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Resource "zika-virus-exposure-assessment" Version "1" (Questionnaire)

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XML or JSON representation. Try out the Questionnaire as a web form . provenance for this resource

      

<?xml version="1.0" encoding="UTF-8"?>
<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="zika-virus-exposure-assessment"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2018-09-06T12:38:08.937Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <pre> </pre> </div>
  </text>
  <url value="http://example.org/Questionnaire/zika-virus-exposure-assessment"/>
  <name value="ExampleZikaVirusExposureAssessment"/>
  <title value="Example Zika Virus Exposure Assessment"/>
  <status value="draft"/>
  <date value="2016-11-14"/>
  <description value="Example questionnaire to assess Zika virus exposure potential."/>
  <effectivePeriod>
    <start value="2016-11-14"/>
  </effectivePeriod>
  <subjectType value="Patient"/>
  <item>
    <extension url="http://example.org/additional-information">
      <valueAttachment>
        <url value="http://www.cdc.gov/zika/geo/index.html"/>
        <title value="Areas with active Zika virus transmission/exposure risk"/>
      </valueAttachment>
    </extension>
    <linkId value="1"/>
    <code>
      <system value="http://example.org/questionnaires"/>
      <code value="CDE: Resident of or Frequent Traveler to Zika Area"/>
    </code>
    <text value="Are you a resident of, or do you travel frequently to, an area with active Zika transmission?"/>
    <type value="boolean"/>
  </item>
  <item>
    <extension url="http://example.org/additional-information">
      <valueAttachment>
        <url value="http://www.cdc.gov/zika/geo/index.html"/>
        <title value="Areas with active Zika virus transmission/exposure risk"/>
      </valueAttachment>
    </extension>
    <linkId value="2"/>
    <code>
      <system value="http://example.org/questionnaires"/>
      <code value="CDE: Recent Travel to Zika Area"/>
    </code>
    <text value="Have you recently traveled to a an area with active Zika transmission?"/>
    <type value="boolean"/>
    <enableWhen>
      <question value="1"/>
      <answerBoolean value="false"/>
    </enableWhen>
  </item>
  <item>
    <linkId value="3"/>
    <code>
      <system value="http://example.org/questionnaires"/>
      <code value="CDE: Time Since Returned From Travel"/>
    </code>
    <text value="How long has it been since you returned?"/>
    <type value="quantity"/>
    <enableWhen>
      <question value="2"/>
      <answerBoolean value="true"/>
    </enableWhen>
  </item>
  <item>
    <extension url="http://example.org/additional-information">
      <valueAttachment>
        <url value="http://www.cdc.gov/zika/geo/index.html"/>
        <title value="Areas with active Zika virus transmission/exposure risk"/>
      </valueAttachment>
    </extension>
    <linkId value="4"/>
    <code>
      <system value="http://example.org/questionnaires"/>
      <code value="CDE: Recent Sexual Encounter with Traveler to Zika Area"/>
    </code>
    <text value="Have you recently had condomless sex with a partner that has travelled in an area with active Zika transmission?"/>
    <type value="boolean"/>
    <enableWhen>
      <question value="2"/>
      <answerBoolean value="false"/>
    </enableWhen>
  </item>
  <item>
    <linkId value="5"/>
    <code>
      <system value="http://example.org/questionnaires"/>
      <code value="CDE: Time Since Sexual Encounter"/>
    </code>
    <text value="How long has it been since your last condomless sexual encounter?"/>
    <type value="quantity"/>
    <enableWhen>
      <question value="4"/>
      <answerBoolean value="true"/>
    </enableWhen>
  </item>
  <item>
    <extension url="http://example.org/additional-information">
      <valueAttachment>
        <url value="http://www.cdc.gov/zika/geo/index.html"/>
        <title value="Areas with active Zika virus transmission/exposure risk"/>
      </valueAttachment>
    </extension>
    <linkId value="6"/>
    <code>
      <system value="http://example.org/questionnaires"/>
      <code value="CDE: Planned Travel to Zika Area"/>
    </code>
    <text value="Do you plan to travel to an area with active Zika transmission?"/>
    <type value="boolean"/>
    <enableWhen>
      <question value="4"/>
      <answerBoolean value="false"/>
    </enableWhen>
  </item>
</Questionnaire>