{
  "description": "This questionnaire demonstrates all FHIR R4 item types that are supported by CHR",
  "_filename": "examples/Questionnaire-chr-on-west-Questionnaire-1001-AllTypes.json",
  "package_name": "telus.dw.emr.extract-1-1-21",
  "date": "2024-12-08",
  "meta": {
    "source": "urn:telus:emr:chr:on-west",
    "profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwQuestionnaire" ],
    "lastUpdated": "2024-12-08T10:00:00Z"
  },
  "publisher": "TELUS Health",
  "jurisdiction": [ {
    "coding": [ {
      "code": "CA",
      "system": "urn:iso:std:iso:3166",
      "display": "Canada"
    } ]
  } ],
  "purpose": "To demonstrate and document all FHIR R4 item types supported by CHR FormTemplates and Questionnaires for integration with external FHIR-compliant systems",
  "name": "AllSupportedItemTypes",
  "item": [ {
    "text": "Patient Demographics Section",
    "type": "display",
    "linkId": "section_header",
    "required": false
  }, {
    "text": "Patient Full Name",
    "type": "string",
    "linkId": "patient_name",
    "required": true
  }, {
    "text": "Please describe your medical history",
    "type": "text",
    "linkId": "medical_history",
    "required": false
  }, {
    "text": "Date of Birth",
    "type": "date",
    "linkId": "date_of_birth",
    "required": true
  }, {
    "text": "Preferred appointment time",
    "type": "time",
    "linkId": "appointment_time",
    "required": false
  }, {
    "text": "Do you have health insurance?",
    "type": "boolean",
    "linkId": "has_insurance",
    "required": true
  }, {
    "text": "Age (years)",
    "type": "integer",
    "linkId": "age_years",
    "required": true
  }, {
    "text": "Weight (kg)",
    "type": "decimal",
    "linkId": "weight_kg",
    "required": false
  }, {
    "text": "Gender",
    "type": "choice",
    "linkId": "gender",
    "repeats": false,
    "required": true,
    "answerOption": [ {
      "valueString": "Male"
    }, {
      "valueString": "Female"
    }, {
      "valueString": "Other"
    }, {
      "valueString": "Prefer not to say"
    } ]
  }, {
    "text": "Select all symptoms you are experiencing",
    "type": "choice",
    "linkId": "symptoms",
    "repeats": true,
    "required": false,
    "answerOption": [ {
      "valueString": "Fever"
    }, {
      "valueString": "Cough"
    }, {
      "valueString": "Shortness of breath"
    }, {
      "valueString": "Fatigue"
    }, {
      "valueString": "Headache"
    } ]
  }, {
    "text": "Rate your pain level (0 = no pain, 10 = worst pain)",
    "type": "choice",
    "linkId": "pain_scale",
    "repeats": false,
    "required": false,
    "answerOption": [ {
      "valueString": "0 - No pain"
    }, {
      "valueString": "1"
    }, {
      "valueString": "2"
    }, {
      "valueString": "3"
    }, {
      "valueString": "4"
    }, {
      "valueString": "5 - Moderate pain"
    }, {
      "valueString": "6"
    }, {
      "valueString": "7"
    }, {
      "valueString": "8"
    }, {
      "valueString": "9"
    }, {
      "valueString": "10 - Worst pain"
    } ]
  }, {
    "text": "Please provide insurance details",
    "type": "text",
    "linkId": "insurance_details",
    "required": false,
    "enableWhen": [ {
      "operator": "=",
      "question": "has_insurance",
      "answerBoolean": true
    } ],
    "enableBehavior": "any"
  }, {
    "item": [ {
      "text": "Medication Name",
      "type": "string",
      "linkId": "medication_name",
      "repeats": true,
      "required": false
    }, {
      "text": "Dosage",
      "type": "string",
      "linkId": "dosage",
      "repeats": true,
      "required": false
    }, {
      "text": "Frequency",
      "type": "string",
      "linkId": "frequency",
      "repeats": true,
      "required": false
    } ],
    "text": "Current Medications",
    "type": "group",
    "linkId": "medications_table",
    "required": false
  }, {
    "text": "Patient Signature",
    "type": "attachment",
    "linkId": "patient_signature",
    "required": true
  }, {
    "text": "Signature Date",
    "type": "date",
    "linkId": "signature_date",
    "required": true
  } ],
  "copyright": "Copyright © 2026 TELUS Health. All rights reserved.",
  "type": null,
  "experimental": null,
  "resourceType": "Questionnaire",
  "title": "CHR Questionnaire - All Supported Item Types",
  "package_version": "1.1.21",
  "status": "active",
  "id": "7eb9541e-e4ec-4104-a8e9-962454dc79b8",
  "kind": null,
  "url": "https://www.telus.com/health/fhir/dwemrextract/Questionnaire/chr-on-west-1001",
  "identifier": [ {
    "value": "1001",
    "system": "urn:telus:emr:chr:on-west:questionnaireid"
  } ],
  "version": "1.0",
  "contact": [ {
    "name": "TELUS Health",
    "telecom": [ {
      "value": "https://www.telus.com/health",
      "system": "url"
    } ]
  }, {
    "name": "TELUS Health",
    "telecom": [ {
      "value": "https://www.telus.com/health",
      "system": "url"
    } ]
  } ]
}