SDOHCC-QuestionnairePRAPARE
type: Questionnaire
node role: treeRoot
id:
  v: SDOHCC-QuestionnairePRAPARE
meta:
  profile:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap
    link: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap
language:
  v: en
text:
  status:
    v: extensions
  div: Generated Narrative: Questionnaire SDOHCC-QuestionnairePRAPARE Profile: Extractable Questionnaire - StructureMap Structure LinkID Text Cardinality Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> SDOHCCQuestionnairePRAPARE Questionnaire http://hl7.org/fhir/us/sdoh-clinicalcare/Questionnaire/SDOHCC-QuestionnairePRAPARE#3.0.0-draft #xD; /93025-5 Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE] 0..1 group #xD; /93043-8 Personal characteristics 0..1 group #xD; /93043-8/56051-6 Hispanic or Latino 0..1 choice Options: 3 options #xD; /93043-8/32624-9 Race 0..* choice Options: 8 options #xD; /93043-8/93035-4 Has season or migrant farm work been your or your family's main source of income at any point in past 2 years? 0..1 choice Options: 3 options #xD; /93043-8/93034-7 Have you been discharged from the armed forces of the United States? 0..1 choice Options: 3 options #xD; /93043-8/54899-0 Preferred language 0..1 choice Options: 3 options #xD; /93042-0 Family and home 0..1 group #xD; /93042-0/63512-8 How many people are living or staying at this address? 0..1 integer #xD; /93042-0/71802-3 Housing status 0..1 choice Options: 3 options #xD; /93042-0/71802-3-help Describes patients living arrangement 0..1 display #xD; /93042-0/93033-9 Are you worried about losing your housing? 0..1 choice Options: 3 options #xD; /93042-0/56799-0 Address 0..1 string #xD; /93041-2 Money and resources 0..1 group #xD; /93041-2/82589-3 Highest level of educ 0..1 choice Options: 4 options #xD; /93041-2/67875-5 Employment status current 0..1 choice Options: 5 options #xD; /93041-2/76437-3 Primary insurance 0..1 choice Options: 7 options #xD; /93041-2/63586-2 What was your best estimate of the total income of all family members from all sources, before taxes, in last year? 0..1 decimal #xD; /93041-2/93031-3 In the past year, have you or any family members you live with been unable to get any of the following when…
extension:
  url:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-targetStructureMap
  value: canonical
    v: http://hl7.org/fhir/us/sdoh-clinicalcare/StructureMap/SDOHCC-StructureMapPRAPARE
    link: http://hl7.org/fhir/us/sdoh-clinicalcare/StructureMap/SDOHCC-StructureMapPRAPARE
url:
  v: http://hl7.org/fhir/us/sdoh-clinicalcare/Questionnaire/SDOHCC-QuestionnairePRAPARE
version:
  v: 3.0.0-draft
name:
  v: SDOHCCQuestionnairePRAPARE
title:
  v: SDOHCC Questionnaire PRAPARE
status:
  v: draft
subject type:
  v: Patient
date:
  v: 2021-04-01T04:01:34+00:00
publisher:
  v: HL7 International / Patient Care
contact:
  name:
    v: HL7 International / Patient Care
  telecom:
    system:
      v: url
    value:
      v: http://www.hl7.org/Special/committees/patientcare
  telecom:
    system:
      v: email
jurisdiction:
  coding:
    system:
      v: urn:iso:std:iso:3166
    code:
      v: US
    display:
      v: United States of America
item:
  link id:
    v: /93025-5
  code: https://loinc.org/rdf/93025-5
    system:
      v: http://loinc.org
    code:
      v: 93025-5
    display:
      v: Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]
  text:
    v: Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]
  type:
    v: group
  required:
    v: false
  item:
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    code: https://loinc.org/rdf/93043-8
      system:
        v: http://loinc.org
      code:
        v: 93043-8
      display:
        v: Personal characteristics [PRAPARE]
    text:
      v: Personal characteristics
    type:
      v: group
    required:
      v: false
    item:
      extension:
        value: CodeableConcept
      link id:
        v: /93043-8/56051-6
      code: https://loinc.org/rdf/56051-6
      text:
        v: Hispanic or Latino
      type:
        v: choice
      required:
        v: false
      answer option:
        value: Coding
      answer option:
        value: Coding
      answer option:
        value: Coding
    item:
      extension:
        value: CodeableConcept
      link id:
        v: /93043-8/32624-9
      code: https://loinc.org/rdf/32624-9
      text:
        v: Race
      type:
        v: choice
      required:
        v: false
      repeats:
        v: true
      answer option:
        value: Coding
      answer option:
        value: Coding
      answer option:
        value: Coding
      answer option:
        value: Coding
      answer option:
        value: Coding
      answer option:
        value: Coding
      answer option:
        value: Coding
      answer option:
        value: Coding
    item:
      extension:
        value: CodeableConcept
      link id:
        v: /93043-8/93035-4
      code: https://loinc.org/rdf/93035-4
      text:
        v: Has season or migrant farm work been your or your family's main source of income at any point in past 2 years?
      type:
        v: choice
      required:
        v: false
      answer option:
        value: Coding
      answer option:
        value: Coding
      answer option:
        value: Coding
    item:
      extension:
        value: CodeableConcept
      link id:
        v: /93043-8/93034-7
      code: https://loinc.org/rdf/93034-7
      text:
        v: Have you been discharged from the armed forces of the United States?
      type:
        v: choice
      required:
        v: false
      answer option:
        value: Coding
      answer option:
        value: Coding
      answer option:
        value: Coding
    item:
      extension:
        value: CodeableConcept
      link id:
        v: /93043-8/54899-0
      code: https://loinc.org/rdf/54899-0
      text:
        v: Preferred language
      type:
        v: choice
      required:
        v: false
      answer option:
        value: Coding
      answer option:
        value: Coding
      answer option:
        value: Coding
  item:
    link id:
      v: /93042-0
    code: https://loinc.org/rdf/93042-0
      system:
        v: http://loinc.org
      code:
        v: 93042-0
      display:
        v: Family and home [PRAPARE]
    text:
      v: Family and home
    type:
      v: group

