Health New Zealand Te Whatu Ora Shared Care FHIR API
0.4.4 - release

Health New Zealand Te Whatu Ora Shared Care FHIR API - Local Development build (v0.4.4) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## : Private Colposcopy Referral Summary Questionnaire - JSON Representation

Draft as of 2025-12-11

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    {
      "resourceType" : "Questionnaire",
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Questionnaire PrivateColposcopyReferralQuestionnaire</b></p><a name=\"PrivateColposcopyReferralQuestionnaire\"> </a><a name=\"hcPrivateColposcopyReferralQuestionnaire\"> </a><b>Structure</b><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The linkID for the item\">LinkID</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the item can appear in the instance\">Cardinality</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Type</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the item\">Description &amp; Constraints</a><span style=\"float: right\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireRoot\" class=\"hierarchy\"/> PrivateColposcopyReferralQuestionnaire</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/PrivateColposcopyReferralQuestionnaire#0.1.1</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" id=\"item.p01-ClinicInformation\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> p01-ClinicInformation</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">page 01. Clinic Information</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" id=\"item.p01-q01-FacilityID\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-reference.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"reference\" class=\"hierarchy\"/> p01-q01-FacilityID</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">page 01 question 1. Colposcopy HPI facility ID</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-reference\">reference</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" id=\"item.p02-ReferralInformation\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> p02-ReferralInformation</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">page 02. Referral Information</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111.png)\" id=\"item.p02-q01-SelfReferral\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-boolean.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" class=\"hierarchy\"/> p02-q01-SelfReferral</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">page 02 question 1. Self Referral?</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1100.png)\" id=\"item.p02-q02.1-SelfReferral\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-display.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"display\" class=\"hierarchy\"/> p02-q02.1-SelfReferral</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">page 02 question 2.1. If your patient has self-referred enter in their GP’s HPI-CPN and HPI Health Facility ID</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display\">display</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.p02-q02-ReferredByName\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-reference.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"reference\" class=\"hierarchy\"/> p02-q02-ReferredByName</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">page 02 question 2. Referred by health worker name</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-reference\">reference</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.p02-q03-ReferredByFacilityID\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-reference.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"reference\" class=\"hierarchy\"/> p02-q03-ReferredByFacilityID</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">page 02 question 3. Referred by health facility ID</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-reference\">reference</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.p02-q04-ReferralDateReceived\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-date.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"date\" class=\"hierarchy\"/> p02-q04-ReferralDateReceived</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">page 02 question 5. Referral received date</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date\">date</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.p02-q05-ReferralDateAccepted\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-date.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"date\" class=\"hierarchy\"/> p02-q05-ReferralDateAccepted</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">page 02 question 6. Referral accepted date</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date\">date</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.p02-q06-AppointmentDate\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-date.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"date\" class=\"hierarchy\"/> p02-q06-AppointmentDate</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">page 02 question 7. Appointment date</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date\">date</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.p02-q07-FirstVisit\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-boolean.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" class=\"hierarchy\"/> p02-q07-FirstVisit</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">page 02 question 8. First colposcopy visit?