Adult Health Questionnaire for EBUS - JSON Representation - Health New Zealand Te Whatu Ora Shared Care FHIR API v1.4.8

Health New Zealand Te Whatu Ora Shared Care FHIR API - Local Development build (v1.4.8) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
: Adult Health Questionnaire for EBUS - JSON Representation

Active as of 2026-10-19
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{
  "resourceType" : "Questionnaire",
  "id" : "RespiratoryAdultHealthQuestionnaire",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Questionnaire RespiratoryAdultHealthQuestionnaire</b></p><a name=\"RespiratoryAdultHealthQuestionnaire\"> </a><a name=\"hcRespiratoryAdultHealthQuestionnaire\"> </a><b>Structure</b><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" class=\"xhtTableBorder1\"><tr class=\"xhtRowBorder2\"><th scope=\"col\" style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The linkID for the item\">LinkID</a></th><th scope=\"col\" style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th scope=\"col\" style=\"\" class=\"hierarchy xhtCellBorder1\"><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 scope=\"col\" style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Type</a></th><th scope=\"col\" style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Other attributes of the item\">Flags</a></th><th scope=\"col\" style=\"\" class=\"hierarchy xhtCellBorder1\"><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 class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck1.png)\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> RespiratoryAdultHealthQuestionnaire</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Questions about respiratory procedure health assessment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"></td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Questionnaire</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"></td><td style=\"\" class=\"hierarchy xhtCellBorder1\">https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/RespiratoryAdultHealthQuestionnaire#1.0.0</td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck10.png)\" id=\"item.meta-specialty-code\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / </span>meta-specialty-code</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Specialty Code</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-hidden.html\" title=\"Is a hidden item\"><img src=\"icon-qi-hidden.png\" alt=\"\"/></a><img src=\"icon-qi-hidden.png\" alt=\"\"/></td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Initial Value: string = M65</td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck10.png)\" id=\"item.meta-specialty-name\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / </span>meta-specialty-name</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Specialty Name</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-hidden.html\" title=\"Is a hidden item\"><img src=\"icon-qi-hidden.png\" alt=\"\"/></a><img src=\"icon-qi-hidden.png\" alt=\"\"/></td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Initial Value: string = Respiratory Medicine</td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck11.png)\" id=\"item.Section0PatientID\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / </span>Section0PatientID</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Patient ID</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.Surname\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section0PatientID / </span>Surname</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Surname</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.FirstNames\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section0PatientID / </span>FirstNames</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">First Names</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.NHI\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section0PatientID / </span>NHI</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">NHI</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.DateOfBirth\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section0PatientID / </span>DateOfBirth</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Date of Birth</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date\">date</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck100.png)\" id=\"item.Sex\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section0PatientID / </span>Sex</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Sex</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck11.png)\" id=\"item.Section1PatientDetails\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / </span>Section1PatientDetails</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Section 1 – Patient details</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.TodaysDate\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>TodaysDate</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Today's date</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date\">date</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.Height\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-decimal.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"decimal\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>Height</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Your height (cm)</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal\">decimal</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.Weight\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-decimal.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"decimal\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>Weight</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Your weight (kg)</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal\">decimal</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.BMI\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-decimal.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"decimal\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>BMI</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">BMI</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal\">decimal</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.ProposedProcedure\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>ProposedProcedure</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Proposed surgery / procedure</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Initial Value: string = Endobronchial Ultrasound (EBUS)</td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck111.png)\" id=\"item.ContactDetailsGroup\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-group.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>ContactDetailsGroup</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If a phone call is required for further information relating to this questionnaire, please provide details on how we can contact you.</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck1110.png)\" id=\"item.ContactHomePhone\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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.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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / ContactDetailsGroup / </span>ContactHomePhone</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Home phone</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck1110.png)\" id=\"item.ContactWorkPhone\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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.png\" alt=\"\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / ContactDetailsGroup / </span>ContactWorkPhone</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Work phone</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck1110.png)\" id=\"item.ContactMobilePhone\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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.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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / ContactDetailsGroup / </span>ContactMobilePhone</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Mobile phone</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck1100.png)\" id=\"item.ContactEmail\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / ContactDetailsGroup / </span>ContactEmail</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Email</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.HappyToLeaveMessage\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>HappyToLeaveMessage</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Are you happy for us to leave a message?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.HappyToLeaveMessage\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.MessageWithPerson\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>MessageWithPerson</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">With a person?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.HappyToLeaveMessage\">HappyToLeaveMessage</a> = Yes (yes)</span><br/>Options: <a href=\"#opt-item.MessageWithPerson\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.MessageWithPersonName\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>MessageWithPersonName</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, please give person's name</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <ul><li><a href=\"#item.HappyToLeaveMessage\">HappyToLeaveMessage</a> = Yes (yes)</li><li><a href=\"#item.MessageWithPerson\">MessageWithPerson</a> = Yes (yes)</li></ul></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.MessageOnAnswerPhone\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>MessageOnAnswerPhone</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">On answer phone?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.HappyToLeaveMessage\">HappyToLeaveMessage</a> = Yes (yes)</span><br/>Options: <a href=\"#opt-item.MessageOnAnswerPhone\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck100.png)\" id=\"item.BestTimeToCall\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>BestTimeToCall</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">When is the best time for you to receive telephone calls from staff?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck11.png)\" id=\"item.Section2DHBUseOnly\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / </span>Section2DHBUseOnly</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Section 2 – Capital and Coast DHB use only</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.AssessorName\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section2DHBUseOnly / </span>AssessorName</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Name</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.AssessorPosition\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section2DHBUseOnly / </span>AssessorPosition</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Position</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.AssessmentDate\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section2DHBUseOnly / </span>AssessmentDate</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Date</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date\">date</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck100.png)\" id=\"item.PreAnaesthesiaRequirements\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section2DHBUseOnly / </span>PreAnaesthesiaRequirements</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Pre-anaesthesia Requirements</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..*</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.PreAnaesthesiaRequirements\">5 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck11.png)\" id=\"item.Section3MedicalConditions\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / </span>Section3MedicalConditions</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Section 3 – Medical conditions</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.HighBloodPressure\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HighBloodPressure</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">1. High blood pressure?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.HighBloodPressure\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.HighBloodPressureBPAtClinic\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HighBloodPressureBPAtClinic</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">BP at clinic</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.HighBloodPressure\">HighBloodPressure</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.HeartConditions\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HeartConditions</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">2. Heart conditions (e.g. heart murmur, valve disease, chest pain or discomfort, angina, palpitations or irregular heart beat)?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.HeartConditions\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.HeartConditionsComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-text.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HeartConditionsComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.HeartConditions\">HeartConditions</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.HeartLungSurgery\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HeartLungSurgery</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">3. Heart/Lung surgery?