "text": "Triage Considerations",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "Triage&#xa0;Considerations<br/><br/>"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                "valueString": "font-weight:bold;"
              }
            ]
          },
          "type": "group",
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://example.com/CodeSystem/item-controls",
                        "code": "push-button",
                        "display": "Push Button"
                      }
                    ]
                  }
                },
                {
                  "extension": [
                    {
                      "url": "sortIndex",
                      "valuePositiveInt": 1
                    },
                    {
                      "url": "text",
                      "valueString": "Requested Priority:"
                    },
                    {
                      "url": "sameLine",
                      "valueBoolean": true
                    },
                    {
                      "url": "answerStyle",
                      "valueString": "font-weight:bold;color:#EE6B00;"
                    }
                  ],
                  "url": "http://example.com/StructureDefinition/question-note-info"
                }
              ],
              "linkId": "referral_requestedpriority",
              "text": "Requested Priority:",
              "type": "choice",
              "required": true,
              "answerOption": [
                {
                  "extension": [
                    {
                      "extension": [
                        {
                          "url": "text",
                          "valueString": "Routine"
                        },
                        {
                          "url": "style",
                          "valueString": "font-weight:bold;color:#EE6B00;"
                        }
                      ],
                      "url": "http://example.com/StructureDefinition/option-note-info"
                    }
                  ],
                  "valueCoding": {
                    "system": "http://hl7.org/fhir/request-priority",
                    "code": "routine",
                    "display": "Routine"
                  },
                  "initialSelected": true
                },
                {
                  "valueCoding": {
                    "system": "http://hl7.org/fhir/request-priority",
                    "code": "urgent",
                    "display": "Urgent"
                  }
                }
              ],
              "item": [
                {
                  "linkId": "referral_requestedpriority_urgentreason",
                  "text": "Reason for urgent triage",
                  "type": "string",
                  "enableWhen": [
                    {
                      "question": "referral_requestedpriority",
                      "operator": "=",
                      "answerCoding": {
                        "system": "http://hl7.org/fhir/request-priority",
                        "code": "urgent",
                        "display": "Urgent"
                      }
                    }
                  ],
                  "required": true
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                },
                {
                  "extension": [
                    {
                      "url": "sortIndex",
                      "valuePositiveInt": 2
                    },
                    {
                      "url": "text",
                      "valueString": "Second Opinion"
                    }
                  ],
                  "url": "http://example.com/StructureDefinition/question-note-info"
                }
              ],
              "linkId": "referral_secondopinion",
              "text": "Second Opinion",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "choice",
              "repeats": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "http://snomed.info/sct",
                    "code": "77406008",
                    "display": "Second or third medical opinion"
                  }
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                  "valueString": "background-color:white;border-style:solid;"
                }
              ],
              "linkId": "referral_secondopinion_reason",
              "text": "Reason for second opinion:",
              "type": "text",
              "enableWhen": [
                {
                  "question": "referral_secondopinion",
                  "operator": "=",
                  "answerCoding": {
                    "system": "http://snomed.info/sct",
                    "code": "77406008",
                    "display": "Second or third medical opinion"
                  }
                }
              ]
            }
          ]
        },
        {
          "extension": [
            {
              "extension": [
                {
                  "url": "sortIndex",
                  "valuePositiveInt": 2
                },
                {
                  "url": "text",
                  "valueString": "Service(s) Requested"
                },
                {
                  "url": "style",
                  "valueString": "font-weight:bold;"
                }
              ],
              "url": "http://example.com/StructureDefinition/group-note-info"
            }
          ],
          "linkId": "695991571585",
          "text": "Service(s) Requested Select all that apply:",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "<b>Service(s)&#xa0;Requested</b><br/><i>Select&#xa0;all&#xa0;that&#xa0;apply:</i><br/><br/>"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                "valueString": "color:Gray20;"
              }
            ]
          },
          "type": "group",
          "required": true,
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression",
                  "valueExpression": {
                    "description": "Calculates HSC services based on selected checkboxes for cardiac testing and cardiology consult",
                    "language": "text/fhirpath",
                    "expression": "iif(%resource.item.where(linkId='223886162384').answer.value.exists(), 'CARDIOLOGY_SERVICES', '') + iif(%resource.item.where(linkId='223886162384').answer.value.exists() and %resource.item.where(linkId='785727177547').answer.value.exists(), '|', '') + iif(%resource.item.where(linkId='785727177547').answer.value.exists(), 'CARDIOLOGY', '')"
                  }
                },
                {
                  "extension": [
                    {
                      "url": "text",
                      "valueString": "HSCs Assigned:"
                    },
                    {
                      "url": "style",
                      "valueString": "font-weight:bold;"
                    }
                  ],
                  "url": "http://example.com/StructureDefinition/question-note-info"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                  "valueBoolean": true
                }
              ],
              "linkId": "referralService",
              "text": "HSCs Assigned:",
              "type": "string",
              "readOnly": true
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                }
              ],
              "linkId": "223886162384",
              "text": "Cardiac Testing",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "choice",
              "repeats": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                    "code": "20001",
                    "display": "Cardiac Testing"
                  }
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                  "valueString": "background-color:white;border-style:solid;"
                }
              ],
              "linkId": "660331267409",
              "text": "Exam(s) Requested",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "Exam(s)&#xa0;Requested<br/><br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "color:Gray20;font-weight:bold;"
                  }
                ]
              },
              "type": "group",
              "enableWhen": [
                {
                  "question": "223886162384",
                  "operator": "=",
                  "answerCoding": {
                    "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                    "code": "20001",
                    "display": "Cardiac Testing"
                  }
                }
              ],
              "enableBehavior": "all",
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                      "valueCode": "horizontal"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box",
                            "display": "Check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "720409326878",
                  "text": "24 Hour Ambulatory Blood Pressure Monitoring",
                  "_text": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "<br/>"
                      },
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                        "valueString": "display:none;"
                      }
                    ]
                  },
                  "type": "choice",
                  "repeats": true,
                  "answerOption": [
                    {
                      "valueCoding": {
                        "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                        "code": "20003",
                        "display": "24 Hour Ambulatory Blood Pressure Monitoring"
                      }
