LinkID	Text	Cardinality	Type	Flags	Description & Constraints
DHOPreoperativeQuestionnaireDaySurgeryDunedinHospital	Pre-operative assessment questionnaire for day surgery patients at Dunedin Hospital.		Questionnaire		https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/DHOPreoperativeQuestionnaireDaySurgeryDunedinHospital#1.0
section1	Section One	0..1	group
section1_01	1. Have you ever had an operation and/or anaesthetic?	0..1	boolean
section1_02	If YES, please provide an overview and date	0..1	string		Enable When: section1_01 =
section1_03	2. Have you or a close relative ever had problems with an anaesthetic?	0..1	boolean
section1_04	If YES, describe the problem	0..1	string		Enable When: section1_03 =
section1_05	3. Are you allergic to any medications or other substances?	0..1	boolean
section1_06	If YES, please list	0..1	string		Enable When: section1_05 =
section1_07	4. Are you taking or have you taken any medications in the last 6 months?	0..1	boolean
section1_08	If YES, please list all medications	0..1	string		Enable When: section1_07 =
section1_09	5. Have you ever had MDRO? (Superbug infection)	0..1	boolean
section1_10	6. Have you worked or been a patient in a hospital in NZ or overseas in the last 6 months?	0..1	boolean
section1_11	If YES, state when and where	0..1	string		Enable When: section1_10 =
section1_12	7. Do you have an artificial joint, heart valve or a pacemaker?	0..1	boolean
section1_13	8. Do you have dentures, partial plate, loose teeth?	0..1	boolean
section1_14	9. Do you smoke?	0..1	boolean
section1_15	If YES, how many per day?	0..1	string		Enable When: section1_14 =
section1_16	10. Are you suffering from or recovering from a cold, sore throat, flu or covid19?	0..1	boolean
section1_17	11. Are you or could you be pregnant?	0..1	boolean
section2	Section Two	0..1	group
section2_01	1. Have you suffered from any of these symptoms or medical conditions?	0..*	choice		Options: 25 options
section2_02	If you select other, please provide an explanation.	0..1	string		Enable When: section2_01 =
section2_03	2. Mobility and balance	0..*	choice		Options: 2 options
section2_04	3. Confidence and safety	0..*	choice		Options: 2 options
Documentation for this format

Options Sets

Answer options for section2_01

• null#null ("Heart condition")
• null#null ("Chest pain/angina")
• null#null ("High blood pressure")
• null#null ("Ankle swelling")
• null#null ("Abnormal shortness of breath")
• null#null ("Blood clots in legs/lungs")
• null#null ("Rheumatic fever")
• null#null ("Persistent cough")
• null#null ("Asthma")
• null#null ("Other lung problems")
• null#null ("Heartburn/reflux")
• null#null ("Stomach ulcer")
• null#null ("Bleeding disorders")
• null#null ("Anaemia")
• null#null ("Stroke/blackouts")
• null#null ("Kidney disorders")
• null#null ("Hepatitis/jaundice")
• null#null ("Epilepsy/fits")
• null#null ("Migraine")
• null#null ("Diabetes type 1 / 2")
• null#null ("Depression/nerves")
• null#null ("Arthritis")
• null#null ("Alcohol related problems")
• null#null ("Motion sickness")
• null#null ("Other")

Answer options for section2_03

• null#null ("Have you fallen in the past 12 months?")
• null#null ("Do you use any aids to help you walk or get around? (e.g. walking stick, frame, wheelchair)")

Answer options for section2_04

• null#null ("Do you ever feel unsteady when walking or standing?")
• null#null ("Do you need help from another person to move around safely?")