</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.p02-q8-FollowUpType\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> p02-q8-FollowUpType</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">page 02 question 9. Follow-up Colposcopy Visit</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.p02-q07-FirstVisit\">p02-q07-FirstVisit</a> = </span><br/>Options: <a href=\"#opt-item.p02-q8-FollowUpType\">4 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" id=\"item.p02-q9-FollowUpTimeFrame\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> p02-q9-FollowUpTimeFrame</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">page 02 question 9. Follow-up timeframe</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.p02-q07-FirstVisit\">p02-q07-FirstVisit</a> = </span><br/>Options: <a href=\"#opt-item.p02-q9-FollowUpTimeFrame\">15 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)\" id=\"item.p03-RefferalReason\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> p03-RefferalReason</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">page 03. Reason for Referral</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" id=\"item.p03-q01-AssessmentReason\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> p03-q01-AssessmentReason</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">page 03 question 1. Assessment for the reason for referral</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.p03-q01-AssessmentReason\">12 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)\" id=\"item.p03-q02-OtherReason\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> p03-q02-OtherReason</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">page 03 question 2. Other Reason (if Any)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.p03-q01-AssessmentReason\">p03-q01-AssessmentReason</a> = </span></td></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name=\"opt-item.p02-q8-FollowUpType\"> </a><p><b>Answer options for p02-q8-FollowUpType </b></p><ul><li style=\"font-size: 11px\">null#null (&quot;1st Follow Up Visit&quot;)</li><li style=\"font-size: 11px\">null#null (&quot;2nd Follow Up Visit&quot;)</li><li style=\"font-size: 11px\">null#null (&quot;3rd Follow Up Visit&quot;)</li><li style=\"font-size: 11px\">null#null (&quot;4th or more Follow up Visit&quot;)</li></ul><a name=\"opt-item.p02-q9-FollowUpTimeFrame\"> </a><p><b>Answer options for p02-q9-FollowUpTimeFrame </b></p><ul><li style=\"font-size: 11px\">null#7D (&quot;7 Days&quot;)</li><li style=\"font-size: 11px\">null#2W (&quot;2 Weeks&quot;)</li><li style=\"font-size: 11px\">null#6W (&quot;6 Weeks&quot;)</li><li style=\"font-size: 11px\">null#1M (&quot;1 Month&quot;)</li><li style=\"font-size: 11px\">null#2M (&quot;2 Months&quot;)</li><li style=\"font-size: 11px\">null#3M (&quot;3 Months&quot;)</li><li style=\"font-size: 11px\">null#4M (&quot;4 Months&quot;)</li><li style=\"font-size: 11px\">null#5M (&quot;5 Months&quot;)</li><li style=\"font-size: 11px\">null#6M (&quot;6 Months&quot;)</li><li style=\"font-size: 11px\">null#7M (&quot;7 Months&quot;)</li><li style=\"font-size: 11px\">null#9M (&quot;9 Months&quot;)</li><li style=\"font-size: 11px\">null#12M (&quot;12 Months&quot;)</li><li style=\"font-size: 11px\">null#18M (&quot;18 Months&quot;)</li><li style=\"font-size: 11px\">null#36M (&quot;36 Months&quot;)</li><li style=\"font-size: 11px\">null#60M (&quot;60 Months&quot;)</li></ul><a name=\"opt-item.p03-q01-AssessmentReason\"> </a><p><b>Answer options for p03-q01-AssessmentReason </b></p><ul><li style=\"font-size: 11px\">null#null (&quot;Any cytological evidence or suspicion of invasion&quot;)</li><li style=\"font-size: 11px\">null#null (&quot;Any cytological glandular abnormality&quot;)</li><li style=\"font-size: 11px\">null#null (&quot;HPV 16/18 with or without cytology&quot;)</li><li style=\"font-size: 11px\">null#null (&quot;HPV other where the participant is immune compromised&quot;)</li><li style=\"font-size: 11px\">null#null (&quot;HPV other with LSIL on two occasions if over 50 and 3 occasions if under 50&quot;)</li><li style=\"font-size: 11px\">null#null (&quot;Positive test of cure&quot;)</li><li style=\"font-size: 11px\">null#null (&quot;Low-grade clinical assessment&quot;)</li><li style=\"font-size: 11px\">null#null (&quot;High-grade clinical assessment&quot;)</li><li style=\"font-size: 11px\">null#null (&quot;Suspicion of an invasive cancer clinical assessment&quot;)</li><li style=\"font-size: 11px\">null#null (&quot;HPV not detected with high-grade cytology&quot;)</li><li style=\"font-size: 11px\">null#null (&quot;HPV not detected with suspicion or evidence of cancer on cytology&quot;)</li><li style=\"font-size: 11px\">null#null (&quot;Other&quot;)</li></ul></div>"
      },
      "url" : "https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/PrivateColposcopyReferralQuestionnaire",
      "identifier" : [
        {
          "use" : "official",
          "value" : "PrivateColposcopyReferralQuestionnaire"
        }
      ],
      "version" : "0.1.1",
      "name" : "PrivateColposcopyReferralQuestionnaire",
      "title" : "Private Colposcopy Referral Summary Questionnaire",
      "status" : "draft",
      "experimental" : false,
      "subjectType" : [
        "Patient"
      ],
      "date" : "2025-12-11T23:52:07+00:00",
      "publisher" : "Te Whatu Ora",
      "contact" : [
        {
          "name" : "Te Whatu Ora",