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                      "valueCode": "horizontal"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box",
                            "display": "Check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "960455115596",
                  "text": "Coronary Angiogram",
                  "_text": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "<br/>"
                      },
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                        "valueString": "display:none;"
                      }
                    ]
                  },
                  "type": "choice",
                  "repeats": true,
                  "answerOption": [
                    {
                      "valueCoding": {
                        "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                        "code": "20004",
                        "display": "Coronary Angiogram"
                      }
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                      "valueCode": "horizontal"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box",
                            "display": "Check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "297634898828",
                  "text": "Echocardiogram - Resting",
                  "_text": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "<br/>"
                      },
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                        "valueString": "display:none;"
                      }
                    ]
                  },
                  "type": "choice",
                  "repeats": true,
                  "answerOption": [
                    {
                      "valueCoding": {
                        "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                        "code": "20005",
                        "display": "Echocardiogram - Resting"
                      }
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                      "valueString": "background-color:grey;border-style:solid;"
                    }
                  ],
                  "linkId": "443484577720",
                  "text": "sub Echocardiogram - Resting",
                  "_text": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "<br/>"
                      },
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                        "valueString": "display:none;"
                      }
                    ]
                  },
                  "type": "group",
                  "enableWhen": [
                    {
                      "question": "297634898828",
                      "operator": "=",
                      "answerCoding": {
                        "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                        "code": "20005",
                        "display": "Echocardiogram - Resting"
                      }
                    }
                  ],
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "check-box",
                                "display": "Check-box"
                              }
                            ]
                          }
                        }
                      ],
                      "linkId": "165530569567",
                      "text": "Echocardiogram (2D)",
                      "_text": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          },
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                            "valueString": "display:none;"
                          }
                        ]
                      },
                      "type": "choice",
                      "repeats": true,
                      "answerOption": [
                        {
                          "valueCoding": {
                            "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                            "code": "20012",
                            "display": "Echocardiogram (2D)"
                          }
                        }
                      ]
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "check-box",
                                "display": "Check-box"
                              }
                            ]
                          }
                        }
                      ],
                      "linkId": "286552421895",
                      "text": "Echocardiogram with Contrast",
                      "_text": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          },
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                            "valueString": "display:none;"
                          }
                        ]
                      },
                      "type": "choice",
                      "repeats": true,
                      "answerOption": [
                        {
                          "valueCoding": {
                            "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                            "code": "20013",
                            "display": "Echocardiogram with Contrast"
                          }
                        }
                      ]
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "check-box",
                                "display": "Check-box"
                              }
                            ]
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "910527687300",
                      "text": "Echocardiogram with Saline (Bubble)",
                      "_text": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          },
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                            "valueString": "display:none;"
                          }
                        ]
                      },
                      "type": "choice",
                      "repeats": true,
                      "answerOption": [
                        {
                          "valueCoding": {
                            "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                            "code": "20014",
                            "display": "Echocardiogram with Saline (Bubble)"
                          }
                        }
                      ]
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "check-box",
                                "display": "Check-box"
                              }
                            ]
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "657824763133",
                      "text": "Pediatric Echocardiogram",
                      "_text": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          },
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                            "valueString": "display:none;"
                          }
                        ]
                      },
                      "type": "choice",
                      "repeats": true,
                      "answerOption": [
                        {
                          "valueCoding": {
                            "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                            "code": "20015",
                            "display": "Pediatric Echocardiogram"
                          }
                        }
                      ]
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "check-box",
                                "display": "Check-box"
                              }
                            ]
                          }
                        }
                      ],
                      "linkId": "992743200182",
                      "text": "Transesophageal Echocardiogram (TEE)",
                      "_text": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          },
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                            "valueString": "display:none;"
                          }
                        ]
                      },
                      "type": "choice",
                      "repeats": true,
                      "answerOption": [
                        {
                          "valueCoding": {
                            "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                            "code": "20016",
                            "display": "Transesophageal Echocardiogram (TEE)"
                          }
                        }
                      ]
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                      "valueCode": "horizontal"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box",
                            "display": "Check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "894277763438",
                  "text": "Electrocardiogram (ECG)",
                  "_text": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "<br/>"
                      },
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                        "valueString": "display:none;"
                      }
                    ]
                  },
                  "type": "choice",
                  "repeats": true,
                  "answerOption": [
                    {
                      "valueCoding": {
                        "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                        "code": "20006",
                        "display": "Electrocardiogram (ECG)"
                      }
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                      "valueCode": "horizontal"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box",
                            "display": "Check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "279226023495",
                  "text": "Holter Monitoring",
