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

Health New Zealand Te Whatu Ora Shared Care FHIR API - Local Development build (v0.4.5) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## : COVID19 Public Health History Questionnaire - JSON Representation

Draft as of 2023-07-19

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    {
      "resourceType" : "Questionnaire",
      "id" : "COVIDPublicHealthHistoryQuestionnaire",
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Questionnaire COVIDPublicHealthHistoryQuestionnaire</b></p><a name=\"COVIDPublicHealthHistoryQuestionnaire\"> </a><a name=\"hcCOVIDPublicHealthHistoryQuestionnaire\"> </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\"/> COVIDPublicHealthHistoryQuestionnaire</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\">Questions about a patient's recent COVID-19 history</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\">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://fhir-ig.digital.health.nz/shared-care/Questionnaire/COVIDPublicHealthHistoryQuestionnaire#0.4.5</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_bck10.png)\" id=\"item.summary\" 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-display.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"display\" class=\"hierarchy\"/> summary</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\">Questions about a patient's recent COVID-19 history</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_bck01.png)\" id=\"item.p01\" 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\"/> p01</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\">Public Health History</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-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.p01-q01-PlacesVisitedRecently\" 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-text.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> p01-q01-PlacesVisitedRecently</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\">question 1. Places visited in last 14 days</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-text\">text</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_bck010.png)\" id=\"item.p01-q02-PrevPositive\" 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-boolean.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" class=\"hierarchy\"/> p01-q02-PrevPositive</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\">question 2. Previous positive COVID-19 test?</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_bck010.png)\" id=\"item.p01-q02-1-PrevPositiveMonth\" 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\"/> p01-q02-1-PrevPositiveMonth</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\">question 2-1. Month of positive COVID-19 test?</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.p01-q02-PrevPositive\">p01-q02-PrevPositive</a> = </span><br/>Options: <a href=\"#opt-item.p01-q02-1-PrevPositiveMonth\">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_bck010.png)\" id=\"item.p01-q02-2-PrevPositiveYear\" 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: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> p01-q02-2-PrevPositiveYear</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\">question 2-2. Year of positive COVID-19 test?</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.p01-q02-PrevPositive\">p01-q02-PrevPositive</a> = </span><br/>Options: <a href=\"#opt-item.p01-q02-2-PrevPositiveYear\">11 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_bck010.png)\" id=\"item.p01-q03-HighSuspicionOfCOVID\" 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-boolean.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" class=\"hierarchy\"/> p01-q03-HighSuspicionOfCOVID</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\">question 3. High suspicion of prev. COVID-19?</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_bck010.png)\" id=\"item.p01-q04-PotentialCloseContact\" 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-boolean.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" class=\"hierarchy\"/> p01-q04-PotentialCloseContact</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\">question 4. Potential close contact with a COVID-19 positive person in the last 14 days?</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_bck010.png)\" id=\"item.p01-q05-COVID19Vaccine\" 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\"/> p01-q05-COVID19Vaccine</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\">question 5. COVID-19 vaccine?</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.p01-q05-COVID19Vaccine\">3 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_bck010.png)\" id=\"item.p01-q06-dose1-date\" 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-date.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"date\" class=\"hierarchy\"/> p01-q06-dose1-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\">question 6 - 1st Dose. 