FHIR IG analytics| Package | hl7.fhir.uv.sdc |
| Resource Type | Questionnaire |
| Id | Questionnaire-CardiologyForm.json |
| FHIR Version | R4 |
| Source | https://build.fhir.org/ig/HL7/sdc/Questionnaire-CardiologyForm.html |
| URL | http://hl7.org/fhir/uv/sdc/Questionnaire/CardiologyForm |
| Version | 4.0.0-ci-build |
| Status | active |
| Date | 2026-01-20T15:05:51.993+00:00 |
| Title | Cardiology Form |
| Realm | uv |
| Authority | hl7 |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire CardiologyForm
Language: en
| LinkID | Text | Cardinality | Type | Flags | Description & Constraints |
|---|---|---|---|---|---|
![]() | Questionnaire | http://hl7.org/fhir/uv/sdc/Questionnaire/CardiologyForm#4.0.0-ci-build | |||
![]() ![]() | Patient Information | 0..1 | group | ||
![]() ![]() ![]() | Surname: | 1..1 | string | ||
![]() ![]() ![]() | First Name: | 1..1 | string | ||
![]() ![]() ![]() | DOB: | 1..1 | date | ||
![]() ![]() ![]() | Gender: | 1..1 | choice | Options: 3 options | |
![]() ![]() ![]() | HN PC: | 0..1 | string | Max Length: 2 | |
![]() ![]() ![]() ![]() | HN: | 0..1 | string | Max Length: 10 | |
![]() ![]() ![]() ![]() | HN VC: | 0..1 | string | ||
![]() ![]() ![]() | Address (Line 1): | 1..1 | string | ||
![]() ![]() ![]() ![]() | Address (Line 2): | 0..1 | string | ||
![]() ![]() ![]() ![]() | City: | 1..1 | string | ||
![]() ![]() ![]() ![]() | Province: | 1..1 | string | Max Length: 2 | |
![]() ![]() ![]() ![]() | Postal Code: | 1..1 | string | ||
![]() ![]() ![]() | Mobile #: | 0..1 | string | ||
![]() ![]() ![]() | Home #: | 0..1 | string | ||
![]() ![]() ![]() | Business #: | 0..1 | string | ||
![]() ![]() ![]() | Email: | 0..1 | string | ||
![]() ![]() | [Optional] Additional Patient Information | 0..1 | group | ||
![]() ![]() ![]() | Sex assigned at birth: | 0..1 | choice | Options: 4 options | |
![]() ![]() ![]() | Pronouns: | 0..1 | choice | Options: 4 options | |
![]() ![]() ![]() ![]() | Other pronouns: | 1..1 | string | Enable When: additionalinfo_pronouns = other (NullFlavor#OTH) | |
![]() ![]() ![]() | Preferred language: | 0..1 | choice | Options: 3 options | |
![]() ![]() ![]() ![]() | Specify: | 1..1 | string | Enable When: additionalinfo_preferredlanguage = other (NullFlavor#OTH) | |
![]() ![]() ![]() ![]() | Translator required | 0..* | string | Enable When: additionalinfo_preferredlanguage = other (NullFlavor#OTH) Options: 1 option | |
![]() ![]() ![]() | Best method of contact: | 0..1 | choice | Options: 4 options | |
![]() ![]() ![]() ![]() | Voicemails acceptable | 0..* | string | Enable When: additionalinfo_bestmethodofcontact = Mobile (ContactPointUse#mobile) Options: 1 option | |
![]() ![]() ![]() | Preferred name | 0..* | string | Options: 1 option | |
![]() ![]() ![]() | Prefered name String | 0..1 | string | Enable When: additionalinfo_preferredname_select = Preferred Name | |
![]() ![]() ![]() | Alternate contact | 0..* | string | Options: 1 option | |
![]() ![]() ![]() | Name: | 1..1 | string | Enable When: additionalinfo_alternatecontact_select = Alternate contact | |
![]() ![]() ![]() | Alternate contact phone #: | 0..1 | string | Enable When: additionalinfo_alternatecontact_select = Alternate contact | |
![]() ![]() ![]() | Relationship: | 0..1 | string | Enable When: additionalinfo_alternatecontact_select = Alternate contact | |
![]() ![]() ![]() | Is Alternate contact the appointment booking contact?: | 0..1 | choice | Enable When: additionalinfo_alternatecontact_select = Alternate contact Options: 2 options | |
![]() ![]() ![]() | Unsafe contact persons (do not speak with) | 0..* | string | Options: 1 option | |
![]() ![]() ![]() | Only speak with patient directly | 0..* | string | Enable When: additionalinfo_unsafecontacts_select = Unsafe contact persons (do not speak with) Options: 1 option | |
![]() ![]() ![]() | Do not speak with: | 0..1 | string | Enable When: additionalinfo_unsafecontacts_select = Unsafe contact persons (do not speak with) | |
![]() ![]() ![]() | Accessibility concerns or disability | 0..* | string | Options: 1 option | |
![]() ![]() ![]() | Accessibility concerns Options | 0..* | choice | Enable When: additionalinfo_accessibilityconcernsordisability_selectt = Accessibility concerns or disability Options: 4 options | |
![]() ![]() ![]() | Special considerations (e.g. barriers, tips for care delivery, 3rd party insurance, patient requires escort, cognitive issues) | 0..* | string | Options: 1 option | |
![]() ![]() ![]() | Details of special considerations: | 1..1 | text | Enable When: additionalinfo_specialconsiderations_select = Special considerations (e.g. barriers, tips for care delivery, 3rd party insurance, patient requires escort, cognitive issues) | |