                  "_text": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "<br/>"
                      },
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                        "valueString": "display:none;"
                      }
                    ]
                  },
                  "type": "choice",
                  "repeats": true,
                  "answerOption": [
                    {
                      "valueCoding": {
                        "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                        "code": "20007",
                        "display": "Holter Monitoring"
                      }
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                      "valueString": "background-color:grey;border-style:solid;"
                    }
                  ],
                  "linkId": "440449731882",
                  "text": "sub holter monitoring",
                  "_text": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "<br/>"
                      },
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                        "valueString": "display:none;"
                      }
                    ]
                  },
                  "type": "group",
                  "enableWhen": [
                    {
                      "question": "279226023495",
                      "operator": "=",
                      "answerCoding": {
                        "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                        "code": "20007",
                        "display": "Holter Monitoring"
                      }
                    }
                  ],
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "check-box",
                                "display": "Check-box"
                              }
                            ]
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "671328703851",
                      "text": "24 Hours",
                      "_text": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          },
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                            "valueString": "display:none;"
                          }
                        ]
                      },
                      "type": "choice",
                      "repeats": true,
                      "answerOption": [
                        {
                          "valueCoding": {
                            "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                            "code": "20017",
                            "display": "24 Hours"
                          }
                        }
                      ]
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "check-box",
                                "display": "Check-box"
                              }
                            ]
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "423992261841",
                      "text": "48 Hours",
                      "_text": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          },
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                            "valueString": "display:none;"
                          }
                        ]
                      },
                      "type": "choice",
                      "repeats": true,
                      "answerOption": [
                        {
                          "valueCoding": {
                            "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                            "code": "20018",
                            "display": "48 Hours"
                          }
                        }
                      ]
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "check-box",
                                "display": "Check-box"
                              }
                            ]
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "419924239187",
                      "text": "72 Hours",
                      "_text": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          },
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                            "valueString": "display:none;"
                          }
                        ]
                      },
                      "type": "choice",
                      "repeats": true,
                      "answerOption": [
                        {
                          "valueCoding": {
                            "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                            "code": "20019",
                            "display": "72 Hours"
                          }
                        }
                      ]
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "check-box",
                                "display": "Check-box"
                              }
                            ]
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "731054417270",
                      "text": "7 Days",
                      "_text": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          },
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                            "valueString": "display:none;"
                          }
                        ]
                      },
                      "type": "choice",
                      "repeats": true,
                      "answerOption": [
                        {
                          "valueCoding": {
                            "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                            "code": "20020",
                            "display": "7 Days"
                          }
                        }
                      ]
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "check-box",
                                "display": "Check-box"
                              }
                            ]
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "235876421044",
                      "text": "14 Days",
                      "_text": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          },
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                            "valueString": "display:none;"
                          }
                        ]
                      },
                      "type": "choice",
                      "repeats": true,
                      "answerOption": [
                        {
                          "valueCoding": {
                            "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                            "code": "20021",
                            "display": "14 Days"
                          }
                        }
                      ]
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                      "valueCode": "horizontal"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box",
                            "display": "Check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "374742834400",
                  "text": "Loop / Event Monitor",
                  "_text": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "<br/>"
                      },
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                        "valueString": "display:none;"
                      }
                    ]
                  },
                  "type": "choice",
                  "repeats": true,
                  "answerOption": [
                    {
                      "valueCoding": {
                        "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                        "code": "20008",
                        "display": "Loop / Event Monitor"
                      }
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box",
                            "display": "Check-box"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                      "valueCode": "horizontal"
                    }
                  ],
                  "linkId": "159161544747",
                  "text": "Cardiovascular stress testing",
                  "_text": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "<br/>"
                      },
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                        "valueString": "display:none;"
                      }
                    ]
                  },
                  "type": "choice",
                  "repeats": true,
                  "answerOption": [
                    {
                      "valueCoding": {
                        "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                        "code": "20009",
                        "display": "Stress Testing"
                      }
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                      "valueString": "background-color:grey;border-style:solid;"
                    }
                  ],
                  "linkId": "370275060390",
                  "text": "Sub Stress Testing",
                  "_text": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "<br/>"
                      },
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                        "valueString": "display:none;"
                      }
                    ]
                  },
                  "type": "group",
                  "enableWhen": [
                    {
                      "question": "159161544747",
                      "operator": "=",
                      "answerCoding": {
                        "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                        "code": "20009",
                        "display": "Stress Testing"
                      }
                    }
                  ],