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.HeartLungSurgery\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.HeartLungSurgeryComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HeartLungSurgeryComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.HeartLungSurgery\">HeartLungSurgery</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.ICDorPacemaker\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>ICDorPacemaker</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">4. Implanted cardiac defibrillator (ICD) or Pacemaker?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.ICDorPacemaker\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.ICDorPacemakerLastChecked\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>ICDorPacemakerLastChecked</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">When was it last checked?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.ICDorPacemaker\">ICDorPacemaker</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.ShortnessOfBreathAtNight\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>ShortnessOfBreathAtNight</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">5. Shortness of breath at night?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.ShortnessOfBreathAtNight\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.ShortnessOfBreathAtNightComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>ShortnessOfBreathAtNightComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.ShortnessOfBreathAtNight\">ShortnessOfBreathAtNight</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.BlackoutsOrFainting\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>BlackoutsOrFainting</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">6. Blackouts or fainting?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.BlackoutsOrFainting\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.BlackoutsOrFaintingCircumstances\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>BlackoutsOrFaintingCircumstances</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Under what circumstances?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.BlackoutsOrFainting\">BlackoutsOrFainting</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.SwollenAnkles\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>SwollenAnkles</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">7. Swollen ankles?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.SwollenAnkles\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.SwollenAnklesComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>SwollenAnklesComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.SwollenAnkles\">SwollenAnkles</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.BreathingDifficulties\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>BreathingDifficulties</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">8. Breathing difficulties (e.g. asthma, emphysema, C.O.R.D., bronchitis)?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.BreathingDifficulties\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.BreathingDifficultiesComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>BreathingDifficultiesComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">(Please bring peak flow recordings with you if available)</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.BreathingDifficulties\">BreathingDifficulties</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.SteroidsForBreathing\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>SteroidsForBreathing</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">9. Have you taken steroids for your breathing difficulty in the past 5 years?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.SteroidsForBreathing\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.SteroidsForBreathingLastCourse\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>SteroidsForBreathingLastCourse</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">When was the last course?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.SteroidsForBreathing\">SteroidsForBreathing</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.SleepApnoea\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>SleepApnoea</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">10. Sleep apnoea (or have you been told you stop breathing while asleep)?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.SleepApnoea\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.SleepApnoeaComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-text.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>SleepApnoeaComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.SleepApnoea\">SleepApnoea</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.KidneyCondition\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>KidneyCondition</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">11. Kidney (Renal) condition?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.KidneyCondition\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.KidneyConditionComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>KidneyConditionComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.KidneyCondition\">KidneyCondition</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.Diabetes\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>Diabetes</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">12. Diabetes?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.Diabetes\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.DiabetesType\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>DiabetesType</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Please tick which type</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.Diabetes\">Diabetes</a> = Yes (yes)</span><br/>Options: <a href=\"#opt-item.DiabetesType\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.DiabetesManagement\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>DiabetesManagement</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Do you currently use (please tick):</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..*</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.Diabetes\">Diabetes</a> = Yes (yes)</span><br/>Options: <a href=\"#opt-item.DiabetesManagement\">3 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.Stroke\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>Stroke</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">13. Stroke (Cerebrovascular accident or CVA)?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.Stroke\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.StrokeComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-text.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>StrokeComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.Stroke\">Stroke</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.SuddenLossVisionSpeechMovement\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>SuddenLossVisionSpeechMovement</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">14. Sudden loss of vision, speech or movement?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.SuddenLossVisionSpeechMovement\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.SuddenLossVisionSpeechMovementComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>SuddenLossVisionSpeechMovementComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.SuddenLossVisionSpeechMovement\">SuddenLossVisionSpeechMovement</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.BloodClotsOrBleedingDisorder\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>BloodClotsOrBleedingDisorder</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">15. Blood clots in lungs or legs or a bleeding disorder (PE, DVT, thrombosis)?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.BloodClotsOrBleedingDisorder\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.BloodClotsOrBleedingDisorderComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-text.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>BloodClotsOrBleedingDisorderComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.BloodClotsOrBleedingDisorder\">BloodClotsOrBleedingDisorder</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.HeartburnRefluxHiatusHernia\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HeartburnRefluxHiatusHernia</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">16. Heartburn/reflux of acid/hiatus hernia?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.HeartburnRefluxHiatusHernia\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.HeartburnRefluxHiatusHerniaComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HeartburnRefluxHiatusHerniaComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.HeartburnRefluxHiatusHernia\">HeartburnRefluxHiatusHernia</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.ThyroidProblems\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>ThyroidProblems</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">17. Thyroid problems?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.ThyroidProblems\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.ThyroidProblemsComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>ThyroidProblemsComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.ThyroidProblems\">ThyroidProblems</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.Dementia\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>Dementia</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">18. Dementia? (e.g. Alzheimer's, forgetfulness)</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.Dementia\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.DementiaComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-text.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>DementiaComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.Dementia\">Dementia</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.Epilepsy\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>Epilepsy</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">19. Epilepsy?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.Epilepsy\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.EpilepsySeizureFrequency\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>EpilepsySeizureFrequency</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">How often do you have seizures?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.Epilepsy\">Epilepsy</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.EpilepsyLastSeizure\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>EpilepsyLastSeizure</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">When was your last seizure?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.Epilepsy\">Epilepsy</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.Arthritis\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>Arthritis</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">20. Arthritis?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.Arthritis\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.ArthritisComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>ArthritisComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.Arthritis\">Arthritis</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.JointReplacementOrMetalware\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>JointReplacementOrMetalware</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">21. Joint replacement or orthopaedic metalware?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.JointReplacementOrMetalware\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.JointReplacementOrMetalwareType\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>JointReplacementOrMetalwareType</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">What type?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.JointReplacementOrMetalware\">JointReplacementOrMetalware</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.MuscleOrNeurologicalDisease\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>MuscleOrNeurologicalDisease</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">22. Muscle or Neurological disease (e.g. MS, Parkinson's, Muscular dystrophy)?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.MuscleOrNeurologicalDisease\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.MuscleOrNeurologicalDiseaseComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-text.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>MuscleOrNeurologicalDiseaseComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.MuscleOrNeurologicalDisease\">MuscleOrNeurologicalDisease</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.JawOrNeckProblems\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>JawOrNeckProblems</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">23. Jaw or neck problems?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.JawOrNeckProblems\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.JawOrNeckProblemsComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>JawOrNeckProblemsComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.JawOrNeckProblems\">JawOrNeckProblems</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.HepatitisOrLiverCondition\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HepatitisOrLiverCondition</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">24. Hepatitis A, B, C, jaundice or liver condition?