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_bck010.png)\" id=\"item.p01-q06-dose1-vaccine\" 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\"/> p01-q06-dose1-vaccine</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\">question 6 - 1st Dose. Vaccine given</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-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.p01-q06-dose1-date\">p01-q06-dose1-date</a> exists </span><br/>Options: <a href=\"#opt-item.p01-q06-dose1-vaccine\">8 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_bck010.png)\" id=\"item.p01-q06-dose1-country\" 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: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> p01-q06-dose1-country</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\">question 6 - 1st Dose. Country where vaccinated</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-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.p01-q06-dose1-date\">p01-q06-dose1-date</a> exists </span><br/>Value Set: <a href=\"http://hl7.org/fhir/R4/valueset-iso3166-1-2.html\">Iso 3166 Part 1: 2 Letter Codes</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_bck010.png)\" id=\"item.p01-q06-dose2-date\" 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-date.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"date\" class=\"hierarchy\"/> p01-q06-dose2-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\">question 6 - 2nd Dose. 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\">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-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_bck010.png)\" id=\"item.p01-q06-dose2-vaccine\" 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: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> p01-q06-dose2-vaccine</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\">question 6 - 2nd Dose. Vaccine given</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-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.p01-q06-dose2-date\">p01-q06-dose2-date</a> exists </span><br/>Options: <a href=\"#opt-item.p01-q06-dose2-vaccine\">8 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_bck010.png)\" id=\"item.p01-q06-dose2-country\" 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\"/> p01-q06-dose2-country</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\">question 6 - 2nd Dose. Country where vaccinated</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-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.p01-q06-dose2-date\">p01-q06-dose2-date</a> exists </span><br/>Value Set: <a href=\"http://hl7.org/fhir/R4/valueset-iso3166-1-2.html\">Iso 3166 Part 1: 2 Letter Codes</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_bck010.png)\" id=\"item.p01-q06-dose3-date\" 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-date.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"date\" class=\"hierarchy\"/> p01-q06-dose3-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\">question 6 - 3rd Dose. 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_bck010.png)\" id=\"item.p01-q06-dose3-vaccine\" 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\"/> p01-q06-dose3-vaccine</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\">question 6 - 3rd Dose. Vaccine given</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-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.p01-q06-dose3-date\">p01-q06-dose3-date</a> exists </span><br/>Options: <a href=\"#opt-item.p01-q06-dose3-vaccine\">8 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.p01-q06-dose3-country\" 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-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> p01-q06-dose3-country</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\">question 6 - 3rd Dose. Country where vaccinated</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-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.p01-q06-dose3-date\">p01-q06-dose3-date</a> exists </span><br/>Value Set: <a href=\"http://hl7.org/fhir/R4/valueset-iso3166-1-2.html\">Iso 3166 Part 1: 2 Letter Codes</a></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.p01-q02-1-PrevPositiveMonth\"> </a><p><b>Answer options for p01-q02-1-PrevPositiveMonth </b></p><ul><li style=\"font-size: 11px\">January</li><li style=\"font-size: 11px\">February</li><li style=\"font-size: 11px\">March</li><li style=\"font-size: 11px\">April</li><li style=\"font-size: 11px\">May</li><li style=\"font-size: 11px\">June</li><li style=\"font-size: 11px\">July</li><li style=\"font-size: 11px\">August</li><li style=\"font-size: 11px\">September</li><li style=\"font-size: 11px\">October</li><li style=\"font-size: 11px\">November</li><li style=\"font-size: 11px\">December</li></ul><a name=\"opt-item.p01-q02-2-PrevPositiveYear\"> </a><p><b>Answer options for p01-q02-2-PrevPositiveYear </b></p><ul><li style=\"font-size: 11px\">2020</li><li style=\"font-size: 11px\">2021</li><li style=\"font-size: 11px\">2022</li><li style=\"font-size: 11px\">2023</li><li style=\"font-size: 11px\">2024</li><li style=\"font-size: 11px\">2025</li><li style=\"font-size: 11px\">2026</li><li style=\"font-size: 11px\">2027</li><li style=\"font-size: 11px\">2028</li><li style=\"font-size: 11px\">2029</li><li style=\"font-size: 11px\">2030</li></ul><a name=\"opt-item.p01-q05-COVID19Vaccine\"> </a><p><b>Answer options for p01-q05-COVID19Vaccine </b></p><ul><li