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "check-box",
                                "display": "Check-box"
                              }
                            ]
                          }
                        }
                      ],
                      "linkId": "814218498309",
                      "text": "ECG - Exercise Stress Test",
                      "_text": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          },
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                            "valueString": "display:none;"
                          }
                        ]
                      },
                      "type": "choice",
                      "repeats": true,
                      "answerOption": [
                        {
                          "valueCoding": {
                            "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                            "code": "20022",
                            "display": "ECG - Exercise Stress Test"
                          }
                        }
                      ]
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "check-box",
                                "display": "Check-box"
                              }
                            ]
                          }
                        }
                      ],
                      "linkId": "307107493993",
                      "text": "ECG - Dobutamine/Persantine Stress Test",
                      "_text": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          },
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                            "valueString": "display:none;"
                          }
                        ]
                      },
                      "type": "choice",
                      "repeats": true,
                      "answerOption": [
                        {
                          "valueCoding": {
                            "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                            "code": "20023",
                            "display": "ECG - Dobutamine/Persantine Stress Test"
                          }
                        }
                      ]
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "check-box",
                                "display": "Check-box"
                              }
                            ]
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "805303414102",
                      "text": "Echocardiogram - Exercise Stress Test",
                      "_text": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          },
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                            "valueString": "display:none;"
                          }
                        ]
                      },
                      "type": "choice",
                      "repeats": true,
                      "answerOption": [
                        {
                          "valueCoding": {
                            "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                            "code": "20024",
                            "display": "Echocardiogram - Exercise Stress Test"
                          }
                        }
                      ]
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "check-box",
                                "display": "Check-box"
                              }
                            ]
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        }
                      ],
                      "linkId": "193586908489",
                      "text": "Echocardiogram - Dobutamine/Persantine Stress Test",
                      "_text": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          },
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                            "valueString": "display:none;"
                          }
                        ]
                      },
                      "type": "choice",
                      "repeats": true,
                      "answerOption": [
                        {
                          "valueCoding": {
                            "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                            "code": "20025",
                            "display": "Echocardiogram - Dobutamine/Persantine Stress Test"
                          }
                        }
                      ]
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box",
                            "display": "Check-box"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                      "valueCode": "horizontal"
                    }
                  ],
                  "linkId": "918517139023",
                  "text": "Nuclear Medicine",
                  "_text": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "<br/>"
                      },
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                        "valueString": "display:none;"
                      }
                    ]
                  },
                  "type": "choice",
                  "repeats": true,
                  "answerOption": [
                    {
                      "valueCoding": {
                        "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                        "code": "20010",
                        "display": "Nuclear Medicine"
                      }
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                      "valueString": "background-color:grey;border-style:solid;"
                    }
                  ],
                  "linkId": "222686221935",
                  "text": "sub Nuclear Medicine",
                  "_text": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "<br/>"
                      },
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                        "valueString": "display:none;"
                      }
                    ]
                  },
                  "type": "group",
                  "enableWhen": [
                    {
                      "question": "918517139023",
                      "operator": "=",
                      "answerCoding": {
                        "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                        "code": "20010",
                        "display": "Nuclear Medicine"
                      }
                    }
                  ],
                  "item": [
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "check-box",
                                "display": "Check-box"
                              }
                            ]
                          }
                        }
                      ],
                      "linkId": "924189648184",
                      "text": "MUGA - Resting",
                      "_text": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          },
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                            "valueString": "display:none;"
                          }
                        ]
                      },
                      "type": "choice",
                      "repeats": true,
                      "answerOption": [
                        {
                          "valueCoding": {
                            "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                            "code": "20026",
                            "display": "MUGA - Resting"
                          }
                        }
                      ]
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "check-box",
                                "display": "Check-box"
                              }
                            ]
                          }
                        }
                      ],
                      "linkId": "857163514910",
                      "text": "Cardiac Pyrophosphate",
                      "_text": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          },
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                            "valueString": "display:none;"
                          }
                        ]
                      },
                      "type": "choice",
                      "repeats": true,
                      "answerOption": [
                        {
                          "valueCoding": {
                            "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                            "code": "20027",
                            "display": "Cardiac Pyrophosphate"
                          }
                        }
                      ]
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                          "valueCode": "horizontal"
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "check-box",
                                "display": "Check-box"
                              }
                            ]
                          }
                        }
                      ],
                      "linkId": "892165959617",
                      "text": "Myocardial perfusion scan",
                      "_text": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          },
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                            "valueString": "display:none;"
                          }
                        ]
                      },
                      "type": "choice",
                      "repeats": true,
                      "answerOption": [
                        {
                          "valueCoding": {