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.HepatitisOrLiverCondition\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.HepatitisOrLiverConditionComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HepatitisOrLiverConditionComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.HepatitisOrLiverCondition\">HepatitisOrLiverCondition</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.TransmittableDisease\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>TransmittableDisease</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">25. Transmittable disease (such as MRSA, 'golden staph', boils, skin or other infection, septicaemia, HIV, VRSA)?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.TransmittableDisease\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.TransmittableDiseaseComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-text.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>TransmittableDiseaseComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.TransmittableDisease\">TransmittableDisease</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.Tuberculosis\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>Tuberculosis</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">26. Tuberculosis (TB)?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.Tuberculosis\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.TuberculosisTreatment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>TuberculosisTreatment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Have you had or are you on treatment for this?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.Tuberculosis\">Tuberculosis</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.FamilyConditions\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>FamilyConditions</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">27. Are there any conditions that run in your family? (e.g. malignant hyperthermia, thalassaemia, muscular dystrophy)?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.FamilyConditions\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.FamilyConditionsComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-text.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>FamilyConditionsComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.FamilyConditions\">FamilyConditions</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.Anaemia\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>Anaemia</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">28. Anaemia?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.Anaemia\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.AnaemiaComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>AnaemiaComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.Anaemia\">Anaemia</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.PreviousBloodTransfusion\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>PreviousBloodTransfusion</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">29. Previous blood transfusion?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.PreviousBloodTransfusion\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.PreviousBloodTransfusionComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>PreviousBloodTransfusionComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">When was the last?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.PreviousBloodTransfusion\">PreviousBloodTransfusion</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.BloodTransfusionRefusal\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>BloodTransfusionRefusal</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">30. Do you have any reasons which might stop you from accepting a blood transfusion?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.BloodTransfusionRefusal\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.BloodTransfusionRefusalComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-text.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>BloodTransfusionRefusalComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">What was the reason?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.BloodTransfusionRefusal\">BloodTransfusionRefusal</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.Phobias\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>Phobias</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">31. Phobias (e.g. claustrophobia, anxiety attacks)?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.Phobias\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.PhobiasComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-text.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>PhobiasComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.Phobias\">Phobias</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.TravelledOverseas\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>TravelledOverseas</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">32. Travelled overseas in the last 6 months?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.TravelledOverseas\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.TravelledOverseasHospitalised\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>TravelledOverseasHospitalised</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Were you hospitalised?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.TravelledOverseas\">TravelledOverseas</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.VisualOrHearingImpairment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>VisualOrHearingImpairment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">33. A visual or hearing impairment?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.VisualOrHearingImpairment\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.VisualOrHearingImpairmentComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>VisualOrHearingImpairmentComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.VisualOrHearingImpairment\">VisualOrHearingImpairment</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.CurrentPainProblems\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>CurrentPainProblems</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">34. Do you have any current pain problems?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.CurrentPainProblems\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.CurrentPainProblemsLocation\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>CurrentPainProblemsLocation</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">What is the location of the pain?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.CurrentPainProblems\">CurrentPainProblems</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck100.png)\" id=\"item.OtherRelevantMedicalCondition\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-text.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>OtherRelevantMedicalCondition</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">35. Is there any other relevant medical condition that you need to tell us about?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck11.png)\" id=\"item.Section4HealthProfessionals\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / </span>Section4HealthProfessionals</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Section 4 – Health professionals</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck101.png)\" id=\"item.HealthProfessionalsGroup\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-group.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section4HealthProfessionals / </span>HealthProfessionalsGroup</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">List the name(s) of the hospital/clinic/doctors/surgeons/nurses you see.</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..*</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck1010.png)\" id=\"item.HealthProfessionalName\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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_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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section4HealthProfessionals / HealthProfessionalsGroup / </span>HealthProfessionalName</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Doctor's name</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck1010.png)\" id=\"item.HealthProfessionalReason\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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_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-string.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section4HealthProfessionals / HealthProfessionalsGroup / </span>HealthProfessionalReason</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Reason you see this doctor</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck1000.png)\" id=\"item.HealthProfessionalLastVisit\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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_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-date.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"date\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section4HealthProfessionals / HealthProfessionalsGroup / </span>HealthProfessionalLastVisit</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Date of last visit</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date\">date</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck11.png)\" id=\"item.Section5FitnessAndLifestyle\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / </span>Section5FitnessAndLifestyle</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Section 5 – Fitness and lifestyle</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.StairsWithoutStoppingNow\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>StairsWithoutStoppingNow</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">1. What can you do without stopping or getting breathless?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.StairsWithoutStoppingNow\">4 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.ManageAroundHouse\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>ManageAroundHouse</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">2. Can you manage around the house?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.ManageAroundHouse\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.ChangedInLast6Months\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>ChangedInLast6Months</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">3. Has this changed in the last 6 months?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.ChangedInLast6Months\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.StairsWithoutStopping6MonthsAgo\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>StairsWithoutStopping6MonthsAgo</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, what could you do without stopping or getting breathless 6 months ago?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.ChangedInLast6Months\">ChangedInLast6Months</a> = Yes (yes)</span><br/>Options: <a href=\"#opt-item.StairsWithoutStopping6MonthsAgo\">4 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.WhatStopsWalking\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-text.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>WhatStopsWalking</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">4. What stops or restricts you from walking now? (e.g. getting breathless, pain in joints, pain in calf muscles)</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.DoYouSmoke\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>DoYouSmoke</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">5. Do you smoke?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.DoYouSmoke\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.SmokeHowManyPerDay\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-integer.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>SmokeHowManyPerDay</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">How many per day?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.DoYouSmoke\">DoYouSmoke</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.EverSmoked\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>EverSmoked</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">6. Have you ever smoked?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.EverSmoked\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.WhenDidYouStopSmoking\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>WhenDidYouStopSmoking</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If so, when did you stop?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.EverSmoked\">EverSmoked</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.DrinkAlcoholRegularly\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>DrinkAlcoholRegularly</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">7. Do you drink alcohol regularly?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.DrinkAlcoholRegularly\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.AlcoholHowMuchPerWeek\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>AlcoholHowMuchPerWeek</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">How much per week?