FHIR IG Statistics: Questionnaire/HIV.I6ProvideInformationToReferralFacility

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Narrative

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

Generated Narrative: Questionnaire HIV.I6ProvideInformationToReferralFacility

Language: en

Profiles: Extractable Questionnaire - StructureMap, CRMI Shareable Questionnaire, CRMI Publishable Questionnaire

LinkID	Text	Cardinality	Type	Flags	Description & Constraints
	Questionnaire for provide information to referral facility		Questionnaire		http://smart.who.int/hiv/Questionnaire/HIV.I6ProvideInformationToReferralFacility#0.4.4
HIV.I.DE2	Reason for referral	1..1	choice		Value Set: #HIV.I.DE2
HIV.I.DE8	Referral for other general services (specify)	0..1	string
HIV.I.DE9	Any treatment given before referral?	1..1	boolean
HIV.I.DE10	Date of scheduled referral appointment	1..1	dateTime
HIV.I.DE11	Location of scheduled referral appointment	1..1	string
HIV.I.DE12	Date referral was made	1..1	dateTime
HIV.I.DE13	Provider who made referral	1..1	string
HIV.I.DE14	Provider's facility	1..1	string
HIV.I.DE15	Provider's telephone number	1..1	integer
HIV.I.DE16	Referral notes	1..1	string
HIV.I.DE17	Client history summary	1..1	string
Documentation for this format

Source

{
  "resourceType": "Questionnaire",
  "id": "HIV.I6ProvideInformationToReferralFacility",
  "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.I6ProvideInformationToReferralFacility",
  "version": "0.4.4",
  "title": "Provide information to referral facility",
  "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 provide information to referral facility",
  "item": [
    {
      "id": "HIV.I.DE2",
      "linkId": "HIV.I.DE2",
      "text": "Reason for referral",
      "type": "choice",
      "required": true,
      "repeats": false,
      "readOnly": false,
      "answerValueSet": "#HIV.I.DE2"
    },
    {
      "id": "HIV.I.DE8",
      "linkId": "HIV.I.DE8",
      "text": "Referral for other general services (specify)",
      "type": "string",
      "required": false,
      "repeats": false,
      "readOnly": false
    },
    {
      "id": "HIV.I.DE9",
      "linkId": "HIV.I.DE9",
      "text": "Any treatment given before referral?",
      "type": "boolean",
      "required": true,
      "repeats": false,
      "readOnly": false
    },
    {
      "id": "HIV.I.DE10",
      "linkId": "HIV.I.DE10",
      "text": "Date of scheduled referral appointment",
      "type": "dateTime",
      "required": true,
      "repeats": false,
      "readOnly": false
    },
    {
      "id": "HIV.I.DE11",
      "linkId": "HIV.I.DE11",
      "text": "Location of scheduled referral appointment",
      "type": "string",
      "required": true,
      "repeats": false,
      "readOnly": false
    },
    {
      "id": "HIV.I.DE12",
      "linkId": "HIV.I.DE12",
      "text": "Date referral was made",
      "type": "dateTime",
      "required": true,
      "repeats": false,
      "readOnly": false
    },
    {
      "id": "HIV.I.DE13",
      "linkId": "HIV.I.DE13",
      "text": "Provider who made referral",
      "type": "string",
      "required": true,
      "repeats": false,
      "readOnly": false
    },
    {
      "id": "HIV.I.DE14",
      "linkId": "HIV.I.DE14",
      "text": "Provider's facility",
      "type": "string",
      "required": true,
      "repeats": false,
      "readOnly": false
    },
    {
      "id": "HIV.I.DE15",
      "linkId": "HIV.I.DE15",
      "text": "Provider's telephone number",
      "type": "integer",
      "required": true,
      "repeats": false,
      "readOnly": false
    },
    {
      "id": "HIV.I.DE16",
      "linkId": "HIV.I.DE16",
      "text": "Referral notes",
      "type": "string",
      "required": true,
      "repeats": false,
      "readOnly": false
    },
    {
      "id": "HIV.I.DE17",
      "linkId": "HIV.I.DE17",
      "text": "Client history summary",
      "type": "string",
      "required": true,
      "repeats": false,
      "readOnly": false
    }
  ]
}