![]() ![]() ![]() | Send copies of reports to additional providers | 0..* | string | Options: 1 option | |
![]() ![]() ![]() | Name(s): | 1..1 | string | Enable When: additionalinfo_sendcopiestoadditionalproviders = Send copies of reports to additional providers | |
![]() ![]() ![]() ![]() | Contact information: | 1..1 | string | Enable When: additionalinfo_sendcopiestoadditionalproviders = Send copies of reports to additional providers | |
![]() ![]() ![]() ![]() | This is the Primary Care Provider | 0..* | string | Enable When: additionalinfo_sendcopiestoadditionalproviders = Send copies of reports to additional providers Options: 1 option | |
![]() ![]() | Referral Details | 0..1 | group | ||
![]() ![]() ![]() | Triage Considerations | 0..1 | group | ||
![]() ![]() ![]() ![]() | Requested Priority: | 1..1 | choice | Options: 2 options | |
![]() ![]() ![]() ![]() ![]() | Reason for urgent triage | 1..1 | string | Enable When: referral_requestedpriority = Urgent (RequestPriority#urgent) | |
![]() ![]() ![]() ![]() | Second Opinion | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() | Reason for second opinion: | 0..1 | text | Enable When: referral_secondopinion = Second or third medical opinion (SNOMED CT#77406008) | |
![]() ![]() ![]() | Service(s) Requested Select all that apply: | 1..1 | group | ||
![]() ![]() ![]() ![]() | HSCs Assigned: | 0..1 | string | ||
![]() ![]() ![]() ![]() | Cardiac Testing | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() | Exam(s) Requested | 0..1 | group | Enable When: 223886162384 = Cardiac Testing (standardized-referral-form-codes#20001) | |
![]() ![]() ![]() ![]() ![]() | 24 Hour Ambulatory Blood Pressure Monitoring | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() | Coronary Angiogram | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() | Echocardiogram - Resting | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() | sub Echocardiogram - Resting | 0..1 | group | Enable When: 297634898828 = Echocardiogram - Resting (standardized-referral-form-codes#20005) | |
![]() ![]() ![]() ![]() ![]() ![]() | Echocardiogram (2D) | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() ![]() | Echocardiogram with Contrast | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() ![]() | Echocardiogram with Saline (Bubble) | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() ![]() | Pediatric Echocardiogram | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() ![]() | Transesophageal Echocardiogram (TEE) | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() | Electrocardiogram (ECG) | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() | Holter Monitoring | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() | sub holter monitoring | 0..1 | group | Enable When: 279226023495 = Holter Monitoring (standardized-referral-form-codes#20007) | |
![]() ![]() ![]() ![]() ![]() ![]() | 24 Hours | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() ![]() | 48 Hours | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() ![]() | 72 Hours | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() ![]() | 7 Days | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() ![]() | 14 Days | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() | Loop / Event Monitor | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() | Cardiovascular stress testing | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() | Sub Stress Testing | 0..1 | group | Enable When: 159161544747 = Stress Testing (standardized-referral-form-codes#20009) | |
![]() ![]() ![]() ![]() ![]() ![]() | ECG - Exercise Stress Test | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() ![]() | ECG - Dobutamine/Persantine Stress Test | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() ![]() | Echocardiogram - Exercise Stress Test | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() ![]() | Echocardiogram - Dobutamine/Persantine Stress Test | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() | Nuclear Medicine | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() | sub Nuclear Medicine | 0..1 | group | Enable When: 918517139023 = Nuclear Medicine (standardized-referral-form-codes#20010) | |