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.DrinkAlcoholRegularly\">DrinkAlcoholRegularly</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.PregnantOrMayBePregnant\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>PregnantOrMayBePregnant</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">8. Are you or do you think you may be pregnant?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.PregnantOrMayBePregnant\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck100.png)\" id=\"item.PregnancyWeeks\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-integer.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>PregnancyWeeks</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes – how many weeks?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.PregnantOrMayBePregnant\">PregnantOrMayBePregnant</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck11.png)\" id=\"item.Section6Allergies\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / </span>Section6Allergies</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Section 6 – Allergies</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.AllergiesOrReactions\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section6Allergies / </span>AllergiesOrReactions</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">1. Allergies or reactions to medicines (sticking plasters, food, paint, latex / rubber products or x-ray dye)?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.AllergiesOrReactions\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck100.png)\" id=\"item.AllergiesDescription\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-text.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section6Allergies / </span>AllergiesDescription</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Please describe what happens to you:</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.AllergiesOrReactions\">AllergiesOrReactions</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck11.png)\" id=\"item.Section7Medications\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / </span>Section7Medications</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Section 7 – Medications</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck101.png)\" id=\"item.MedicationsGroup\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-group.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section7Medications / </span>MedicationsGroup</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Medication / Therapy</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..*</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck1010.png)\" id=\"item.MedicationName\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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_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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section7Medications / MedicationsGroup / </span>MedicationName</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Name of Medication/Therapy</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck1010.png)\" id=\"item.MedicationHowMuch\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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_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-string.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section7Medications / MedicationsGroup / </span>MedicationHowMuch</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">How much?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck1000.png)\" id=\"item.MedicationHowOften\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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_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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section7Medications / MedicationsGroup / </span>MedicationHowOften</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">How often each day? (Breakfast, lunch, tea)</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck11.png)\" id=\"item.Section8PreviousSurgeryAnaesthesia\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / </span>Section8PreviousSurgeryAnaesthesia</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Section 8 – Previous surgery / anaesthesia</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.PreviousSurgeryOrAdmission\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section8PreviousSurgeryAnaesthesia / </span>PreviousSurgeryOrAdmission</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">1. Have you ever had surgery or been admitted to hospital before? (Including day surgery)</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.PreviousSurgeryOrAdmission\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck101.png)\" id=\"item.PreviousSurgeryGroup\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-group.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section8PreviousSurgeryAnaesthesia / </span>PreviousSurgeryGroup</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, when, what for and what hospital was that in?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..*</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.PreviousSurgeryOrAdmission\">PreviousSurgeryOrAdmission</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck1010.png)\" id=\"item.PreviousSurgeryOperationIllness\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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_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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section8PreviousSurgeryAnaesthesia / PreviousSurgeryGroup / </span>PreviousSurgeryOperationIllness</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Operation / Illness</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck1010.png)\" id=\"item.PreviousSurgeryYear\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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_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-string.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section8PreviousSurgeryAnaesthesia / PreviousSurgeryGroup / </span>PreviousSurgeryYear</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Year</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck1000.png)\" id=\"item.PreviousSurgeryHospital\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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_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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section8PreviousSurgeryAnaesthesia / PreviousSurgeryGroup / </span>PreviousSurgeryHospital</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Hospital</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck11.png)\" id=\"item.Section9AnaesthesiaRelatedIssues\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / </span>Section9AnaesthesiaRelatedIssues</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Section 9 – Anaesthesia related issues</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.ProblemsUnderAnaesthetic\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section9AnaesthesiaRelatedIssues / </span>ProblemsUnderAnaesthetic</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">1. Have you had any problems while under an anaesthetic?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.ProblemsUnderAnaesthetic\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.ProblemsUnderAnaestheticComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section9AnaesthesiaRelatedIssues / </span>ProblemsUnderAnaestheticComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">(e.g. slow to wake, nausea and vomiting, post surgery confusion, agitation)</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.ProblemsUnderAnaesthetic\">ProblemsUnderAnaesthetic</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.RelativeProblemsUnderAnaesthetic\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section9AnaesthesiaRelatedIssues / </span>RelativeProblemsUnderAnaesthetic</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">2. Has any blood relative had problems while under an anaesthetic?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.RelativeProblemsUnderAnaesthetic\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.RelativeProblemsUnderAnaestheticComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section9AnaesthesiaRelatedIssues / </span>RelativeProblemsUnderAnaestheticComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.RelativeProblemsUnderAnaesthetic\">RelativeProblemsUnderAnaesthetic</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.AttendedPreAnaesthesiaAssessment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section9AnaesthesiaRelatedIssues / </span>AttendedPreAnaesthesiaAssessment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">3. Have you attended a pre-anaesthesia assessment before?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.AttendedPreAnaesthesiaAssessment\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck100.png)\" id=\"item.AttendedPreAnaesthesiaAssessmentLastTime\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section9AnaesthesiaRelatedIssues / </span>AttendedPreAnaesthesiaAssessmentLastTime</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">When was the last time?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.AttendedPreAnaesthesiaAssessment\">AttendedPreAnaesthesiaAssessment</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck11.png)\" id=\"item.Section10DischargePlanning\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / </span>Section10DischargePlanning</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Section 10 – Discharge planning</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.RequirePhysicalSupportOrAids\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>RequirePhysicalSupportOrAids</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">1. Do you require any physical support or aids?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.RequirePhysicalSupportOrAids\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.RequirePhysicalSupportOrAidsDetails\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>RequirePhysicalSupportOrAidsDetails</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If so what?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.RequirePhysicalSupportOrAids\">RequirePhysicalSupportOrAids</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.LiveAlone\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>LiveAlone</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">2. Do you live alone?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.LiveAlone\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.LiveAloneComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>LiveAloneComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.LiveAlone\">LiveAlone</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.ProblemsWithDailyActivities\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>ProblemsWithDailyActivities</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">3. Do you have any problems with daily activities?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.ProblemsWithDailyActivities\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.ProblemsWithDailyActivitiesComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>ProblemsWithDailyActivitiesComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">(e.g. showering, bathing, dressing)</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.ProblemsWithDailyActivities\">ProblemsWithDailyActivities</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.WhoWillTakeYouHome\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>WhoWillTakeYouHome</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">4. Who will be taking you home?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.WhoWillTakeYouHome\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.WhoWillTakeYouHomeComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>WhoWillTakeYouHomeComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.WhoWillTakeYouHome\">WhoWillTakeYouHome</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.SomeoneToStayOvernight\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>SomeoneToStayOvernight</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">5. Do you have someone to stay overnight with you when you get home?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.SomeoneToStayOvernight\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.SomeoneToStayOvernightComment\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-text.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>SomeoneToStayOvernightComment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If yes, or not certain, please comment</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.SomeoneToStayOvernight\">SomeoneToStayOvernight</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.UsingCommunitySupportServices\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>UsingCommunitySupportServices</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">6. Are you currently using any community support services?