                            "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                            "code": "20028",
                            "display": "MIBI Scans / Myocardial Perfusion Imaging (MPI):"
                          }
                        }
                      ]
                    },
                    {
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                          "valueCodeableConcept": {
                            "coding": [
                              {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "radio-button",
                                "display": "Radio Button"
                              }
                            ]
                          }
                        },
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                          "valueString": "background-color:white;border-style:solid;"
                        }
                      ],
                      "linkId": "538288549138",
                      "text": "sub MIBI",
                      "_text": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          },
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                            "valueString": "display:none;"
                          }
                        ]
                      },
                      "type": "group",
                      "enableWhen": [
                        {
                          "question": "892165959617",
                          "operator": "=",
                          "answerCoding": {
                            "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                            "code": "20028",
                            "display": "MIBI Scans / Myocardial Perfusion Imaging (MPI):"
                          }
                        }
                      ],
                      "item": [
                        {
                          "extension": [
                            {
                              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                              "valueCodeableConcept": {
                                "coding": [
                                  {
                                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                                    "code": "check-box",
                                    "display": "Check-box"
                                  }
                                ]
                              }
                            }
                          ],
                          "linkId": "373435981917",
                          "text": "MIBI Scan - Exercise Stress Test",
                          "_text": {
                            "extension": [
                              {
                                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                                "valueString": "<br/>"
                              },
                              {
                                "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                                "valueString": "display:none;"
                              }
                            ]
                          },
                          "type": "string",
                          "repeats": true,
                          "answerOption": [
                            {
                              "valueString": "MIBI Scan - Exercise Stress Test"
                            }
                          ]
                        },
                        {
                          "extension": [
                            {
                              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                              "valueCodeableConcept": {
                                "coding": [
                                  {
                                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                                    "code": "check-box",
                                    "display": "Check-box"
                                  }
                                ]
                              }
                            }
                          ],
                          "linkId": "434394942688",
                          "text": "MIBI Scan - Dobutamine/Persantine Stress Test",
                          "_text": {
                            "extension": [
                              {
                                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                                "valueString": "<br/>"
                              },
                              {
                                "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                                "valueString": "display:none;"
                              }
                            ]
                          },
                          "type": "string",
                          "repeats": true,
                          "answerOption": [
                            {
                              "valueString": "MIBI Scan - Dobutamine/Persantine Stress Test"
                            }
                          ]
                        },
                        {
                          "extension": [
                            {
                              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                              "valueCodeableConcept": {
                                "coding": [
                                  {
                                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                                    "code": "check-box",
                                    "display": "Check-box"
                                  }
                                ]
                              }
                            }
                          ],
                          "linkId": "913594478162",
                          "text": "Thallium Viability Test",
                          "_text": {
                            "extension": [
                              {
                                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                                "valueString": "<br/>"
                              },
                              {
                                "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                                "valueString": "display:none;"
                              }
                            ]
                          },
                          "type": "string",
                          "repeats": true,
                          "answerOption": [
                            {
                              "valueString": "Thallium Viability Test"
                            }
                          ]
                        }
                      ]
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                      "valueCode": "horizontal"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box",
                            "display": "Check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "992682216482",
                  "text": "Tilt Table Testing",
                  "_text": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "<br/>"
                      },
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                        "valueString": "display:none;"
                      }
                    ]
                  },
                  "type": "choice",
                  "repeats": true,
                  "answerOption": [
                    {
                      "valueCoding": {
                        "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                        "code": "20011",
                        "display": "Tilt Table Testing"
                      }
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                      "valueCode": "horizontal"
                    },
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box",
                            "display": "Check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "cardiology_referral_services_cardiactesting_other",
                  "text": "Other",
                  "_text": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "<br/>"
                      },
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                        "valueString": "display:none;"
                      }
                    ]
                  },
                  "type": "choice",
                  "repeats": true,
                  "answerOption": [
                    {
                      "valueCoding": {
                        "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
                        "code": "OTH",
                        "display": "other"
                      }
                    }
                  ]
                },
                {
                  "linkId": "cardiology_referral_services_cardiactesting_other_specify",
                  "text": "Specify",
                  "type": "text",
                  "enableWhen": [
                    {
                      "question": "cardiology_referral_services_cardiactesting_other",
                      "operator": "=",
                      "answerCoding": {
                        "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
                        "code": "OTH",
                        "display": "other"
                      }
                    }
                  ],
                  "enableBehavior": "all",
                  "required": true
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                }
