<?xml version="1.0" encoding="UTF-8"?>

<ServiceRequest xmlns="http://hl7.org/fhir">
  <id value="physiotherapy"/>
  <contained>
    <Provenance>
      <id value="signature"/>
      <target>
        <reference value="ServiceRequest/physiotherapy/_history/1"/>
      </target>
      <recorded value="2017-02-01T17:23:07Z"/>
      <agent>
        <role>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/v3-ParticipationType"/>
            <code value="AUT"/>
          </coding>
        </role>
        <who>
          <reference value="Practitioner/example"/>
          <display value="Dr Adam Careful"/>
        </who>
      </agent>
      <signature>
        <type>
          <system value="urn:iso-astm:E1762-95:2013"/>
          <code value="1.2.840.10065.1.12.1.1"/>
          <display value="Author's Signature"/>
        </type>
        <when value="2017-02-01T17:23:07Z"/>
        <who>
          <reference value="Practitioner/example"/>
          <display value="Dr Adam Careful"/>
        </who>
        <targetFormat value="application/fhir+xml"/>
        <sigFormat value="application/signature+xml"/>
        <data value="dGhpcyBibG9iIGlzIHNuaXBwZWQ="/>
      </signature>
    </Provenance>
  </contained>
  <contained>
    <Condition>
      <id value="cystic-fibrosis"/>
      <clinicalStatus>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
          <code value="active"/>
        </coding>
      </clinicalStatus>
      <verificationStatus>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
          <code value="confirmed"/>
        </coding>
      </verificationStatus>
      <category>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/condition-category"/>
          <code value="problem-list-item"/>
          <display value="Problem List Item"/>
        </coding>
      </category>
      <severity>
        <coding>
          <system value="http://snomed.info/sct"/>
          <code value="255604002"/>
          <display value="Mild"/>
        </coding>
      </severity>
      <code>
        <coding>
          <system value="http://hl7.org/fhir/sid/icd-10-cm"/>
          <code value="E84.0"/>
          <display value="Cystic fibrosis with pulmonary manifestations"/>
        </coding>
        <text value="Cystic Fibrosis"/>
      </code>
      <subject>
        <reference value="Patient/example"/>
      </subject>
      <onsetDateTime value="2012-11-12"/>
    </Condition>
  </contained>
  <identifier>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="PLAC"/>
        <display value="Placer Identifier"/>
      </coding>
      <text value="Placer"/>
    </type>
    <system value="http://goodhealth.org/placer-ids"/>
    <value value="20170201-0001"/>
  </identifier>
  <!--   example to show how a CarePlan can be referenced from a request  -->
  <basedOn>
    <reference value="CarePlan/gpvisit"/>
  </basedOn>
  <status value="completed"/>
  <intent value="order"/>
  <!--  Physiotherapy or home excercises would be a common use case for as needed. E.g. exercises for cystic fibrosis - "Chest therapy 1-4 times per day as needed to clear mucus"  -->
  <code>
    <concept>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="34431008"/>
        <display value="Physiotherapy of chest (regime/therapy)"/>
      </coding>
    </concept>
  </code>
  <subject>
    <reference value="Patient/example"/>
  </subject>
  <occurrenceTiming>
    <repeat>
      <duration value="15"/>
      <durationMax value="25"/>
      <durationUnit value="min"/>
      <frequency value="1"/>
      <frequencyMax value="4"/>
      <period value="1"/>
      <periodUnit value="d"/>
    </repeat>
  </occurrenceTiming>
  <!--  TimeStamp when order authorized -->
  <authoredOn value="2017-02-01T17:23:07Z"/>
  <requester>
    <reference value="Practitioner/example"/>
    <display value="Dr Adam Careful"/>
  </requester>
  <!--  demonstrating in this example the reason reference element using a contained resource for the purpose of this example only typically would reference an external resource -->
  <reason>
    <reference>
      <reference value="#cystic-fibrosis"/>
    </reference>
  </reason>
  <!--  demonstrating in this example the relevant history element using a contained resource for the purpose of this example only typically would reference an external resource -->
  <relevantHistory>
    <reference value="#signature"/>
    <display value="Author's Signature"/>
  </relevantHistory>
</ServiceRequest>