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.UsingCommunitySupportServices\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.CommunitySupportServicesList\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>CommunitySupportServicesList</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If so please list:</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.UsingCommunitySupportServices\">UsingCommunitySupportServices</a> = Yes (yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.SpeakUnderstandEnglish\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>SpeakUnderstandEnglish</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">7. Do you speak and understand English?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Options: <a href=\"#opt-item.SpeakUnderstandEnglish\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck110.png)\" id=\"item.FirstLanguage\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>FirstLanguage</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">If not, what is your first language?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.SpeakUnderstandEnglish\">SpeakUnderstandEnglish</a> = No (no)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck100.png)\" id=\"item.AnythingToDiscuss\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-text.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>AnythingToDiscuss</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">8. Is there anything in particular you would like to discuss?</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01.png)\" id=\"item.Section11PatientDeclaration\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / </span>Section11PatientDeclaration</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Section 11 – Patient declaration</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck010.png)\" id=\"item.DeclarationStatement\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-display.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"display\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section11PatientDeclaration / </span>DeclarationStatement</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">The above health information is a true and accurate account of my health status.</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display\">display</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck010.png)\" id=\"item.PatientSignature\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-string.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section11PatientDeclaration / </span>PatientSignature</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Patient's signature</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck000.png)\" id=\"item.DeclarationDate\" class=\"hierarchy xhtCellBorder1 xhtCellNoWrap\"><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-date.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"date\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">RespiratoryAdultHealthQuestionnaire / Section11PatientDeclaration / </span>DeclarationDate</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Date</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">0..1</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date\">date</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr><td colspan=\"6\" 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.HappyToLeaveMessage\"> </a><p><b>Answer options for HappyToLeaveMessage </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.MessageWithPerson\"> </a><p><b>Answer options for MessageWithPerson </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.MessageOnAnswerPhone\"> </a><p><b>Answer options for MessageOnAnswerPhone </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.PreAnaesthesiaRequirements\"> </a><p><b>Answer options for PreAnaesthesiaRequirements </b></p><ul><li style=\"font-size: 11px\">null#nurse-telephone-call (&quot;Nurse telephone call&quot;)</li><li style=\"font-size: 11px\">null#routine (&quot;Routine&quot;)</li><li style=\"font-size: 11px\">null#complex (&quot;Complex&quot;)</li><li style=\"font-size: 11px\">null#high-risk (&quot;High risk&quot;)</li><li style=\"font-size: 11px\">null#paediatric-specialist (&quot;Paediatric specialist&quot;)</li></ul><a name=\"opt-item.HighBloodPressure\"> </a><p><b>Answer options for HighBloodPressure </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.HeartConditions\"> </a><p><b>Answer options for HeartConditions </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.HeartLungSurgery\"> </a><p><b>Answer options for HeartLungSurgery </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.ICDorPacemaker\"> </a><p><b>Answer options for ICDorPacemaker </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.ShortnessOfBreathAtNight\"> </a><p><b>Answer options for ShortnessOfBreathAtNight </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.BlackoutsOrFainting\"> </a><p><b>Answer options for BlackoutsOrFainting </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.SwollenAnkles\"> </a><p><b>Answer options for SwollenAnkles </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.BreathingDifficulties\"> </a><p><b>Answer options for BreathingDifficulties </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.SteroidsForBreathing\"> </a><p><b>Answer options for SteroidsForBreathing </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.SleepApnoea\"> </a><p><b>Answer options for SleepApnoea </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.KidneyCondition\"> </a><p><b>Answer options for KidneyCondition </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.Diabetes\"> </a><p><b>Answer options for Diabetes </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.DiabetesType\"> </a><p><b>Answer options for DiabetesType </b></p><ul><li style=\"font-size: 11px\">null#type-1 (&quot;Type 1&quot;)</li><li style=\"font-size: 11px\">null#type-2 (&quot;Type 2&quot;)</li></ul><a name=\"opt-item.DiabetesManagement\"> </a><p><b>Answer options for DiabetesManagement </b></p><ul><li style=\"font-size: 11px\">null#insulin (&quot;Insulin&quot;)</li><li style=\"font-size: 11px\">null#tablets (&quot;Tablets&quot;)</li><li style=\"font-size: 11px\">null#diet-control (&quot;Diet control&quot;)</li></ul><a name=\"opt-item.Stroke\"> </a><p><b>Answer options for Stroke </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.SuddenLossVisionSpeechMovement\"> </a><p><b>Answer options for SuddenLossVisionSpeechMovement </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.BloodClotsOrBleedingDisorder\"> </a><p><b>Answer options for BloodClotsOrBleedingDisorder </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.HeartburnRefluxHiatusHernia\"> </a><p><b>Answer options for HeartburnRefluxHiatusHernia </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.ThyroidProblems\"> </a><p><b>Answer options for ThyroidProblems </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.Dementia\"> </a><p><b>Answer options for Dementia </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.Epilepsy\"> </a><p><b>Answer options for Epilepsy </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.Arthritis\"> </a><p><b>Answer options for Arthritis </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.JointReplacementOrMetalware\"> </a><p><b>Answer options for JointReplacementOrMetalware </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.MuscleOrNeurologicalDisease\"> </a><p><b>Answer options for MuscleOrNeurologicalDisease </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.JawOrNeckProblems\"> </a><p><b>Answer options for JawOrNeckProblems </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.HepatitisOrLiverCondition\"> </a><p><b>Answer options for HepatitisOrLiverCondition </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.TransmittableDisease\"> </a><p><b>Answer options for TransmittableDisease </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.Tuberculosis\"> </a><p><b>Answer options for Tuberculosis </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.FamilyConditions\"> </a><p><b>Answer options for FamilyConditions </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.Anaemia\"> </a><p><b>Answer options for Anaemia </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.PreviousBloodTransfusion\"> </a><p><b>Answer options for PreviousBloodTransfusion </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.BloodTransfusionRefusal\"> </a><p><b>Answer options for BloodTransfusionRefusal </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.Phobias\"> </a><p><b>Answer options for Phobias </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.TravelledOverseas\"> </a><p><b>Answer options for TravelledOverseas </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.VisualOrHearingImpairment\"> </a><p><b>Answer options for VisualOrHearingImpairment </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.CurrentPainProblems\"> </a><p><b>Answer options for CurrentPainProblems </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.StairsWithoutStoppingNow\"> </a><p><b>Answer options for StairsWithoutStoppingNow </b></p><ul><li style=\"font-size: 11px\">null#10-stairs (&quot;10 stairs&quot;)</li><li style=\"font-size: 11px\">null#20-stairs (&quot;20 stairs&quot;)</li><li style=\"font-size: 11px\">null#30-stairs (&quot;30 stairs&quot;)</li><li style=\"font-size: 11px\">null#40-stairs (&quot;40 stairs&quot;)</li></ul><a name=\"opt-item.ManageAroundHouse\"> </a><p><b>Answer options for ManageAroundHouse </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.ChangedInLast6Months\"> </a><p><b>Answer options for ChangedInLast6Months </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.StairsWithoutStopping6MonthsAgo\"> </a><p><b>Answer options for StairsWithoutStopping6MonthsAgo </b></p><ul><li style=\"font-size: 11px\">null#10-stairs (&quot;10 stairs&quot;)</li><li style=\"font-size: 11px\">null#20-stairs (&quot;20 stairs&quot;)</li><li style=\"font-size: 11px\">null#30-stairs (&quot;30 stairs&quot;)</li><li style=\"font-size: 11px\">null#40-stairs (&quot;40 stairs&quot;)</li></ul><a name=\"opt-item.DoYouSmoke\"> </a><p><b>Answer options for DoYouSmoke </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.EverSmoked\"> </a><p><b>Answer options for EverSmoked </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.DrinkAlcoholRegularly\"> </a><p><b>Answer options for DrinkAlcoholRegularly </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.PregnantOrMayBePregnant\"> </a><p><b>Answer options for PregnantOrMayBePregnant </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.AllergiesOrReactions\"> </a><p><b>Answer options for AllergiesOrReactions </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.PreviousSurgeryOrAdmission\"> </a><p><b>Answer options for PreviousSurgeryOrAdmission </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.ProblemsUnderAnaesthetic\"> </a><p><b>Answer options for ProblemsUnderAnaesthetic </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.RelativeProblemsUnderAnaesthetic\"> </a><p><b>Answer options for RelativeProblemsUnderAnaesthetic </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.AttendedPreAnaesthesiaAssessment\"> </a><p><b>Answer options for AttendedPreAnaesthesiaAssessment </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.RequirePhysicalSupportOrAids\"> </a><p><b>Answer options for RequirePhysicalSupportOrAids </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.LiveAlone\"> </a><p><b>Answer options for LiveAlone </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.ProblemsWithDailyActivities\"> </a><p><b>Answer options for ProblemsWithDailyActivities </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.WhoWillTakeYouHome\"> </a><p><b>Answer options for WhoWillTakeYouHome </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.SomeoneToStayOvernight\"> </a><p><b>Answer options for SomeoneToStayOvernight </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.UsingCommunitySupportServices\"> </a><p><b>Answer options for UsingCommunitySupportServices </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul><a name=\"opt-item.SpeakUnderstandEnglish\"> </a><p><b>Answer options for SpeakUnderstandEnglish </b></p><ul><li style=\"font-size: 11px\">null#yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">null#no (&quot;No&quot;)</li></ul></div>"
  },
  "url" : "https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/RespiratoryAdultHealthQuestionnaire",
  "identifier" : [
    {
      "use" : "official",
      "value" : "RespiratoryAdultHealthQuestionnaire"
    }
  ],
  "version" : "1.0.0",
  "name" : "RespiratoryAdultHealthQuestionnaire",
  "title" : "Adult Health Questionnaire for EBUS",
  "_title" : {
    "extension" : [
      {
        "url" : "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
        "valueString" : "<div><h1 style=\"margin:0 0 12px 0;font-size:30px;line-height:1.2;color:#007d8a;font-weight:700;\">Adult Health Questionnaire for EBUS</h1><div style=\"margin:0 0 18px 0;padding:12px 16px;background-color:#f0f9fa;border-left:4px solid #007d8a;border-radius:4px;\"><p style=\"margin:0 0 4px 0;font-size:18px;line-height:1.4;color:#005f68;font-weight:700;\">Proposed surgery / procedure: Endobronchial Ultrasound (EBUS)</p><p style=\"margin:0;font-size:15px;line-height:1.5;color:#5f6b76;\">Please complete this questionnaire before your procedure. The information helps the Respiratory Service and the anaesthetic team assess your health and plan your care safely.</p></div></div>"
      }
    ]
  },
  "status" : "active",
  "subjectType" : [