              ],
              "linkId": "785727177547",
              "text": "Cardiology Consultation",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "choice",
              "repeats": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                    "code": "20002",
                    "display": "Cardiology Consultation"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId": "186952778859",
          "text": "Concern(s) / Indication(s) Triggering Referral Select all that apply:",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "<b>Concern(s)&#xa0;/&#xa0;Indication(s)&#xa0;Triggering&#xa0;Referral</b><br/><i>Select&#xa0;all&#xa0;that&#xa0;apply:</i><br/>"
              }
            ]
          },
          "type": "group",
          "required": true,
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                }
              ],
              "linkId": "219569805461",
              "text": "Arrhythmias or Palpitations",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "choice",
              "repeats": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "http://snomed.info/sct",
                    "code": "698247007",
                    "display": "Arrhythmias or Palpitations"
                  }
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                }
              ],
              "linkId": "571934328499",
              "text": "Cardiovascular Risk Assessment",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "choice",
              "repeats": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                    "code": "20033",
                    "display": "Cardiovascular Risk Assessment"
                  }
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                }
              ],
              "linkId": "459737733395",
              "text": "Chest Pain or Angina",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "choice",
              "repeats": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                    "code": "20034",
                    "display": "Chest Pain or Angina"
                  }
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                }
              ],
              "linkId": "929919815516",
              "text": "Congenital Heart Disease",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "choice",
              "repeats": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                    "code": "20035",
                    "display": "Congenital Heart Disease"
                  }
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                }
              ],
              "linkId": "832263816528",
              "text": "Congestive Heart Failure",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "choice",
              "repeats": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                    "code": "20036",
                    "display": "Congestive Heart Failure"
                  }
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                }
              ],
              "linkId": "803760213460",
              "text": "Coronary Artery Disease",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "choice",
              "repeats": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                    "code": "20037",
                    "display": "Coronary Artery Disease"
                  }
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                }
              ],
              "linkId": "129767162379",
              "text": "Dyspnea",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "choice",
              "repeats": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                    "code": "20038",
                    "display": "Dyspnea"
                  }
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                }
              ],
              "linkId": "116150628533",
              "text": "Hypertension",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "choice",
              "repeats": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                    "code": "20039",
                    "display": "Hypertension"
                  }
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                }
              ],
              "linkId": "513825527027",
              "text": "Murmur",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "choice",
              "repeats": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                    "code": "20040",
                    "display": "Murmur"
                  }
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                }
              ],
              "linkId": "975075898688",
              "text": "Pericardial Disease",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "choice",
              "repeats": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                    "code": "20041",
                    "display": "Pericardial Disease"
                  }
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                }
              ],
              "linkId": "704148928571",
              "text": "Peripheral Edema",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "choice",
              "repeats": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                    "code": "20042",
                    "display": "Peripheral Edema"
                  }
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                }
              ],
              "linkId": "886489617115",
              "text": "Post-Myocardial Infarction",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "choice",
              "repeats": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                    "code": "20043",
                    "display": "Post-Myocardial Infarction"
                  }
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                }
              ],
              "linkId": "621745958993",
              "text": "Pre-operative Consultation",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "choice",
              "repeats": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                    "code": "20044",
                    "display": "Pre-operative Consultation"
                  }
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                  "valueString": "background-color:white;border-style:solid;"
                }
              ],
              "linkId": "873024527134",
              "code": [
                {
                  "system": "http://snomed.info/sct",
                  "code": "439272007",
                  "display": "Date of procedure"
                }
              ],
              "text": "Procedure Date (if known)",
              "type": "date",
              "enableWhen": [
                {
                  "question": "621745958993",
                  "operator": "=",
                  "answerCoding": {
                    "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                    "code": "20044",
                    "display": "Pre-operative Consultation"
                  }
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                }
              ],
              "linkId": "197975129599",
              "text": "Syncope",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "choice",
              "repeats": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "http://example.com/CodeSystem/standardized-referral-form-codes",
                    "code": "20045",
                    "display": "Syncope"
                  }
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                }
              ],
              "linkId": "675849150752",
              "text": "Valvular Heart Disease or Prosthetic Heart Valve",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "choice",
              "repeats": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "http://snomed.info/sct",
                    "code": "368009",
                    "display": "Valvular Heart Disease or Prosthetic Heart Valve"
                  }
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "check-box",
                        "display": "Check-box"
                      }
                    ]
                  }
                }
              ],
              "linkId": "721982740516",
              "text": "Other",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "<br/>"
                  },
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                    "valueString": "display:none;"
                  }
                ]
              },
              "type": "choice",
              "repeats": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
                    "code": "OTH",
                    "display": "other"
                  }
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                  "valueString": "background-color:white;border-style:solid;"
                }
              ],
              "linkId": "720594942482",
              "text": "Specify",
              "type": "text",
              "enableWhen": [
                {
                  "question": "721982740516",
                  "operator": "=",
                  "answerCoding": {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
                    "code": "OTH",
                    "display": "other"
                  }
                }
              ],
              "required": true
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            }
          ],
          "linkId": "Descriptionofclinicalquestion",