style=\"font-size: 11px\">null#Full (&quot;Full&quot;)</li><li style=\"font-size: 11px\">null#Partial (&quot;Partial&quot;)</li><li style=\"font-size: 11px\">null#Nil (&quot;Nil&quot;)</li></ul><a name=\"opt-item.p01-q06-dose1-vaccine\"> </a><p><b>Answer options for p01-q06-dose1-vaccine </b></p><ul><li style=\"font-size: 11px\">null#207 (&quot;Moderna&quot;)</li><li style=\"font-size: 11px\">null#208 (&quot;Pfizer/BioNtech&quot;)</li><li style=\"font-size: 11px\">null#210 (&quot;AstraZeneca / Covishield&quot;)</li><li style=\"font-size: 11px\">null#211 (&quot;Novavax&quot;)</li><li style=\"font-size: 11px\">null#212 (&quot;Janssen&quot;)</li><li style=\"font-size: 11px\">null#505 (&quot;Sputnik V&quot;)</li><li style=\"font-size: 11px\">null#510 (&quot;Sinopharm&quot;)</li><li style=\"font-size: 11px\">null#511 (&quot;CoronaVac&quot;)</li></ul><a name=\"opt-item.p01-q06-dose2-vaccine\"> </a><p><b>Answer options for p01-q06-dose2-vaccine </b></p><ul><li style=\"font-size: 11px\">null#207 (&quot;Moderna&quot;)</li><li style=\"font-size: 11px\">null#208 (&quot;Pfizer/BioNtech&quot;)</li><li style=\"font-size: 11px\">null#210 (&quot;AstraZeneca / Covishield&quot;)</li><li style=\"font-size: 11px\">null#211 (&quot;Novavax&quot;)</li><li style=\"font-size: 11px\">null#212 (&quot;Janssen&quot;)</li><li style=\"font-size: 11px\">null#505 (&quot;Sputnik V&quot;)</li><li style=\"font-size: 11px\">null#510 (&quot;Sinopharm&quot;)</li><li style=\"font-size: 11px\">null#511 (&quot;CoronaVac&quot;)</li></ul><a name=\"opt-item.p01-q06-dose3-vaccine\"> </a><p><b>Answer options for p01-q06-dose3-vaccine </b></p><ul><li style=\"font-size: 11px\">null#207 (&quot;Moderna&quot;)</li><li style=\"font-size: 11px\">null#208 (&quot;Pfizer/BioNtech&quot;)</li><li style=\"font-size: 11px\">null#210 (&quot;AstraZeneca / Covishield&quot;)</li><li style=\"font-size: 11px\">null#211 (&quot;Novavax&quot;)</li><li style=\"font-size: 11px\">null#212 (&quot;Janssen&quot;)</li><li style=\"font-size: 11px\">null#505 (&quot;Sputnik V&quot;)</li><li style=\"font-size: 11px\">null#510 (&quot;Sinopharm&quot;)</li><li style=\"font-size: 11px\">null#511 (&quot;CoronaVac&quot;)</li></ul></div>"
      },
      "url" : "https://fhir-ig.digital.health.nz/shared-care/Questionnaire/COVIDPublicHealthHistoryQuestionnaire",
      "identifier" : [
        {
          "use" : "official",
          "value" : "COVIDRegularHealthCheckQuestionnaire",
          "period" : {
            "start" : "2023-07-01"
          }
        }
      ],
      "version" : "0.4.5",
      "name" : "COVIDPublicHealthHistoryQuestionnaire",
      "title" : "COVID19 Public Health History Questionnaire",
      "status" : "draft",
      "experimental" : false,
      "subjectType" : [
        "Patient"
      ],
      "date" : "2023-07-19",
      "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"
            }
          ]
        }
      ],
      "description" : "Questions about a patient's recent COVID-19 history",
      "useContext" : [
        {
          "code" : {
            "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
            "code" : "workflow",
            "display" : "Workflow Setting"
          },
          "valueCodeableConcept" : {
            "text" : "COVID Public Health History Questionnaire"
          }
        }
      ],
      "jurisdiction" : [
        {
          "coding" : [
            {
              "system" : "urn:iso:std:iso:3166",
              "code" : "NZ",
              "display" : "New Zealand"
            }
          ]
        }
      ],
      "purpose" : "For assessing patient's recent history of COVID-19 for public health purposes",
      "code" : [
        {
          "system" : "http://snomed.info/sct",
          "code" : "292508471000119105",
          "display" : "History of disease caused by severe acute respiratory syndrome coronavirus 2 (situation)"
        }
      ],
      "item" : [
        {
          "linkId" : "summary",
          "text" : "Questions about a patient's recent COVID-19 history",
          "type" : "display"
        },
        {
          "linkId" : "p01",
          "text" : "Public Health History",
          "type" : "group",
          "item" : [
            {
              "linkId" : "p01-q01-PlacesVisitedRecently",
              "prefix" : "question 1",
              "text" : "Places visited in last 14 days",
              "type" : "text",
              "required" : false
            },
            {
              "linkId" : "p01-q02-PrevPositive",
              "prefix" : "question 2",
              "text" : "Previous positive COVID-19 test?",
              "type" : "boolean",
              "required" : true
            },
            {
              "linkId" : "p01-q02-1-PrevPositiveMonth",
              "prefix" : "question 2-1",
              "text" : "Month of positive COVID-19 test?",
              "type" : "choice",
              "enableWhen" : [
                {
                  "question" : "p01-q02-PrevPositive",
                  "operator" : "=",
                  "answerBoolean" : true
                }
              ],
              "enableBehavior" : "any",
              "required" : true,
