{
  "description": null,
  "_filename": "example/Questionnaire-30551ce1-5a28-4356-b684-2e639094ad4c.json",
  "package_name": "hl7.fhir.be.pss",
  "date": "2025-05-14T10:44:40+02:00",
  "meta": {
    "profile": [ "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/PSSDataAcquisitionForm" ]
  },
  "publisher": "eHealth Platform",
  "jurisdiction": [ {
    "coding": [ {
      "code": "BE",
      "system": "urn:iso:std:iso:3166",
      "display": "Belgium"
    } ]
  } ],
  "name": null,
  "item": [ {
    "text": "Oorzakelijke kiem vulvo-vaginitis",
    "type": "choice",
    "_text": {
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "fr-BE"
        }, {
          "url": "content",
          "valueString": "Germe causal vulvo vaginite"
        } ]
      } ]
    },
    "linkId": "sp_excMand_knownPathogen_vag",
    "repeats": false,
    "required": true,
    "answerOption": [ {
      "extension": [ {
        "url": "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
        "valueCanonical": "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/CandidaCodes"
      } ],
      "valueCoding": {
        "code": "pv_candida_vag",
        "display": "Candida vaginitis",
        "_display": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/translation",
            "extension": [ {
              "url": "lang",
              "valueCode": "fr-BE"
            }, {
              "url": "content",
              "valueString": "Vaginite à candida"
            } ]
          } ]
        }
      }
    }, {
      "extension": [ {
        "url": "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
        "valueCanonical": "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/TrichomonasCodes"
      } ],
      "valueCoding": {
        "code": "pv_trichomonas_vag",
        "display": "Trichomonas vaginalis",
        "_display": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/translation",
            "extension": [ {
              "url": "lang",
              "valueCode": "fr-BE"
            }, {
              "url": "content",
              "valueString": "Trichomonas vaginalis"
            } ]
          } ]
        }
      }
    }, {
      "extension": [ {
        "url": "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
        "valueCanonical": "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/BacterialCodes"
      } ],
      "valueCoding": {
        "code": "pv_bacterial_vag",
        "display": "Bacteriële vaginose",
        "_display": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/translation",
            "extension": [ {
              "url": "lang",
              "valueCode": "fr-BE"
            }, {
              "url": "content",
              "valueString": "Vaginose bactérienne"
            } ]
          } ]
        }
      }
    } ]
  }, {
    "text": "Zwangerschap",
    "type": "boolean",
    "_text": {
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "fr-BE"
        }, {
          "url": "content",
          "valueString": "Grossesse"
        } ]
      } ]
    },
    "linkId": "pv_pregnant",
    "extension": [ {
      "url": "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
      "valueCanonical": "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/PregnancyCodes"
    } ]
  }, {
    "text": "Oorzakelijke kiem Urethritis",
    "type": "choice",
    "_text": {
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "fr-BE"
        }, {
          "url": "content",
          "valueString": "Germe causal Urétrite"
        } ]
      } ]
    },
    "linkId": "sp_exc_causalPathogen_ure",
    "repeats": false,
    "answerOption": [ {
      "extension": [ {
        "url": "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
        "valueCanonical": "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/ChlamydiaCodes"
      } ],
      "valueCoding": {
        "code": "pv_causalPatChlamydia_ure",
        "display": "Chlamydia",
        "_display": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/translation",
            "extension": [ {
              "url": "lang",
              "valueCode": "fr-BE"
            }, {
              "url": "content",
              "valueString": "Chlamydia"
            } ]
          } ]
        }
      }
    }, {
      "extension": [ {
        "url": "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
        "valueCanonical": "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/GonokokCodes"
      } ],
      "valueCoding": {
        "code": "pv_causalPatGonokok_ure",
        "display": "Gonokok",
        "_display": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/translation",
            "extension": [ {
              "url": "lang",
              "valueCode": "fr-BE"
            }, {
              "url": "content",
              "valueString": "Gonocoque"
            } ]
          } ]
        }
      }
    }, {
      "extension": [ {
        "url": "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
        "valueCanonical": "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/MycoplasmaCodes"
      } ],
      "valueCoding": {
        "code": "pv_causalPatMycoplasma_ure",
        "display": "Mycoplasma genitalium",
        "_display": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/translation",
            "extension": [ {
              "url": "lang",
              "valueCode": "fr-BE"
            }, {
              "url": "content",
              "valueString": "Mycoplasma genitalium"
            } ]
          } ]
        }
      }
    }, {
      "extension": [ {
        "url": "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
        "valueCanonical": "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/OtherCodes"
      } ],
      "valueCoding": {
        "code": "pv_causalPatOther_ure",
        "display": "Andere",
        "_display": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/translation",
            "extension": [ {
              "url": "lang",
              "valueCode": "fr-BE"
            }, {
              "url": "content",
              "valueString": "Autres"
            } ]
          } ]
        }
      }
    } ]
  }, {
    "item": [ {
      "text": "Gecompromitteerd immuunsysteem",
      "type": "boolean",
      "_text": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "fr-BE"
          }, {
            "url": "content",
            "valueString": "Immunosuppression / système immunitaire déprimé"
          } ]
        } ]
      },
      "linkId": "pv_compromisedImmuneSystem",
      "extension": [ {
        "url": "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
        "valueCanonical": "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/CompromisedImmuneSystemCodes"
      } ]
    }, {
      "text": "Oncologische patiënt",
      "type": "boolean",
      "_text": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "fr-BE"
          }, {
            "url": "content",
            "valueString": "Patient oncologique"
          } ]
        } ]
      },
      "linkId": "pv_oncologyPatient",
      "extension": [ {
        "url": "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
        "valueCanonical": "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/OncologyPatientCodes"
      } ]
    } ],
    "text": "Risicopatiënt",
    "type": "boolean",
    "_text": {
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "fr-BE"
        }, {
          "url": "content",
          "valueString": "Patient à risque"
        } ]
      } ]
    },
    "linkId": "sp_riskPatient_ast"
  } ],
  "type": null,
  "experimental": null,
  "resourceType": "Questionnaire",
  "title": null,
  "package_version": "1.0.0",
  "status": "active",
  "language": "nl-BE",
  "id": "3ce3c168-c2f6-44b1-bb8c-04de999295f5",
  "kind": null,
  "url": "https://www.ehealth.fgov.be/standards/fhir/pss/Questionnaire/30551ce1-5a28-4356-b684-2e639094ad4c",
  "identifier": [ {
    "value": "urn:oid:2.16.840.1.113883.2.51.22.2.35.1",
    "system": "urn:ietf:rfc:3986"
  } ],
  "version": "1.0.0",
  "contact": [ {
    "name": "eHealth Platform",
    "telecom": [ {
      "value": "http://www.ehealth.fgov.be/",
      "system": "url"
    }, {
      "value": "support@be-ehealth-standards.atlassian.net",
      "system": "email"
    } ]
  }, {
    "name": "Message Structure",
    "telecom": [ {
      "use": "work",
      "value": "support@be-ehealth-standards.atlassian.net",
      "system": "email"
    } ]
  } ]
}