{
  "description": "Example of a Questionnaire for an ANC Quick Check",
  "_filename": "Questionnaire-anc-quick-check.json",
  "package_name": "hl7.fhir.uv.cpg.r4b",
  "subjectType": [ "Patient" ],
  "date": "2023-12-19T19:53:17+00:00",
  "publisher": "HL7 International / Clinical Decision Support",
  "jurisdiction": [ {
    "coding": [ {
      "code": "001",
      "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "display": "World"
    } ]
  } ],
  "name": "ANCQuickCheck",
  "item": [ {
    "text": "Why did you come?",
    "type": "choice",
    "linkId": "reason-for-visit",
    "extension": [ {
      "url": "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource",
      "valueCanonical": "http://hl7.org/fhir/uv/cpg/ValueSet/anc-reason-for-visit-vs"
    }, {
      "url": "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-itemImage",
      "valueAttachment": {
        "url": "http://example.org/images/reason-for-visit.png"
      }
    } ],
    "answerOption": [ {
      "extension": [ {
        "url": "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-responseImage",
        "valueAttachment": {
          "url": "http://example.org/images/reason-for-visit-routine.png"
        }
      } ],
      "valueString": "For a scheduled (routine) visit"
    }, {
      "extension": [ {
        "url": "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-responseImage",
        "valueAttachment": {
          "url": "http://example.org/images/reason-for-visit-specific-complaint.png"
        }
      } ],
      "valueString": "For specific complaints about you or your baby"
    }, {
      "extension": [ {
        "url": "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-responseImage",
        "valueAttachment": {
          "url": "http://example.org/images/reason-for-visit-first.png"
        }
      } ],
      "valueString": "First visit"
    }, {
      "extension": [ {
        "url": "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-responseImage",
        "valueAttachment": {
          "url": "http://example.org/images/reason-for-visit-follow-up.png"
        }
      } ],
      "valueString": "Follow-up visit"
    }, {
      "extension": [ {
        "url": "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-responseImage",
        "valueAttachment": {
          "url": "http://example.org/images/reason-for-visit-include-family-member.png"
        }
      } ],
      "valueString": "Do you want to include your companion or other family member (parent if adolescent) in the examination and discussion?"
    } ]
  } ],
  "type": null,
  "experimental": null,
  "resourceType": "Questionnaire",
  "title": "Questionnaire - ANC Quick Check",
  "package_version": "2.0.0-ballot",
  "extension": [ {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode": "cds"
  } ],
  "status": "active",
  "id": "40ecdc16-45ec-4b00-afba-d9f84fecaa6c",
  "kind": null,
  "url": "http://hl7.org/fhir/uv/cpg/Questionnaire/anc-quick-check",
  "version": "2.0.0-ballot",
  "contact": [ {
    "name": "HL7 International / Clinical Decision Support",
    "telecom": [ {
      "value": "http://www.hl7.org/Special/committees/dss",
      "system": "url"
    } ]
  } ]
}