              "answerOption" : [
                {
                  "valueString" : "January"
                },
                {
                  "valueString" : "February"
                },
                {
                  "valueString" : "March"
                },
                {
                  "valueString" : "April"
                },
                {
                  "valueString" : "May"
                },
                {
                  "valueString" : "June"
                },
                {
                  "valueString" : "July"
                },
                {
                  "valueString" : "August"
                },
                {
                  "valueString" : "September"
                },
                {
                  "valueString" : "October"
                },
                {
                  "valueString" : "November"
                },
                {
                  "valueString" : "December"
                }
              ]
            },
            {
              "linkId" : "p01-q02-2-PrevPositiveYear",
              "prefix" : "question 2-2",
              "text" : "Year of positive COVID-19 test?",
              "type" : "choice",
              "enableWhen" : [
                {
                  "question" : "p01-q02-PrevPositive",
                  "operator" : "=",
                  "answerBoolean" : true
                }
              ],
              "enableBehavior" : "any",
              "required" : true,
              "answerOption" : [
                {
                  "valueDate" : "2020"
                },
                {
                  "valueDate" : "2021"
                },
                {
                  "valueDate" : "2022"
                },
                {
                  "valueDate" : "2023"
                },
                {
                  "valueDate" : "2024"
                },
                {
                  "valueDate" : "2025"
                },
                {
                  "valueDate" : "2026"
                },
                {
                  "valueDate" : "2027"
                },
                {
                  "valueDate" : "2028"
                },
                {
                  "valueDate" : "2029"
                },
                {
                  "valueDate" : "2030"
                }
              ]
            },
            {
              "linkId" : "p01-q03-HighSuspicionOfCOVID",
              "prefix" : "question 3",
              "text" : "High suspicion of prev. COVID-19?",
              "type" : "boolean",
              "required" : true
            },
            {
              "linkId" : "p01-q04-PotentialCloseContact",
              "prefix" : "question 4",
              "text" : "Potential close contact with a COVID-19 positive person in the last 14 days?",
              "type" : "boolean",
              "required" : true
            },
            {
              "linkId" : "p01-q05-COVID19Vaccine",
              "prefix" : "question 5",
              "text" : "COVID-19 vaccine?",
              "type" : "choice",
              "required" : true,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "code" : "Full",
                    "display" : "Full"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "Partial",
                    "display" : "Partial"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "Nil",
                    "display" : "Nil"
                  }
                }
              ]
            },
            {
              "linkId" : "p01-q06-dose1-date",
              "prefix" : "question 6 - 1st Dose",
              "text" : "Date",
              "type" : "date",
              "required" : false,
              "repeats" : false
            },
            {
              "linkId" : "p01-q06-dose1-vaccine",
              "prefix" : "question 6 - 1st Dose",
              "text" : "Vaccine given",
              "type" : "choice",
              "enableWhen" : [
                {
                  "question" : "p01-q06-dose1-date",
                  "operator" : "exists",
                  "answerBoolean" : true
                }
              ],
              "enableBehavior" : "any",
              "required" : false,
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "code" : "207",
                    "display" : "Moderna"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "208",
                    "display" : "Pfizer/BioNtech"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "210",
                    "display" : "AstraZeneca / Covishield"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "211",
                    "display" : "Novavax"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "212",
                    "display" : "Janssen"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "505",
                    "display" : "Sputnik V"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "510",
                    "display" : "Sinopharm"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "511",
                    "display" : "CoronaVac"
                  }
                }
              ]
