{
  "description": "Additional Mental Health referral information completed by Hospital Staff and shared as part of a Supported Hospital Discharge with third parties",
  "_filename": "examples/Questionnaire-example-duplicate-2.json",
  "package_name": "supportedhospitaldischarge.stu3",
  "subjectType": [ "Patient" ],
  "date": "2021-08-25T17:00:00Z",
  "publisher": "NottsCC",
  "purpose": "Additional Mental Health referral information completed by Hospital Staff and shared as part of a Supported Hospital Discharge with third parties",
  "name": "SHD-Questionnaire-AdditionalMHReferralInformation",
  "item": [ {
    "item": [ {
      "text": "Ward Manager / Named Nurse",
      "type": "text",
      "linkId": "1.1",
      "required": false
    }, {
      "text": "Ward Telephone Number",
      "type": "text",
      "linkId": "1.2",
      "required": false
    }, {
      "text": "MH Act Legal Status (e.g. DOLs Requirement, Section 117 Eligible, Section 2, Section 3, CTO, CTR listed, Informal Patient who is no longer detained, etc)",
      "type": "text",
      "linkId": "1.3",
      "required": false
    }, {
      "text": "Provide any communication needs (e.g. sign language, braille, interpreter required)",
      "type": "text",
      "linkId": "1.4",
      "required": false
    }, {
      "text": "Provide details of any relevent Safeguarding Requirements",
      "type": "text",
      "linkId": "1.5",
      "required": false
    }, {
      "text": "Has the patient been involved/agreed in the referral for assessment? If not provide details of why not",
      "type": "text",
      "linkId": "1.6",
      "required": false
    }, {
      "text": "Does the patient have capacity for the referral? If not provide details",
      "type": "text",
      "linkId": "1.7",
      "required": false
    }, {
      "text": "What involvement have any carers had in the referral?  Also provide details of any additional/informal carers other than the primary named carer",
      "type": "text",
      "linkId": "1.8",
      "required": false
    }, {
      "text": "Provide details of any advocacy requirement",
      "type": "text",
      "linkId": "1.9",
      "required": false
    }, {
      "text": "Any other information relevant to the referral",
      "type": "text",
      "linkId": "1.10",
      "required": false
    } ],
    "text": "Additional Mental Health Supported Discharge Referral Information",
    "type": "group",
    "linkId": "1",
    "required": false
  } ],
  "type": null,
  "experimental": null,
  "resourceType": "Questionnaire",
  "title": "SHD-Questionnaire-AdditionalMHReferralInformation",
  "package_version": "0.1.5",
  "status": "draft",
  "id": "fcf5ac7f-2fa1-41a1-a4aa-60e1f8de3bc7",
  "kind": null,
  "url": "https://fhir.nottinghamshire.gov.uk/STU3/Questionnaire/SHD-Questionnaire-AdditionalMHReferralInformation",
  "version": "0.0.1"
}