          "telecom" : [
            {
              "system" : "url",
              "value" : "https://www.tewhatuora.govt.nz/"
            }
          ]
        },
        {
          "name" : "Te Whatu Ora Integration Team",
          "telecom" : [
            {
              "system" : "email",
              "value" : "integration@tewhatuora.govt.nz",
              "use" : "work"
            }
          ]
        }
      ],
      "useContext" : [
        {
          "code" : {
            "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
            "code" : "workflow",
            "display" : "Workflow Setting"
          },
          "valueCodeableConcept" : {
            "text" : "Private Colposcopy Visit Summary"
          }
        }
      ],
      "jurisdiction" : [
        {
          "coding" : [
            {
              "system" : "urn:iso:std:iso:3166",
              "code" : "NZ",
              "display" : "New Zealand"
            }
          ]
        }
      ],
      "purpose" : "To gather the referral details of Private colposcopy procedure.",
      "item" : [
        {
          "linkId" : "p01-ClinicInformation",
          "prefix" : "page 01",
          "text" : "Clinic Information",
          "type" : "group",
          "item" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceResource",
                  "valueCode" : "Location"
                }
              ],
              "linkId" : "p01-q01-FacilityID",
              "prefix" : "page 01 question 1",
              "text" : "Colposcopy HPI facility ID",
              "type" : "reference",
              "required" : true
            }
          ]
        },
        {
          "linkId" : "p02-ReferralInformation",
          "prefix" : "page 02",
          "text" : "Referral Information",
          "type" : "group",
          "item" : [
            {
              "linkId" : "p02-q01-SelfReferral",
              "prefix" : "page 02 question 1",
              "text" : "Self Referral?",
              "type" : "boolean",
              "required" : true,
              "item" : [
                {
                  "extension" : [
                    {
                      "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/questionnaire-item-control",
                            "code" : "help",
                            "display" : "Help-Button"
                          }
                        ],
                        "text" : "Help-Button"
                      }
                    }
                  ],
                  "linkId" : "p02-q02.1-SelfReferral",
                  "prefix" : "page 02 question 2.1",
                  "text" : "If your patient has self-referred enter in their GP’s HPI-CPN and HPI Health Facility ID",
                  "type" : "display"
                }
              ]
            },
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceResource",
                  "valueCode" : "Practitioner"
                }
              ],
              "linkId" : "p02-q02-ReferredByName",
              "prefix" : "page 02 question 2",
              "text" : "Referred by health worker name",
              "type" : "reference",
              "required" : true
            },
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceResource",
                  "valueCode" : "Location"
                }
              ],
              "linkId" : "p02-q03-ReferredByFacilityID",
              "prefix" : "page 02 question 3",
              "text" : "Referred by health facility ID",
              "type" : "reference",
              "required" : true
            },
            {
              "linkId" : "p02-q04-ReferralDateReceived",
              "prefix" : "page 02 question 5",
              "text" : "Referral received date",
              "type" : "date",
              "required" : false
            },
            {
              "linkId" : "p02-q05-ReferralDateAccepted",
              "prefix" : "page 02 question 6",
              "text" : "Referral accepted date",
              "type" : "date",
              "required" : true
            },
            {
              "linkId" : "p02-q06-AppointmentDate",
              "prefix" : "page 02 question 7",
              "text" : "Appointment date",
              "type" : "date",
              "required" : false
            },
            {
              "linkId" : "p02-q07-FirstVisit",
              "prefix" : "page 02 question 8",
              "text" : "First colposcopy visit?",
              "type" : "boolean",
              "required" : true,
              "repeats" : false
            },
            {
              "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" : "p02-q8-FollowUpType",
              "prefix" : "page 02 question 9",
              "text" : "Follow-up Colposcopy Visit",
              "type" : "choice",
              "enableWhen" : [
                {
                  "question" : "p02-q07-FirstVisit",
                  "operator" : "=",
                  "answerBoolean" : false
                }
              ],
              "enableBehavior" : "all",
              "required" : true,
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "display" : "1st Follow Up Visit"
                  }
                },
                {
                  "valueCoding" : {
                    "display" : "2nd Follow Up Visit"
                  }
                },
                {
                  "valueCoding" : {