    "Patient"
  ],
  "date" : "2026-10-19T00:00:00.000Z",
  "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 respiratory procedure health assessment",
  "useContext" : [
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus",
        "display" : "Clinical Focus"
      },
      "valueCodeableConcept" : {
        "text" : "M65 Respiratory Medicine"
      }
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "NZ",
          "display" : "New Zealand"
        }
      ]
    }
  ],
  "purpose" : "Respiratory procedure health assessment",
  "item" : [
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
          "valueBoolean" : true
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-claims-extract",
          "valueString" : "specialtyCode"
        }
      ],
      "linkId" : "meta-specialty-code",
      "text" : "Specialty Code",
      "type" : "string",
      "required" : false,
      "initial" : [
        {
          "valueString" : "M65"
        }
      ]
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
          "valueBoolean" : true
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-claims-extract",
          "valueString" : "specialtyName"
        }
      ],
      "linkId" : "meta-specialty-name",
      "text" : "Specialty Name",
      "type" : "string",
      "required" : false,
      "initial" : [
        {
          "valueString" : "Respiratory Medicine"
        }
      ]
    },
    {
      "linkId" : "Section0PatientID",
      "text" : "Patient ID",
      "type" : "group",
      "item" : [
        {
          "linkId" : "Surname",
          "text" : "Surname",
          "type" : "string",
          "required" : false
        },
        {
          "linkId" : "FirstNames",
          "text" : "First Names",
          "type" : "string",
          "required" : false
        },
        {
          "linkId" : "NHI",
          "text" : "NHI",
          "type" : "string",
          "required" : false
        },
        {
          "linkId" : "DateOfBirth",
          "text" : "Date of Birth",
          "type" : "date",
          "required" : false
        },
        {
          "linkId" : "Sex",
          "text" : "Sex",
          "type" : "string",
          "required" : false
        }
      ]
    },
    {
      "linkId" : "Section1PatientDetails",
      "text" : "Section 1 – Patient details",
      "type" : "group",
      "item" : [
        {
          "linkId" : "TodaysDate",
          "text" : "Today's date",
          "type" : "date",
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/minValue",
              "valueInteger" : 0
            }
          ],
          "linkId" : "Height",
          "text" : "Your height (cm)",
          "type" : "decimal",
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/minValue",
              "valueInteger" : 0
            }
          ],
          "linkId" : "Weight",
          "text" : "Your weight (kg)",
          "type" : "decimal",
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/minValue",
              "valueInteger" : 0
            }
          ],
          "linkId" : "BMI",
          "text" : "BMI",
          "type" : "decimal",
          "required" : false
        },
        {
          "linkId" : "ProposedProcedure",
          "text" : "Proposed surgery / procedure",
          "type" : "string",
          "required" : false,
          "initial" : [
            {
              "valueString" : "Endobronchial Ultrasound (EBUS)"
            }
          ]
        },
        {
          "linkId" : "ContactDetailsGroup",
          "text" : "If a phone call is required for further information relating to this questionnaire, please provide details on how we can contact you.",
          "type" : "group",
          "item" : [
            {
              "linkId" : "ContactHomePhone",
              "text" : "Home phone",
              "type" : "string",
              "required" : false
            },
            {
              "linkId" : "ContactWorkPhone",
              "text" : "Work phone",
              "type" : "string",
              "required" : false
            },
            {
              "linkId" : "ContactMobilePhone",
              "text" : "Mobile phone",
              "type" : "string",
              "required" : false
            },
            {
              "linkId" : "ContactEmail",
              "text" : "Email",
              "type" : "string",
              "required" : false
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "HappyToLeaveMessage",
          "text" : "Are you happy for us to leave a message?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "MessageWithPerson",
          "text" : "With a person?",
          "type" : "choice",
          "enableWhen" : [
            {
              "question" : "HappyToLeaveMessage",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "MessageWithPersonName",
          "text" : "If yes, please give person's name",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "HappyToLeaveMessage",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "question" : "MessageWithPerson",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "enableBehavior" : "all",
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "MessageOnAnswerPhone",
          "text" : "On answer phone?",
          "type" : "choice",
          "enableWhen" : [
            {
              "question" : "HappyToLeaveMessage",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "BestTimeToCall",
          "text" : "When is the best time for you to receive telephone calls from staff?",
          "type" : "string",
          "required" : false
        }
      ]
    },
    {
      "linkId" : "Section2DHBUseOnly",
      "text" : "Section 2 – Capital and Coast DHB use only",
      "type" : "group",
      "item" : [
        {
          "linkId" : "AssessorName",
          "text" : "Name",
          "type" : "string",
          "required" : false
        },
        {
          "linkId" : "AssessorPosition",
          "text" : "Position",
          "type" : "string",
          "required" : false
        },
        {
          "linkId" : "AssessmentDate",
          "text" : "Date",
          "type" : "date",
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "check-box",
                    "display" : "Check-box"
                  }
                ]
              }
            }
          ],
          "linkId" : "PreAnaesthesiaRequirements",
          "text" : "Pre-anaesthesia Requirements",
          "type" : "choice",
          "required" : false,
          "repeats" : true,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "nurse-telephone-call",
                "display" : "Nurse telephone call"
              }
            },
            {
              "valueCoding" : {
                "code" : "routine",
                "display" : "Routine"
              }
            },
            {
              "valueCoding" : {
                "code" : "complex",
                "display" : "Complex"
              }
            },
            {
              "valueCoding" : {
                "code" : "high-risk",
                "display" : "High risk"
              }
            },
            {
              "valueCoding" : {
                "code" : "paediatric-specialist",
                "display" : "Paediatric specialist"
              }
            }
          ]
        }
      ]
    },
    {
      "linkId" : "Section3MedicalConditions",
      "text" : "Section 3 – Medical conditions",
      "type" : "group",
      "item" : [
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "HighBloodPressure",
          "text" : "1. High blood pressure?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "HighBloodPressureBPAtClinic",
          "text" : "BP at clinic",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "HighBloodPressure",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "HeartConditions",
          "text" : "2. Heart conditions (e.g. heart murmur, valve disease, chest pain or discomfort, angina, palpitations or irregular heart beat)?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "HeartConditionsComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "text",
          "enableWhen" : [
            {
              "question" : "HeartConditions",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "HeartLungSurgery",
          "text" : "3. Heart/Lung surgery?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "HeartLungSurgeryComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "HeartLungSurgery",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "ICDorPacemaker",
          "text" : "4. Implanted cardiac defibrillator (ICD) or Pacemaker?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "ICDorPacemakerLastChecked",
          "text" : "When was it last checked?",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "ICDorPacemaker",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "ShortnessOfBreathAtNight",
          "text" : "5. Shortness of breath at night?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "ShortnessOfBreathAtNightComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "ShortnessOfBreathAtNight",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "BlackoutsOrFainting",
          "text" : "6. Blackouts or fainting?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "BlackoutsOrFaintingCircumstances",
          "text" : "Under what circumstances?",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "BlackoutsOrFainting",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "SwollenAnkles",
          "text" : "7. Swollen ankles?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "SwollenAnklesComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "SwollenAnkles",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "BreathingDifficulties",
          "text" : "8. Breathing difficulties (e.g. asthma, emphysema, C.O.R.D., bronchitis)?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "BreathingDifficultiesComment",
          "text" : "(Please bring peak flow recordings with you if available)",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "BreathingDifficulties",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "SteroidsForBreathing",
          "text" : "9. Have you taken steroids for your breathing difficulty in the past 5 years?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "SteroidsForBreathingLastCourse",
          "text" : "When was the last course?",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "SteroidsForBreathing",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "SleepApnoea",
          "text" : "10. Sleep apnoea (or have you been told you stop breathing while asleep)?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "SleepApnoeaComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "text",
          "enableWhen" : [
            {
              "question" : "SleepApnoea",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "KidneyCondition",
          "text" : "11. Kidney (Renal) condition?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "KidneyConditionComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "KidneyCondition",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "Diabetes",
          "text" : "12. Diabetes?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "DiabetesType",
          "text" : "Please tick which type",
          "type" : "choice",
          "enableWhen" : [
            {
              "question" : "Diabetes",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "type-1",
                "display" : "Type 1"
              }
            },
            {
              "valueCoding" : {
                "code" : "type-2",
                "display" : "Type 2"
              }
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "check-box",
                    "display" : "Check-box"
                  }
                ]
              }
            }
          ],
          "linkId" : "DiabetesManagement",
          "text" : "Do you currently use (please tick):",
          "type" : "choice",
          "enableWhen" : [
            {
              "question" : "Diabetes",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false,
          "repeats" : true,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "insulin",
                "display" : "Insulin"
              }
            },
            {
              "valueCoding" : {
                "code" : "tablets",
                "display" : "Tablets"
              }
            },
            {
              "valueCoding" : {
                "code" : "diet-control",
                "display" : "Diet control"
              }
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "Stroke",
          "text" : "13. Stroke (Cerebrovascular accident or CVA)?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "StrokeComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "text",
          "enableWhen" : [
            {
              "question" : "Stroke",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "SuddenLossVisionSpeechMovement",
          "text" : "14. Sudden loss of vision, speech or movement?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "SuddenLossVisionSpeechMovementComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "SuddenLossVisionSpeechMovement",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "BloodClotsOrBleedingDisorder",
