{
  "description": null,
  "_filename": "examples/b2e24662-0ee1-4c95-9088-7be895d97c99.json",
  "package_name": "ca.on.health.sadie",
  "subjectType": [ "Patient" ],
  "date": null,
  "meta": {
    "source": "#oeo1MGn2qKLKeyQY",
    "profile": [ "http://health.gov.on.ca/sadie/fhir/StructureDefinition/FlexForm" ],
    "versionId": "11",
    "lastUpdated": "2021-12-06T20:49:00+00:00"
  },
  "publisher": "ODSP",
  "name": "ODSP_Additional_Medical_Information",
  "item": [ {
    "item": [ {
      "item": [ {
        "text": "Do you have a \"Consent to the Release of Medical and Related Information\" form to attach?",
        "type": "boolean",
        "linkId": "0.0.1",
        "repeats": false,
        "readOnly": false,
        "required": true
      }, {
        "linkId": "0.0.1-attachment",
        "repeats": false,
        "item": [ {
          "text": "Attachment Categories",
          "type": "choice",
          "linkId": "0.0.1-categories",
          "repeats": false,
          "readOnly": false,
          "required": false,
          "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-AttachmentCategories"
        }, {
          "type": "string",
          "linkId": "0.0.1-DocumentType",
          "initial": [ {
            "valueString": "DDP"
          } ],
          "repeats": false,
          "readOnly": false,
          "required": false,
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
            "valueBoolean": true
          } ]
        }, {
          "type": "string",
          "linkId": "0.0.1-DocumentSubType",
          "initial": [ {
            "valueString": "Consent"
          } ],
          "repeats": false,
          "readOnly": false,
          "required": false,
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
            "valueBoolean": true
          } ]
        } ],
        "type": "attachment",
        "enableWhen": [ {
          "operator": "=",
          "question": "0.0.1",
          "answerBoolean": true
        } ],
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "application/vnd.openxmlformats-officedocument.wordprocessingml.document"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "application/msword"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "application/rtf"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "image/tiff"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "application/pdf"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "image/gif"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/maxSize",
          "valueDecimal": 10
        } ],
        "readOnly": false,
        "required": true,
        "text": "Attachments"
      }, {
        "text": "Do you have any medical information you wish to attach?",
        "type": "boolean",
        "linkId": "0.1.1",
        "repeats": false,
        "readOnly": false,
        "required": true
      }, {
        "linkId": "0.1.1-attachment",
        "repeats": true,
        "item": [ {
          "text": "Attachment Categories",
          "type": "choice",
          "linkId": "0.1.1-categories",
          "repeats": false,
          "readOnly": false,
          "required": false,
          "answerValueSet": "http://health.on.ca/sadie/fhir/ValueSet/HSR-AttachmentCategories"
        }, {
          "type": "string",
          "linkId": "0.1.1-DocumentType",
          "initial": [ {
            "valueString": "AMI"
          } ],
          "repeats": false,
          "readOnly": false,
          "required": false,
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
            "valueBoolean": true
          } ]
        }, {
          "type": "string",
          "linkId": "0.1.1-DocumentSubType",
          "initial": [ {
            "valueString": "Regular or IR AMI"
          } ],
          "repeats": false,
          "readOnly": false,
          "required": false,
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
            "valueBoolean": true
          } ]
        } ],
        "type": "attachment",
        "enableWhen": [ {
          "operator": "=",
          "question": "0.1.1",
          "answerBoolean": true
        } ],
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "application/vnd.openxmlformats-officedocument.wordprocessingml.document"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "application/msword"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "application/rtf"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "image/tiff"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "application/pdf"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "image/gif"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/maxSize",
          "valueDecimal": 10
        } ],
        "readOnly": false,
        "required": true,
        "text": "Attachments"
      }, {
        "enableBehavior": "any",
        "linkId": "0.1.2",
        "repeats": false,
        "type": "text",
        "enableWhen": [ {
          "operator": "=",
          "question": "0.0.1",
          "answerBoolean": true
        }, {
          "operator": "=",
          "question": "0.1.1",
          "answerBoolean": true
        } ],
        "readOnly": false,
        "maxLength": 2000,
        "required": false,
        "text": "Notes"
      }, {
        "enableBehavior": "all",
        "linkId": "0.1.3",
        "repeats": false,
        "type": "text",
        "enableWhen": [ {
          "operator": "=",
          "question": "0.0.1",
          "answerBoolean": false
        }, {
          "operator": "=",
          "question": "0.1.1",
          "answerBoolean": false
        } ],
        "readOnly": false,
        "maxLength": 2000,
        "required": true,
        "text": "Notes"
      } ],
      "text": "Additional Medical Information",
      "type": "group",
      "linkId": "0.1",
      "repeats": false,
      "readOnly": false,
      "required": false
    } ],
    "text": "Additional Medical Information",
    "type": "group",
    "linkId": "0",
    "repeats": false,
    "readOnly": false,
    "required": false,
    "extension": [ {
      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
      "valueCodeableConcept": {
        "text": "Header",
        "coding": [ {
          "code": "header",
          "system": "http://hl7.org/fhir/questionnaire-item-control",
          "display": "Header"
        } ]
      }
    } ]
  } ],
  "type": null,
  "experimental": "false",
  "resourceType": "Questionnaire",
  "title": "Additional Medical Information",
  "package_version": "1.0.13",
  "status": "draft",
  "id": "592c8865-bc33-4481-bb41-3a6269268d9d",
  "kind": null,
  "url": "http://health.gov.on.ca/sadie/fhir/FlexForm/ODSP",
  "code": [ {
    "code": "DocumentType",
    "system": "https://health.gov.on.ca/sadie/fhir/CodeSystem/FlexForms-Internal-Complete",
    "display": "DDP"
  }, {
    "code": "DocumentSubType",
    "system": "https://health.gov.on.ca/sadie/fhir/CodeSystem/FlexForms-Internal-Complete",
    "display": "ADDITIONAL"
  } ],
  "identifier": [ {
    "use": "official",
    "value": "ODSP-ADDITIONAL",
    "system": "https://health.gov.on.ca/sadie/fhir/CodeSystem/FlexForms-Internal-Complete"
  } ],
  "version": "1.0.0",
  "effectivePeriod": {
    "start": "2021-01-01T05:00:00.000Z"
  }
}