          "text": "Clinical Question / Goal(s) of Referral with Relevant History, Management and Investigations",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "Clinical&#xa0;Question&#xa0;/&#xa0;Goal(s)&#xa0;of&#xa0;Referral&#xa0;with&#xa0;Relevant&#xa0;History,&#xa0;Management&#xa0;and&#xa0;Investigations<br/>"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                "valueString": "font-weight:bold;"
              }
            ]
          },
          "type": "text",
          "required": true
        }
      ]
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
          "valueString": "background-color:grey;border-style:solid;"
        }
      ],
      "linkId": "cpp_header",
      "text": "Cumulative Patient Profile Please delete any sensitive information you do not intend to share from the CPP",
      "_text": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
            "valueString": "Cumulative Patient Profile<br/><br/><i>Please delete any sensitive information you do not intend to share from the CPP</i>"
          },
          {
            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
            "valueString": "font-weight:bold;"
          }
        ]
      },
      "type": "group",
      "item": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "check-box",
                    "display": "Check-box"
                  }
                ]
              }
            }
          ],
          "linkId": "cpp_separate",
          "text": "CPP attached separately (if not entered below)",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "<br/>"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                "valueString": "display:none;"
              }
            ]
          },
          "type": "string",
          "repeats": true,
          "answerOption": [
            {
              "valueString": "CPP attached separately (if not entered below)"
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            }
          ],
          "linkId": "cpp_currentprob",
          "code": [
            {
              "system": "http://snomed.info/sct",
              "code": "55607006",
              "display": "Problem"
            }
          ],
          "text": "Current Problem List:",
          "type": "text",
          "enableWhen": [
            {
              "question": "cpp_separate",
              "operator": "exists",
              "answerBoolean": false
            }
          ],
          "enableBehavior": "all"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            }
          ],
          "linkId": "cpp_pastmedicalhistory",
          "code": [
            {
              "system": "http://snomed.info/sct",
              "code": "417662000",
              "display": "History of clinical finding in subject"
            }
          ],
          "text": "Past Medical History:",
          "type": "text",
          "enableWhen": [
            {
              "question": "cpp_separate",
              "operator": "exists",
              "answerBoolean": false
            }
          ],
          "enableBehavior": "all"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            }
          ],
          "linkId": "cpp_currentmedications",
          "code": [
            {
              "system": "http://snomed.info/sct",
              "code": "129019007",
              "display": "Taking medication"
            }
          ],
          "text": "Current Medications :",
          "type": "text",
          "enableWhen": [
            {
              "question": "cpp_separate",
              "operator": "exists",
              "answerBoolean": false
            }
          ],
          "enableBehavior": "all"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            }
          ],
          "linkId": "cpp_familyhistory",
          "code": [
            {
              "system": "http://snomed.info/sct",
              "code": "57177007",
              "display": "Family history with explicit context"
            }
          ],
          "text": "Family History:",
          "type": "text",
          "enableWhen": [
            {
              "question": "cpp_separate",
              "operator": "exists",
              "answerBoolean": false
            }
          ],
          "enableBehavior": "all"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            }
          ],
          "linkId": "cpp_allergies",
          "code": [
            {
              "system": "http://snomed.info/sct",
              "code": "609328004",
              "display": "Allergic disposition"
            }
          ],
          "text": "Allergies:",
          "type": "text",
          "enableWhen": [
            {
              "question": "cpp_separate",
              "operator": "exists",
              "answerBoolean": false
            }
          ],
          "enableBehavior": "all"
        }
      ]
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
          "valueString": "background-color:grey;border-style:solid;"
        }
      ],
      "linkId": "preferredconsultlocation_header",
      "text": "Preferred Consultant or Location All patients will be triaged to the shortest wait time unless a preferred consultant or location is entered.",
      "_text": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
            "valueString": "<b>Preferred Consultant or Location</b><br/><br/>All patients will be triaged to the shortest wait time unless a preferred consultant or location is entered."
          }
        ]
      },
      "type": "group",
      "item": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "check-box",
                    "display": "Check-box"
                  }
                ]
              }
            }
          ],
          "linkId": "preferredconsultlocation_selector",
          "text": "Preferred consultant or location",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "<br/>"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                "valueString": "display:none;"
              }
            ]
          },
          "type": "string",
          "repeats": true,
          "answerOption": [
            {
              "valueString": "Preferred consultant or location"
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            }
          ],
          "linkId": "preferredconsultlocation_specify",
          "text": "Please specify either a preferred consultant or location",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "Please specify either a <b>preferred</b> consultant or location"
              }
            ]
          },
          "type": "group",
          "enableWhen": [
            {
              "question": "preferredconsultlocation_selector",
              "operator": "=",
              "answerString": "Preferred consultant or location"
            }
          ],
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                  "valueString": "border-style:solid;"
                }
              ],
              "linkId": "preferredconsultlocation_consultant",
              "text": "Consultant:",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                  "valueString": "border-style:solid;"
                }
              ],
              "linkId": "preferredconsultlocation_location",
              "text": "Location:",
              "type": "string"
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "check-box",
                    "display": "Check-box"
                  }
                ]
              }
            }
          ],
          "linkId": "preferredconsultlocation_willingtotravel",
          "text": "Patient willing to travel for shorter wait time",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "<br/>"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                "valueString": "display:none;"
              }
            ]
          },
          "type": "string",
          "repeats": true,
          "answerOption": [
            {
              "valueString": "Patient willing to travel for shorter wait time"
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            }
          ],
          "linkId": "preferredconsultlocation_otherconsiderations",
          "text": "Other considerations:",
          "type": "string"
        }
      ]
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
          "valueString": "background-color:grey;border-style:solid;"
        }
      ],
      "linkId": "supportingdocumentation_header",
      "text": "Supporting Documentation Please attach all relevant laboratory and diagnostic investigations.",
      "_text": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
            "valueString": "<b>Supporting&#xa0;Documentation</b><br/>Please&#xa0;attach&#xa0;all&#xa0;<b><span style=\"text-decoration: underline\">relevant</span></b>&#xa0;laboratory&#xa0;and&#xa0;diagnostic&#xa0;investigations.<br/>"
          }
        ]
      },
      "type": "group",
      "item": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "check-box",
                    "display": "Check-box"
                  }
                ]
              }
            }
          ],
          "linkId": "supportingdocumentation_details",
          "text": "Personal Health Information that is medically relevant has not been disclosed at the request of the patient.",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "<br/>"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                "valueString": "display:none;"
              }
            ]
          },
          "type": "string",
          "repeats": true,
          "answerOption": [
            {
              "valueString": "Personal Health Information that is medically relevant has not been disclosed at the request of the patient."