          "text" : "15. Blood clots in lungs or legs or a bleeding disorder (PE, DVT, thrombosis)?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "BloodClotsOrBleedingDisorderComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "text",
          "enableWhen" : [
            {
              "question" : "BloodClotsOrBleedingDisorder",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "HeartburnRefluxHiatusHernia",
          "text" : "16. Heartburn/reflux of acid/hiatus hernia?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "HeartburnRefluxHiatusHerniaComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "HeartburnRefluxHiatusHernia",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "ThyroidProblems",
          "text" : "17. Thyroid problems?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "ThyroidProblemsComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "ThyroidProblems",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "Dementia",
          "text" : "18. Dementia? (e.g. Alzheimer's, forgetfulness)",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "DementiaComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "text",
          "enableWhen" : [
            {
              "question" : "Dementia",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "Epilepsy",
          "text" : "19. Epilepsy?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "EpilepsySeizureFrequency",
          "text" : "How often do you have seizures?",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "Epilepsy",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "linkId" : "EpilepsyLastSeizure",
          "text" : "When was your last seizure?",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "Epilepsy",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "Arthritis",
          "text" : "20. Arthritis?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "ArthritisComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "Arthritis",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "JointReplacementOrMetalware",
          "text" : "21. Joint replacement or orthopaedic metalware?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "JointReplacementOrMetalwareType",
          "text" : "What type?",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "JointReplacementOrMetalware",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "MuscleOrNeurologicalDisease",
          "text" : "22. Muscle or Neurological disease (e.g. MS, Parkinson's, Muscular dystrophy)?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "MuscleOrNeurologicalDiseaseComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "text",
          "enableWhen" : [
            {
              "question" : "MuscleOrNeurologicalDisease",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "JawOrNeckProblems",
          "text" : "23. Jaw or neck problems?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "JawOrNeckProblemsComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "JawOrNeckProblems",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "HepatitisOrLiverCondition",
          "text" : "24. Hepatitis A, B, C, jaundice or liver condition?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "HepatitisOrLiverConditionComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "HepatitisOrLiverCondition",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "TransmittableDisease",
          "text" : "25. Transmittable disease (such as MRSA, 'golden staph', boils, skin or other infection, septicaemia, HIV, VRSA)?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "TransmittableDiseaseComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "text",
          "enableWhen" : [
            {
              "question" : "TransmittableDisease",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "Tuberculosis",
          "text" : "26. Tuberculosis (TB)?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "TuberculosisTreatment",
          "text" : "Have you had or are you on treatment for this?",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "Tuberculosis",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "FamilyConditions",
          "text" : "27. Are there any conditions that run in your family? (e.g. malignant hyperthermia, thalassaemia, muscular dystrophy)?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "FamilyConditionsComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "text",
          "enableWhen" : [
            {
              "question" : "FamilyConditions",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "Anaemia",
          "text" : "28. Anaemia?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "AnaemiaComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "Anaemia",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "PreviousBloodTransfusion",
          "text" : "29. Previous blood transfusion?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "PreviousBloodTransfusionComment",
          "text" : "When was the last?",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "PreviousBloodTransfusion",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "BloodTransfusionRefusal",
          "text" : "30. Do you have any reasons which might stop you from accepting a blood transfusion?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "BloodTransfusionRefusalComment",
          "text" : "What was the reason?",
          "type" : "text",
          "enableWhen" : [
            {
              "question" : "BloodTransfusionRefusal",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "Phobias",
          "text" : "31. Phobias (e.g. claustrophobia, anxiety attacks)?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "PhobiasComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "text",
          "enableWhen" : [
            {
              "question" : "Phobias",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "TravelledOverseas",
          "text" : "32. Travelled overseas in the last 6 months?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "TravelledOverseasHospitalised",
          "text" : "Were you hospitalised?",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "TravelledOverseas",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false,
          "repeats" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "VisualOrHearingImpairment",
          "text" : "33. A visual or hearing impairment?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "VisualOrHearingImpairmentComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "VisualOrHearingImpairment",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "CurrentPainProblems",
          "text" : "34. Do you have any current pain problems?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "CurrentPainProblemsLocation",
          "text" : "What is the location of the pain?",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "CurrentPainProblems",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "text-box",
                    "display" : "Text Box"
                  }
                ]
              }
            }
          ],
          "linkId" : "OtherRelevantMedicalCondition",
          "text" : "35. Is there any other relevant medical condition that you need to tell us about?",
          "type" : "text",
          "required" : false
        }
      ]
    },
    {
      "linkId" : "Section4HealthProfessionals",
      "text" : "Section 4 – Health professionals",
      "type" : "group",
      "item" : [
        {
          "linkId" : "HealthProfessionalsGroup",
          "text" : "List the name(s) of the hospital/clinic/doctors/surgeons/nurses you see.",
          "type" : "group",
          "repeats" : true,
          "item" : [
            {
              "linkId" : "HealthProfessionalName",
              "text" : "Doctor's name",
              "type" : "string",
              "required" : false
            },
            {
              "linkId" : "HealthProfessionalReason",
              "text" : "Reason you see this doctor",
              "type" : "string",
              "required" : false
            },
            {
              "linkId" : "HealthProfessionalLastVisit",
              "text" : "Date of last visit",
              "type" : "date",
              "required" : false
            }
          ]
        }
      ]
    },
    {
      "linkId" : "Section5FitnessAndLifestyle",
      "text" : "Section 5 – Fitness and lifestyle",
      "type" : "group",
      "item" : [
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "StairsWithoutStoppingNow",
          "text" : "1. What can you do without stopping or getting breathless?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "10-stairs",
                "display" : "10 stairs"
              }
            },
            {
              "valueCoding" : {
                "code" : "20-stairs",
                "display" : "20 stairs"
              }
            },
            {
              "valueCoding" : {
                "code" : "30-stairs",
                "display" : "30 stairs"
              }
            },
            {
              "valueCoding" : {
                "code" : "40-stairs",
                "display" : "40 stairs"
              }
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "ManageAroundHouse",
          "text" : "2. Can you manage around the house?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "ChangedInLast6Months",
          "text" : "3. Has this changed in the last 6 months?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "StairsWithoutStopping6MonthsAgo",
          "text" : "If yes, what could you do without stopping or getting breathless 6 months ago?",
          "type" : "choice",
          "enableWhen" : [
            {
              "question" : "ChangedInLast6Months",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "10-stairs",
                "display" : "10 stairs"
              }
            },
            {
              "valueCoding" : {
                "code" : "20-stairs",
                "display" : "20 stairs"
              }
            },
            {
              "valueCoding" : {
                "code" : "30-stairs",
                "display" : "30 stairs"
              }
            },
            {
              "valueCoding" : {
                "code" : "40-stairs",
                "display" : "40 stairs"
              }
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "text-box",
                    "display" : "Text Box"
                  }
                ]
              }
            }
          ],
          "linkId" : "WhatStopsWalking",
          "text" : "4. What stops or restricts you from walking now? (e.g. getting breathless, pain in joints, pain in calf muscles)",
          "type" : "text",
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "DoYouSmoke",
          "text" : "5. Do you smoke?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/minValue",
              "valueInteger" : 0
            }
          ],
          "linkId" : "SmokeHowManyPerDay",
          "text" : "How many per day?",
          "type" : "integer",
          "enableWhen" : [
            {
              "question" : "DoYouSmoke",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
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            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
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                ]
              }
            }
          ],
          "linkId" : "EverSmoked",
          "text" : "6. Have you ever smoked?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "WhenDidYouStopSmoking",
          "text" : "If so, when did you stop?",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "EverSmoked",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
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            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
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                    "code" : "radio-button",
                    "display" : "Radio Button"
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                ]
              }
            }
          ],
          "linkId" : "DrinkAlcoholRegularly",
          "text" : "7. Do you drink alcohol regularly?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "AlcoholHowMuchPerWeek",
          "text" : "How much per week?",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "DrinkAlcoholRegularly",
              "operator" : "=",
              "answerCoding" : {
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            }
          ],
          "required" : false
        },
        {
          "extension" : [
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              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "PregnantOrMayBePregnant",
          "text" : "8. Are you or do you think you may be pregnant?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
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          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/minValue",
              "valueInteger" : 0
            }
          ],
          "linkId" : "PregnancyWeeks",
          "text" : "If yes – how many weeks?",
          "type" : "integer",
          "enableWhen" : [
            {
              "question" : "PregnantOrMayBePregnant",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        }
