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Source1

{
  "resourceType": "Questionnaire",
  "id": "c624f57d-347a-4f82-b92f-d0bf420cb813",
  "url": "https://fhir.nhs.uk/Questionnaire/COVIDVaccinationMedicalExemption",
  "version": "0.0.2",
  "name": "COVIDVaccinnationMedicalExemption",
  "title": "COVID Vaccinnation Medical Exemption",
  "status": "draft",
  "subjectType": [
    "Patient"
  ],
  "item": [
    {
      "type": "choice",
      "code": [],
      "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"
              }
            ],
            "text": "Drop down"
          }
        }
      ],
      "required": true,
      "linkId": "exemptionStatus",
      "text": "Exemption status",
      "answerOption": [
        {
          "valueCoding": {
            "system": "https://fhir.nhs.uk/CodeSystem/covid-vaccination-medical-exemption",
            "code": "1",
            "display": "Approved: Exemption from COVID vaccination"
          }
        },
        {
          "valueCoding": {
            "system": "https://fhir.nhs.uk/CodeSystem/covid-vaccination-medical-exemption",
            "code": "2",
            "display": "Approved: Exemption from COVID vaccination and testing"
          }
        },
        {
          "valueCoding": {
            "system": "https://fhir.nhs.uk/CodeSystem/covid-vaccination-medical-exemption",
            "code": "3",
            "display": "Rejected: Exemption from COVID vaccination"
          }
        },
        {
          "valueCoding": {
            "system": "https://fhir.nhs.uk/CodeSystem/covid-vaccination-medical-exemption",
            "code": "4",
            "display": "Rejected: Exemption from COVID vaccination and testing"
          }
        }
      ],
      "item": [
        {
          "text": "This will be the code associated with the option selected by the user.",
          "type": "display",
          "linkId": "exemption-Status-help"
        }
      ]
    },
    {
      "type": "dateTime",
      "required": true,
      "linkId": "exemptionPeriodStart",
      "text": "Exemption Period Start",
      "item": [
        {
          "text": "The date upon which the exemption outcome is recorded in SCRa. .",
          "type": "display",
          "linkId": "exemptionPeriodStart-help"
        }
      ]
    },
    {
      "type": "dateTime",
      "required": false,
      "linkId": "exemptionPeriodEnd",
      "text": "Exemption Period End",
      "item": [
        {
          "text": "The date upon which the exemption outcome is moved to history (i.e. removed/deleted).",
          "type": "display",
          "linkId": "exemptionPeriodEnd-help"
        }
      ]
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile",
          "valueCanonical": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole"
        }
      ],
      "type": "reference",
      "required": false,
      "linkId": "exemptionRecordedByUser",
      "text": "Exemption by User"
    },
    {
      "type": "string",
      "required": false,
      "linkId": "exemptionRecordedByUserRole",
      "text": "Exemption Recorded by user role",
      "item": [
        {
          "text": "The RBAC role associated with the user’s selected User Role Profile when the exemption outcome was recorded.",
          "type": "display",
          "linkId": "exemptionRecordedByUserRole-help"
        }
      ]
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile",
          "valueCanonical": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Organization"
        }
      ],
      "type": "reference",
      "required": false,
      "linkId": "exemptionRecordedByOrganisation",
      "text": "Exemption by Organization"
    },
    {
      "type": "group",
      "required": false,
      "linkId": "removalReason",
      "text": "Removal Reason",
      "item": [
        {
          "type": "choice",
          "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"
                  }
                ],
                "text": "Drop down"
              }
            }
          ],
          "required": false,
          "linkId": "removalReasonCode",
          "text": "Removal Reason Code",
          "answerOption": [
            {
              "valueCoding": {
                "system": "https://fhir.nhs.uk/CodeSystem/covid-vaccination-medical-exemption",
                "code": "5",
                "display": "Added in error"
              }
            },
            {
              "valueCoding": {
                "system": "https://fhir.nhs.uk/CodeSystem/covid-vaccination-medical-exemption",
                "code": "6",
                "display": "No longer required"
              }
            }
          ],
          "item": [
            {
              "text": "The code associated with the selected option will be provided.",
              "type": "display",
              "linkId": "removalReasonCode-help"
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile",
              "valueCanonical": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole"
            }
          ],
          "type": "reference",
          "required": false,
          "linkId": "removedByUser",
          "text": "Removed by User",
          "item": [
            {
              "text": "The name of the user who removed the exemption outcome from SCRa.",
              "type": "display",
              "linkId": "RemovedByUser-help"
            }
          ]
        },
        {
          "type": "string",
          "required": false,
          "linkId": "removedByUserRole",
          "text": "Removed by user role",
          "item": [
            {
              "text": "The RBAC role associated with the user’s selected User Role Profile when the exemption outcome was removed from SCRa.",
              "type": "display",
              "linkId": "removedByUserRole-help"
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile",
              "valueCanonical": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Organization"
            }
          ],
          "type": "reference",
          "required": false,
          "linkId": "removedByOrganisation",
          "text": "Removed by organisation",
          "item": [
            {
              "text": "The name and ods code of the organisation associated with the selected User Role Profile when the exemption outcome was removed from SCRa.",
              "type": "display",
              "linkId": "removedByOrganisationName-help"
            }
          ]
        },
        {
          "text": "Only populated on historic (i.e. removed/deleted) exemption records. This is the reason for removal specified by the user.",
          "type": "display",
          "linkId": "undefined-help"
        }
      ]
    }
  ]
}