            }
          ]
        }
      ]
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "application/pdf"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "image/gif"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "image/bmp"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "application/vnd.openxmlformats-officedocument.spreadsheetml.sheet"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "video/mp4"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "text/csv"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "image/jpeg"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "application/msword"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "image/png"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "application/vnd.openxmlformats-officedocument.wordprocessingml.document"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "application/vnd.ms-excel"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "text/plain"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "audio/mp4"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "audio/mpeg"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "image/tiff"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/maxSize",
          "valueDecimal": 5000000
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
          "valueString": "background-color:grey;border-style:solid;"
        },
        {
          "extension": [
            {
              "url": "positiveText",
              "valueString": "Attachment Provided"
            }
          ],
          "url": "http://example.com/StructureDefinition/question-note-info"
        }
      ],
      "linkId": "supportingdocumentation_attachment",
      "text": "Add Attachments",
      "type": "attachment"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
          "valueString": "background-color:grey;border-style:solid;"
        }
      ],
      "linkId": "feedbacksurvey_cardiology",
      "text": "Click here to provide feedback on this form",
      "_text": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
            "valueString": "<a href=\"https://www.surveymonkey.com/r/cardioSRF\" rel=\"noopener noreferrer\" target=\"_blank\">Click&#xa0;here&#xa0;to&#xa0;provide&#xa0;feedback&#xa0;on&#xa0;this&#xa0;form</a><br/>"
          }
        ]
      },
      "type": "display"
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
          "valueString": "background-color:grey;border-style:solid;"
        }
      ],
      "linkId": "referrer_header",
      "text": "Referrer's Information",
      "_text": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
            "valueString": "font-weight:bold;"
          }
        ]
      },
      "type": "group",
      "item": [
        {
          "linkId": "referrer_sitename",
          "text": "Site Name:",
          "type": "string"
        },
        {
          "linkId": "referrer_address_line1",
          "text": "Address (Line 1):",
          "type": "string",
          "required": true,
          "item": [
            {
              "linkId": "referrer_address_line2",
              "text": "Address (Line 2):",
              "type": "string"
            },
            {
              "linkId": "referrer_address_city",
              "text": "City:",
              "type": "string",
              "required": true
            },
            {
              "linkId": "referrer_address_province",
              "text": "Province:",
              "type": "string",
              "required": true,
              "maxLength": 2
            },
            {
              "extension": [
                {
                  "extension": [
                    {
                      "url": "key",
                      "valueId": "ref-pcode"
                    },
                    {
                      "url": "severity",
                      "valueCode": "error"
                    },
                    {
                      "url": "expression",
                      "valueExpression": {
                        "language": "text/fhirpath",
                        "expression": "%resource.repeat(item).where(linkId='referrer_address_postalcode').answer.all(value.matches('^(?!.*[DFIOQU])[A-VXY][0-9][A-Z] ?[0-9][A-Z][0-9][%content%]#39;))"
                      }
                    },
                    {
                      "url": "human",
                      "valueString": "Must be a valid Canadian postal-code"
                    }
                  ],
                  "url": "http://hl7.org/fhir/StructureDefinition/targetConstraint"
                }
              ],
              "linkId": "referrer_address_postalcode",
              "text": "Postal Code:",
              "type": "string",
              "required": true
            }
          ]
        },
        {
          "extension": [
            {
              "extension": [
                {
                  "url": "key",
                  "valueId": "refphone"
                },
                {
                  "url": "severity",
                  "valueCode": "error"
                },
                {
                  "url": "expression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%resource.repeat(item).where(linkId='referrer_phone').answer.all(value.matches('^(\\+\\d{1,2}\\s?)?\\(?\\d{3}\\)?[\\s.-]?\\d{3}[\\s.-]?\\d{4}[%content%]#39;))"
                  }
                },
                {
                  "url": "human",
                  "valueString": "Must be a valid phone number"
                }
              ],
              "url": "http://hl7.org/fhir/StructureDefinition/targetConstraint"
            }
          ],
          "linkId": "referrer_phone",
          "text": "Phone #:",
          "type": "string"
        },
        {
          "extension": [
            {
              "extension": [
                {
                  "url": "key",
                  "valueId": "reffax"
                },
                {
                  "url": "severity",
                  "valueCode": "error"
                },
                {
                  "url": "expression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%resource.repeat(item).where(linkId='referrer_fax').answer.all(value.matches('^(\\+\\d{1,2}\\s?)?\\(?\\d{3}\\)?[\\s.-]?\\d{3}[\\s.-]?\\d{4}[%content%]#39;))"
                  }
                },
                {
                  "url": "human",
                  "valueString": "Must be a valid phone number"
                }
              ],
              "url": "http://hl7.org/fhir/StructureDefinition/targetConstraint"
            }
          ],
          "linkId": "referrer_fax",
          "text": "Fax #:",
          "type": "string"
        },
        {
          "linkId": "referrer_billing",
          "text": "Billing Number:",
          "type": "integer"
        },
        {
          "linkId": "referrer_professionalid",
          "text": "Professional ID:",
          "type": "integer"
        },
        {
          "linkId": "referrer_signature",
          "text": "Signed:",
          "type": "text",
          "required": true
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "drop-down",
                    "display": "Drop down"
                  }
                ]
              }
            }
          ],
          "linkId": "referrer_role",
          "text": "Role:",
          "type": "choice",
          "answerOption": [
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "309398001",
                "display": "Allied Health Professional"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "62247001",
                "display": "Family Physician"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "449161006",
                "display": "Physician Assistant"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "398130009",
                "display": "Medical Student"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "106292003",
                "display": "Nurse"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "224571005",
                "display": "Nurse Practitioner"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "405277009",
                "display": "Resident"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "69280009",
                "display": "Specialist"
              }
            },
            {
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
                "code": "OTH",
                "display": "other"
              }
            }
          ]
        }
      ]
    }
  ]
}