![]() ![]() ![]() ![]() ![]() ![]() | MUGA - Resting | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() ![]() | Cardiac Pyrophosphate | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() ![]() | Myocardial perfusion scan | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() ![]() | sub MIBI | 0..1 | group | Enable When: 892165959617 = MIBI Scans / Myocardial Perfusion Imaging (MPI): (standardized-referral-form-codes#20028) | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | MIBI Scan - Exercise Stress Test | 0..* | string | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | MIBI Scan - Dobutamine/Persantine Stress Test | 0..* | string | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Thallium Viability Test | 0..* | string | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() | Tilt Table Testing | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() | Other | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() ![]() | Specify | 1..1 | text | Enable When: cardiology_referral_services_cardiactesting_other = other (NullFlavor#OTH) | |
![]() ![]() ![]() ![]() | Cardiology Consultation | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() | Concern(s) / Indication(s) Triggering Referral Select all that apply: | 1..1 | group | ||
![]() ![]() ![]() ![]() | Arrhythmias or Palpitations | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() | Cardiovascular Risk Assessment | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() | Chest Pain or Angina | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() | Congenital Heart Disease | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() | Congestive Heart Failure | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() | Coronary Artery Disease | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() | Dyspnea | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() | Hypertension | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() | Murmur | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() | Pericardial Disease | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() | Peripheral Edema | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() | Post-Myocardial Infarction | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() | Pre-operative Consultation | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() | Procedure Date (if known) | 0..1 | date | Enable When: 621745958993 = Pre-operative Consultation (standardized-referral-form-codes#20044) | |
![]() ![]() ![]() ![]() | Syncope | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() | Valvular Heart Disease or Prosthetic Heart Valve | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() | Other | 0..* | choice | Options: 1 option | |
![]() ![]() ![]() ![]() | Specify | 1..1 | text | Enable When: 721982740516 = other (NullFlavor#OTH) | |
![]() ![]() ![]() | Clinical Question / Goal(s) of Referral with Relevant History, Management and Investigations | 1..1 | text | ||
![]() ![]() | Cumulative Patient Profile Please delete any sensitive information you do not intend to share from the CPP | 0..1 | group | ||
![]() ![]() ![]() | CPP attached separately (if not entered below) | 0..* | string | Options: 1 option | |
![]() ![]() ![]() | Current Problem List: | 0..1 | text | Enable When: cpp_separate exists false | |
![]() ![]() ![]() | Past Medical History: | 0..1 | text | Enable When: cpp_separate exists false | |
![]() ![]() ![]() | Current Medications : | 0..1 | text | Enable When: cpp_separate exists false | |
![]() ![]() ![]() | Family History: | 0..1 | text | Enable When: cpp_separate exists false | |
![]() ![]() ![]() | Allergies: | 0..1 | text | Enable When: cpp_separate exists false | |
![]() ![]() | Preferred Consultant or Location All patients will be triaged to the shortest wait time unless a preferred consultant or location is entered. | 0..1 | group | ||
![]() ![]() ![]() | Preferred consultant or location | 0..* | string | Options: 1 option | |
![]() ![]() ![]() | Please specify either a preferred consultant or location | 0..1 | group | Enable When: preferredconsultlocation_selector = Preferred consultant or location | |
![]() ![]() ![]() ![]() | Consultant: | 0..1 | string | ||
![]() ![]() ![]() ![]() | Location: | 0..1 | string | ||
![]() ![]() ![]() | Patient willing to travel for shorter wait time | 0..* | string | Options: 1 option | |
![]() ![]() ![]() | Other considerations: | 0..1 | string | ||
![]() ![]() | Supporting Documentation Please attach all relevant laboratory and diagnostic investigations. | 0..1 | group | ||
![]() ![]() ![]() | Personal Health Information that is medically relevant has not been disclosed at the request of the patient. | 0..* | string | Options: 1 option | |
![]() ![]() | Add Attachments | 0..1 | attachment | ||
![]() ![]() | Click here to provide feedback on this form | 0..1 | display | ||
![]() ![]() | Referrer's Information | 0..1 | group | ||
![]() ![]() ![]() | Site Name: | 0..1 | string | ||
![]() ![]() ![]() | Address (Line 1): | 1..1 | string | ||