            },
            {
              "linkId" : "p01-q06-dose1-country",
              "prefix" : "question 6 - 1st Dose",
              "text" : "Country where vaccinated",
              "type" : "choice",
              "enableWhen" : [
                {
                  "question" : "p01-q06-dose1-date",
                  "operator" : "exists",
                  "answerBoolean" : true
                }
              ],
              "enableBehavior" : "any",
              "required" : false,
              "repeats" : false,
              "answerValueSet" : "http://hl7.org/fhir/ValueSet/iso3166-1-2"
            },
            {
              "linkId" : "p01-q06-dose2-date",
              "prefix" : "question 6 - 2nd Dose",
              "text" : "Date",
              "type" : "date",
              "required" : false,
              "repeats" : false
            },
            {
              "linkId" : "p01-q06-dose2-vaccine",
              "prefix" : "question 6 - 2nd Dose",
              "text" : "Vaccine given",
              "type" : "choice",
              "enableWhen" : [
                {
                  "question" : "p01-q06-dose2-date",
                  "operator" : "exists",
                  "answerBoolean" : true
                }
              ],
              "enableBehavior" : "any",
              "required" : false,
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "code" : "207",
                    "display" : "Moderna"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "208",
                    "display" : "Pfizer/BioNtech"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "210",
                    "display" : "AstraZeneca / Covishield"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "211",
                    "display" : "Novavax"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "212",
                    "display" : "Janssen"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "505",
                    "display" : "Sputnik V"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "510",
                    "display" : "Sinopharm"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "511",
                    "display" : "CoronaVac"
                  }
                }
              ]
            },
            {
              "linkId" : "p01-q06-dose2-country",
              "prefix" : "question 6 - 2nd Dose",
              "text" : "Country where vaccinated",
              "type" : "choice",
              "enableWhen" : [
                {
                  "question" : "p01-q06-dose2-date",
                  "operator" : "exists",
                  "answerBoolean" : true
                }
              ],
              "enableBehavior" : "any",
              "required" : false,
              "repeats" : false,
              "answerValueSet" : "http://hl7.org/fhir/ValueSet/iso3166-1-2"
            },
            {
              "linkId" : "p01-q06-dose3-date",
              "prefix" : "question 6 - 3rd Dose",
              "text" : "Date",
              "type" : "date",
              "required" : false,
              "repeats" : false
            },
            {
              "linkId" : "p01-q06-dose3-vaccine",
              "prefix" : "question 6 - 3rd Dose",
              "text" : "Vaccine given",
              "type" : "choice",
              "enableWhen" : [
                {
                  "question" : "p01-q06-dose3-date",
                  "operator" : "exists",
                  "answerBoolean" : true
                }
              ],
              "enableBehavior" : "any",
              "required" : false,
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "code" : "207",
                    "display" : "Moderna"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "208",
                    "display" : "Pfizer/BioNtech"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "210",
                    "display" : "AstraZeneca / Covishield"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "211",
                    "display" : "Novavax"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "212",
                    "display" : "Janssen"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "505",
                    "display" : "Sputnik V"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "510",
                    "display" : "Sinopharm"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "511",
                    "display" : "CoronaVac"
                  }
                }
              ]
            },
            {
              "linkId" : "p01-q06-dose3-country",
              "prefix" : "question 6 - 3rd Dose",
              "text" : "Country where vaccinated",
              "type" : "choice",
              "enableWhen" : [
                {
                  "question" : "p01-q06-dose3-date",
                  "operator" : "exists",
                  "answerBoolean" : true
                }
              ],
              "enableBehavior" : "any",
              "required" : false,
              "repeats" : false,
              "answerValueSet" : "http://hl7.org/fhir/ValueSet/iso3166-1-2"
            }
          ]
        }
      ]
    }