| Package | smart.who.int.hiv |
| Resource Type | Questionnaire |
| Id | HIV.A5CreateNewClientRecord |
| FHIR Version | R4 |
| Source | http://smart.who.int/hiv/https://build.fhir.org/ig/WorldHealthOrganization/smart-hiv/Questionnaire-HIV.A5CreateNewClientRecord.html |
| URL | http://smart.who.int/hiv/Questionnaire/HIV.A5CreateNewClientRecord |
| Version | 0.4.4 |
| Status | draft |
| Date | 2025-07-24T19:24:35+00:00 |
| Title | Create new client record |
| Authority | who |
| Description | Questionnaire for create new client record |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire HIV.A5CreateNewClientRecord
Language: en
Profiles: Extractable Questionnaire - StructureMap, CRMI Shareable Questionnaire, CRMI Publishable Questionnaire
| LinkID | Text | Cardinality | Type | Flags | Description & Constraints |
|---|---|---|---|---|---|
  | Questionnaire for create new client record | Questionnaire | http://smart.who.int/hiv/Questionnaire/HIV.A5CreateNewClientRecord#0.4.4 | ||
  HIV.A.DE8 | Unique identifier | 1..1 | string | ||
| HIV.A.DE9 | National ID | 0..1 | string | ||
| HIV.A.DE10 | National health ID | 0..1 | string | ||
| HIV.A.DE11 | National programme ID | 0..1 | string | ||
| HIV.A.DE12 | National health insurance ID | 0..1 | string | ||
 HIV.A.DE13 | Country of birth | 1..1 | choice | Value Set: #HIV.A.DE13 | |
 HIV.A.DE14 | Date of birth | 0..1 | date | ||
 HIV.A.DE15 | Date of birth unknown | 0..1 | boolean | ||
 HIV.A.DE16 | Estimated age | 0..1 | integer | ||
| HIV.A.DE17 | Age | 0..1 | integer | ||
| HIV.A.DE18 | Gender | 1..1 | choice | Value Set: #HIV.A.DE18 | |
| HIV.A.DE24 | Other (specify) | 0..1 | string | ||
| HIV.A.DE25 | Sex | 1..1 | choice | Value Set: #HIV.A.DE25 | |
| HIV.A.DE29 | Address | 1..1 | string | ||
| HIV.A.DE30 | Marital Status | 0..1 | choice | Value Set: #HIV.A.DE30 | |
| HIV.A.DE42 | Telephone number | 1..1 | integer | ||
| HIV.A.DE43 | Administrative Area | 1..1 | choice | Value Set: #HIV.A.DE43 | |
| HIV.A.DE44 | Communication consent | 0..1 | boolean | ||
| HIV.A.DE45 | Reminder messages | 0..1 | boolean | ||
| HIV.A.DE46 | Communication preference(s) | 0..1 | choice | Value Set: #HIV.A.DE46 | |
| HIV.A.DE49 | Client's email | 0..1 | string | ||
| HIV.A.DE50 | Alternate contact's name | 0..1 | string | ||
| HIV.A.DE51 | Alternate contact's phone number | 0..1 | integer | ||
| HIV.A.DE52 | Alternate contact's address | 0..1 | string | ||
 HIV.A.DE53 | Alternate contact relationship | 0..1 | string | ||
| Documentation for this format | |||||
FHIR{
"resourceType": "Questionnaire",
"id": "HIV.A5CreateNewClientRecord",
"meta": {
"profile": [
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap",
"http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablequestionnaire",
"http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-publishablequestionnaire"
]
},
"language": "en",
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"url": "http://smart.who.int/hiv/Questionnaire/HIV.A5CreateNewClientRecord",
"version": "0.4.4",
"title": "Create new client record",
"status": "draft",
"experimental": true,
"subjectType": [
"Patient"
],
"date": "2025-07-24T19:24:35+00:00",
"publisher": "WHO",
"contact": [
{
"name": "WHO",
"telecom": [
{
"system": "url",
"value": "http://who.int"
}
]
}
],
"description": "Questionnaire for create new client record",
"item": [
{
"id": "HIV.A.DE8",
"linkId": "HIV.A.DE8",
"text": "Unique identifier",
"type": "string",
"required": true,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.A.DE9",