![]() ![]() ![]() ![]() | Address (Line 2): | 0..1 | string | ||
![]() ![]() ![]() ![]() | City: | 1..1 | string | ||
![]() ![]() ![]() ![]() | Province: | 1..1 | string | Max Length: 2 | |
![]() ![]() ![]() ![]() | Postal Code: | 1..1 | string | ||
![]() ![]() ![]() | Phone #: | 0..1 | string | ||
![]() ![]() ![]() | Fax #: | 0..1 | string | ||
![]() ![]() ![]() | Billing Number: | 0..1 | integer | ||
![]() ![]() ![]() | Professional ID: | 0..1 | integer | ||
![]() ![]() ![]() | Signed: | 1..1 | text | ||
![]() ![]() ![]() | Role: | 0..1 | choice | Options: 9 options | |
Options Sets
Answer options for patient_gender
Answer options for additionalinfo_sexassignedatbirth
Answer options for additionalinfo_pronouns
Answer options for additionalinfo_preferredlanguage
Answer options for additionalinfo_preferredlanguage_translatorrequired
Answer options for additionalinfo_bestmethodofcontact
Answer options for additionalinfo_bestmethodofcontact_voicemails
Answer options for additionalinfo_preferredname_select
Answer options for additionalinfo_alternatecontact_select
Answer options for additionalinfo_alternatecontact_bookingcontact
Answer options for additionalinfo_unsafecontacts_select
Answer options for additionalinfo_unsafecontacts_speakwithpatientdirectly
Answer options for additionalinfo_accessibilityconcernsordisability_selectt
Answer options for additionalinfo_accessibilityconcernsordisability
Answer options for additionalinfo_specialconsiderations_select
Answer options for additionalinfo_sendcopiestoadditionalproviders
Answer options for additionalinfo_sendcopiestoadditionalproviders_ispcp
Answer options for referral_requestedpriority
Answer options for referral_secondopinion
Answer options for 223886162384
Answer options for 720409326878
Answer options for 960455115596
Answer options for 297634898828
Answer options for 165530569567
Answer options for 286552421895
Answer options for 910527687300
Answer options for 657824763133
Answer options for 992743200182
Answer options for 894277763438
Answer options for 279226023495
Answer options for 671328703851
Answer options for 423992261841
Answer options for 419924239187
Answer options for 731054417270
Answer options for 235876421044
Answer options for 374742834400
Answer options for 159161544747
Answer options for 814218498309
Answer options for 307107493993
Answer options for 805303414102
Answer options for 193586908489
Answer options for 918517139023
Answer options for 924189648184
Answer options for 857163514910
Answer options for 892165959617
Answer options for 373435981917
Answer options for 434394942688
Answer options for 913594478162
Answer options for 992682216482
Answer options for cardiology_referral_services_cardiactesting_other
Answer options for 785727177547
Answer options for 219569805461
Answer options for 571934328499
Answer options for 459737733395
Answer options for 929919815516
Answer options for 832263816528
Answer options for 803760213460
Answer options for 129767162379
Answer options for 116150628533
Answer options for 513825527027
Answer options for 975075898688
Answer options for 704148928571
Answer options for 886489617115
Answer options for 621745958993
Answer options for 197975129599
Answer options for 675849150752
Answer options for 721982740516
Answer options for cpp_separate
Answer options for preferredconsultlocation_selector
Answer options for preferredconsultlocation_willingtotravel
Answer options for supportingdocumentation_details
Answer options for referrer_role
| 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 |
|
| Generated using version 0.5.4 of the sample-content-ig Liquid templates | |
{
"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] Additional Patient 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 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 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) Requested</b><br/><i>Select all that 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) 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"
},
{
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},
"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) / Indication(s) Triggering Referral</b><br/><i>Select all that 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 Question / Goal(s) of Referral with Relevant History, Management and 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 Documentation</b><br/>Please attach all <b><span style=\"text-decoration: underline\">relevant</span></b> laboratory and diagnostic 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 here to provide feedback on this 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"
}
}
]
}
]
}
]
}