      ]
    },
    {
      "linkId" : "Section6Allergies",
      "text" : "Section 6 – Allergies",
      "type" : "group",
      "item" : [
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
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                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "AllergiesOrReactions",
          "text" : "1. Allergies or reactions to medicines (sticking plasters, food, paint, latex / rubber products or x-ray dye)?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "text-box",
                    "display" : "Text Box"
                  }
                ]
              }
            }
          ],
          "linkId" : "AllergiesDescription",
          "text" : "Please describe what happens to you:",
          "type" : "text",
          "enableWhen" : [
            {
              "question" : "AllergiesOrReactions",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
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              }
            }
          ],
          "required" : false
        }
      ]
    },
    {
      "linkId" : "Section7Medications",
      "text" : "Section 7 – Medications",
      "type" : "group",
      "item" : [
        {
          "linkId" : "MedicationsGroup",
          "text" : "Medication / Therapy",
          "type" : "group",
          "repeats" : true,
          "item" : [
            {
              "linkId" : "MedicationName",
              "text" : "Name of Medication/Therapy",
              "type" : "string",
              "required" : false
            },
            {
              "linkId" : "MedicationHowMuch",
              "text" : "How much?",
              "type" : "string",
              "required" : false
            },
            {
              "linkId" : "MedicationHowOften",
              "text" : "How often each day? (Breakfast, lunch, tea)",
              "type" : "string",
              "required" : false
            }
          ]
        }
      ]
    },
    {
      "linkId" : "Section8PreviousSurgeryAnaesthesia",
      "text" : "Section 8 – Previous surgery / anaesthesia",
      "type" : "group",
      "item" : [
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
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                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "PreviousSurgeryOrAdmission",
          "text" : "1. Have you ever had surgery or been admitted to hospital before? (Including day surgery)",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "PreviousSurgeryGroup",
          "text" : "If yes, when, what for and what hospital was that in?",
          "type" : "group",
          "enableWhen" : [
            {
              "question" : "PreviousSurgeryOrAdmission",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
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            }
          ],
          "repeats" : true,
          "item" : [
            {
              "linkId" : "PreviousSurgeryOperationIllness",
              "text" : "Operation / Illness",
              "type" : "string",
              "required" : false
            },
            {
              "linkId" : "PreviousSurgeryYear",
              "text" : "Year",
              "type" : "string",
              "required" : false
            },
            {
              "linkId" : "PreviousSurgeryHospital",
              "text" : "Hospital",
              "type" : "string",
              "required" : false
            }
          ]
        }
      ]
    },
    {
      "linkId" : "Section9AnaesthesiaRelatedIssues",
      "text" : "Section 9 – Anaesthesia related issues",
      "type" : "group",
      "item" : [
        {
          "extension" : [
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              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
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                    "code" : "radio-button",
                    "display" : "Radio Button"
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                ]
              }
            }
          ],
          "linkId" : "ProblemsUnderAnaesthetic",
          "text" : "1. Have you had any problems while under an anaesthetic?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "ProblemsUnderAnaestheticComment",
          "text" : "(e.g. slow to wake, nausea and vomiting, post surgery confusion, agitation)",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "ProblemsUnderAnaesthetic",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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                    "display" : "Radio Button"
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                ]
              }
            }
          ],
          "linkId" : "RelativeProblemsUnderAnaesthetic",
          "text" : "2. Has any blood relative had problems while under an anaesthetic?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "RelativeProblemsUnderAnaestheticComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "RelativeProblemsUnderAnaesthetic",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
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            }
          ],
          "required" : false
        },
        {
          "extension" : [
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              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
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                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
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                ]
              }
            }
          ],
          "linkId" : "AttendedPreAnaesthesiaAssessment",
          "text" : "3. Have you attended a pre-anaesthesia assessment before?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "AttendedPreAnaesthesiaAssessmentLastTime",
          "text" : "When was the last time?",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "AttendedPreAnaesthesiaAssessment",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
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            }
          ],
          "required" : false
        }
      ]
    },
    {
      "linkId" : "Section10DischargePlanning",
      "text" : "Section 10 – Discharge planning",
      "type" : "group",
      "item" : [
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
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                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
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                ]
              }
            }
          ],
          "linkId" : "RequirePhysicalSupportOrAids",
          "text" : "1. Do you require any physical support or aids?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "RequirePhysicalSupportOrAidsDetails",
          "text" : "If so what?",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "RequirePhysicalSupportOrAids",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
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          ],
          "required" : false
        },
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              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
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                ]
              }
            }
          ],
          "linkId" : "LiveAlone",
          "text" : "2. Do you live alone?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
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            }
          ]
        },
        {
          "linkId" : "LiveAloneComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "LiveAlone",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
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            }
          ],
          "required" : false
        },
        {
          "extension" : [
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              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
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                ]
              }
            }
          ],
          "linkId" : "ProblemsWithDailyActivities",
          "text" : "3. Do you have any problems with daily activities?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "ProblemsWithDailyActivitiesComment",
          "text" : "(e.g. showering, bathing, dressing)",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "ProblemsWithDailyActivities",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
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            }
          ],
          "required" : false
        },
        {
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              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
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                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "WhoWillTakeYouHome",
          "text" : "4. Who will be taking you home?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "WhoWillTakeYouHomeComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "WhoWillTakeYouHome",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
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            }
          ]
        },
        {
          "extension" : [
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              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
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                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "SomeoneToStayOvernight",
          "text" : "5. Do you have someone to stay overnight with you when you get home?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "SomeoneToStayOvernightComment",
          "text" : "If yes, or not certain, please comment",
          "type" : "text",
          "enableWhen" : [
            {
              "question" : "SomeoneToStayOvernight",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
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            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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                "coding" : [
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                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "UsingCommunitySupportServices",
          "text" : "6. Are you currently using any community support services?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "CommunitySupportServicesList",
          "text" : "If so please list:",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "UsingCommunitySupportServices",
              "operator" : "=",
              "answerCoding" : {
                "code" : "yes",
                "display" : "Yes"
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            }
          ],
          "required" : false
        },
        {
          "extension" : [
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              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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                "coding" : [
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                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "radio-button",
                    "display" : "Radio Button"
                  }
                ]
              }
            }
          ],
          "linkId" : "SpeakUnderstandEnglish",
          "text" : "7. Do you speak and understand English?",
          "type" : "choice",
          "required" : false,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "yes",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "code" : "no",
                "display" : "No"
              }
            }
          ]
        },
        {
          "linkId" : "FirstLanguage",
          "text" : "If not, what is your first language?",
          "type" : "string",
          "enableWhen" : [
            {
              "question" : "SpeakUnderstandEnglish",
              "operator" : "=",
              "answerCoding" : {
                "code" : "no",
                "display" : "No"
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            }
          ],
          "required" : false
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
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                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "text-box",
                    "display" : "Text Box"
                  }
                ]
              }
            }
          ],
          "linkId" : "AnythingToDiscuss",
          "text" : "8. Is there anything in particular you would like to discuss?",
          "type" : "text",
          "required" : false
        }
      ]
    },
    {
      "linkId" : "Section11PatientDeclaration",
      "text" : "Section 11 – Patient declaration",
      "type" : "group",
      "item" : [
        {
          "linkId" : "DeclarationStatement",
          "text" : "The above health information is a true and accurate account of my health status.",
          "type" : "display"
        },
        {
          "linkId" : "PatientSignature",
          "text" : "Patient's signature",
          "type" : "string",
          "required" : false
        },
        {
          "linkId" : "DeclarationDate",
          "text" : "Date",
          "type" : "date",
          "required" : false
        }
      ]
    }
  ]
}