"linkId": "HIV.A.DE9",
"text": "National ID",
"type": "string",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.A.DE10",
"linkId": "HIV.A.DE10",
"text": "National health ID",
"type": "string",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.A.DE11",
"linkId": "HIV.A.DE11",
"text": "National programme ID",
"type": "string",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.A.DE12",
"linkId": "HIV.A.DE12",
"text": "National health insurance ID",
"type": "string",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.A.DE13",
"linkId": "HIV.A.DE13",
"text": "Country of birth",
"type": "choice",
"required": true,
"repeats": false,
"readOnly": false,
"answerValueSet": "#HIV.A.DE13"
},
{
"id": "HIV.A.DE14",
"linkId": "HIV.A.DE14",
"text": "Date of birth",
"type": "date",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.A.DE15",
"linkId": "HIV.A.DE15",
"text": "Date of birth unknown",
"type": "boolean",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.A.DE16",
"linkId": "HIV.A.DE16",
"text": "Estimated age",
"type": "integer",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.A.DE17",
"linkId": "HIV.A.DE17",
"text": "Age",
"type": "integer",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.A.DE18",
"linkId": "HIV.A.DE18",
"text": "Gender",
"type": "choice",
"required": true,
"repeats": false,
"readOnly": false,
"answerValueSet": "#HIV.A.DE18"
},
{
"id": "HIV.A.DE24",
"linkId": "HIV.A.DE24",
"text": "Other (specify)",
"type": "string",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.A.DE25",
"linkId": "HIV.A.DE25",
"text": "Sex",
"type": "choice",
"required": true,
"repeats": false,
"readOnly": false,
"answerValueSet": "#HIV.A.DE25"
},
{
"id": "HIV.A.DE29",
"linkId": "HIV.A.DE29",
"text": "Address",
"type": "string",
"required": true,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.A.DE30",
"linkId": "HIV.A.DE30",
"text": "Marital Status",
"type": "choice",
"required": false,
"repeats": false,
"readOnly": false,
"answerValueSet": "#HIV.A.DE30"
},
{
"id": "HIV.A.DE42",
"linkId": "HIV.A.DE42",
"text": "Telephone number",
"type": "integer",
"required": true,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.A.DE43",
"linkId": "HIV.A.DE43",
"text": "Administrative Area",
"type": "choice",
"required": true,
"repeats": false,
"readOnly": false,
"answerValueSet": "#HIV.A.DE43"
},
{
"id": "HIV.A.DE44",
"linkId": "HIV.A.DE44",
"text": "Communication consent",
"type": "boolean",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.A.DE45",
"linkId": "HIV.A.DE45",
"text": "Reminder messages",
"type": "boolean",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.A.DE46",
"linkId": "HIV.A.DE46",
"text": "Communication preference(s)",
"type": "choice",
"required": false,
"repeats": false,
"readOnly": false,
"answerValueSet": "#HIV.A.DE46"
},
{
"id": "HIV.A.DE49",
"linkId": "HIV.A.DE49",
"text": "Client's email",
"type": "string",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.A.DE50",
"linkId": "HIV.A.DE50",
"text": "Alternate contact's name",
"type": "string",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.A.DE51",
"linkId": "HIV.A.DE51",
"text": "Alternate contact's phone number",
"type": "integer",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.A.DE52",
"linkId": "HIV.A.DE52",
"text": "Alternate contact's address",
"type": "string",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.A.DE53",
"linkId": "HIV.A.DE53",
"text": "Alternate contact relationship",
"type": "string",
"required": false,
"repeats": false,
"readOnly": false
}
]
}