                    "display" : "3rd Follow Up Visit"
                  }
                },
                {
                  "valueCoding" : {
                    "display" : "4th or more Follow up Visit"
                  }
                }
              ]
            },
            {
              "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" : "p02-q9-FollowUpTimeFrame",
              "prefix" : "page 02 question 9",
              "text" : "Follow-up timeframe",
              "type" : "choice",
              "enableWhen" : [
                {
                  "question" : "p02-q07-FirstVisit",
                  "operator" : "=",
                  "answerBoolean" : false
                }
              ],
              "enableBehavior" : "all",
              "required" : true,
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "code" : "7D",
                    "display" : "7 Days"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "2W",
                    "display" : "2 Weeks"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "6W",
                    "display" : "6 Weeks"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "1M",
                    "display" : "1 Month"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "2M",
                    "display" : "2 Months"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "3M",
                    "display" : "3 Months"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "4M",
                    "display" : "4 Months"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "5M",
                    "display" : "5 Months"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "6M",
                    "display" : "6 Months"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "7M",
                    "display" : "7 Months"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "9M",
                    "display" : "9 Months"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "12M",
                    "display" : "12 Months"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "18M",
                    "display" : "18 Months"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "36M",
                    "display" : "36 Months"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "60M",
                    "display" : "60 Months"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId" : "p03-RefferalReason",
          "prefix" : "page 03",
          "text" : "Reason for Referral",
          "type" : "group",
          "required" : true,
          "repeats" : false,
          "item" : [
            {
              "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" : "p03-q01-AssessmentReason",
              "prefix" : "page 03 question 1",
              "text" : "Assessment for the reason for referral",
              "type" : "choice",
              "required" : true,
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "display" : "Any cytological evidence or suspicion of invasion"
                  }
                },
                {
                  "valueCoding" : {
                    "display" : "Any cytological glandular abnormality"
                  }
                },
                {
                  "valueCoding" : {
                    "display" : "HPV 16/18 with or without cytology"
                  }
                },
                {
                  "valueCoding" : {
                    "display" : "HPV other where the participant is immune compromised"
                  }
                },
                {
                  "valueCoding" : {
                    "display" : "HPV other with LSIL on two occasions if over 50 and 3 occasions if under 50"
                  }
                },
                {
                  "valueCoding" : {
                    "display" : "Positive test of cure"
                  }
                },
                {
                  "valueCoding" : {
                    "display" : "Low-grade clinical assessment"
                  }
                },
                {
                  "valueCoding" : {
                    "display" : "High-grade clinical assessment"
                  }
                },
                {
                  "valueCoding" : {
                    "display" : "Suspicion of an invasive cancer clinical assessment"
                  }
                },
                {
                  "valueCoding" : {
                    "display" : "HPV not detected with high-grade cytology"
                  }
                },
                {
                  "valueCoding" : {
                    "display" : "HPV not detected with suspicion or evidence of cancer on cytology"
                  }
                },
                {
                  "valueCoding" : {
                    "display" : "Other"
                  }
                }
              ]
            },
            {
              "linkId" : "p03-q02-OtherReason",
              "prefix" : "page 03 question 2",
              "text" : "Other Reason (if Any)",
              "type" : "string",
              "enableWhen" : [
                {
                  "question" : "p03-q01-AssessmentReason",
                  "operator" : "=",
                  "answerCoding" : {
                    "display" : "Other"
                  }
                }
              ],
              "enableBehavior" : "all"
            }
          ]
        }
      ]
    }