CodeableConcept
coding:
  system:
    v: http://hl7.org/fhir/questionnaire-item-control
  code:
    v: drop-down
  display:
    v: Drop down
text:
  v: Drop down

v: 56051-6

v: Hispanic or Latino

Coding
type: LA33-6
system:
  v: http://loinc.org
code:
  v: LA33-6
display:
  v: Yes

Coding
type: LA32-8
system:
  v: http://loinc.org
code:
  v: LA32-8
display:
  v: No

Coding
type: LA30122-8
system:
  v: http://loinc.org
code:
  v: LA30122-8
display:
  v: I choose not to answer this question

CodeableConcept
coding:
  system:
    v: http://hl7.org/fhir/questionnaire-item-control
  code:
    v: drop-down
  display:
    v: Drop down
text:
  v: Drop down

v: 32624-9

v: Race

Coding
type: LA6156-9
system:
  v: http://loinc.org
code:
  v: LA6156-9
display:
  v: Asian

Coding
type: LA14045-1
system:
  v: http://loinc.org
code:
  v: LA14045-1
display:
  v: Native Hawaiian

Coding
type: LA30187-1
system:
  v: http://loinc.org
code:
  v: LA30187-1
display:
  v: Pacific Islander

Coding
type: LA14042-8
system:
  v: http://loinc.org
code:
  v: LA14042-8
display:
  v: Black/African American

Coding
type: LA4457-3
system:
  v: http://loinc.org
code:
  v: LA4457-3
display:
  v: White

Coding
type: LA4-4
system:
  v: http://loinc.org
code:
  v: LA4-4
display:
  v: American Indian/Alaskan Native

Coding
type: LA46-8
system:
  v: http://loinc.org
code:
  v: LA46-8
display:
  v: Other

Coding
type: LA30122-8
system:
  v: http://loinc.org
code:
  v: LA30122-8
display:
  v: I choose not to answer this question

CodeableConcept
coding:
  system:
    v: http://hl7.org/fhir/questionnaire-item-control
  code:
    v: drop-down
  display:
    v: Drop down
text:
  v: Drop down

v: 93035-4

v: Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]

Coding
type: LA33-6
system:
  v: http://loinc.org
code:
  v: LA33-6
display:
  v: Yes

Coding
type: LA32-8
system:
  v: http://loinc.org
code:
  v: LA32-8
display:
  v: No

Coding
type: LA30122-8
system:
  v: http://loinc.org
code:
  v: LA30122-8
display:
  v: I choose not to answer this question

CodeableConcept
coding:
  system:
    v: http://hl7.org/fhir/questionnaire-item-control
  code:
    v: drop-down
  display:
    v: Drop down
text:
  v: Drop down

v: 93034-7

v: Discharged from the U.S. Armed Forces

Coding
type: LA33-6
system:
  v: http://loinc.org
code:
  v: LA33-6
display:
  v: Yes

Coding
type: LA32-8
system:
  v: http://loinc.org
code:
  v: LA32-8
display:
  v: No

Coding
type: LA30122-8
system:
  v: http://loinc.org
code:
  v: LA30122-8
display:
  v: I choose not to answer this question

CodeableConcept
coding:
  system:
    v: http://hl7.org/fhir/questionnaire-item-control
  code:
    v: drop-down
  display:
    v: Drop down
text:
  v: Drop down

v: 54899-0

v: Preferred language

Coding
type: LA43-5
system:
  v: http://loinc.org
code:
  v: LA43-5
display:
  v: English

Coding
type: LA30188-9
system:
  v: http://loinc.org
code:
  v: LA30188-9
display:
  v: Language other than English

Coding
type: LA30122-8
system:
  v: http://loinc.org
code:
  v: LA30122-8
display:
  v: I choose not to answer this question

v: false

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-unit
  value: Coding
    system:
      v: http://unitsofmeasure.org
    code:
      v: {#}
    display:
      v: {#}
link id:
  v: /93042-0/63512-8
code: https://loinc.org/rdf/63512-8
  system:
    v: http://loinc.org
  code:
    v: 63512-8
  display:
    v: How many people are living or staying at this address [#]
text:
  v: How many people are living or staying at this address?
type:
  v: integer
required:
  v: false

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
      code:
        v: drop-down
      display:
        v: Drop down
    text:
      v: Drop down
link id:
  v: /93042-0/71802-3
code: https://loinc.org/rdf/71802-3
  system:
    v: http://loinc.org
  code:
    v: 71802-3
  display:
    v: Housing status
text:
  v: Housing status
type:
  v: choice
required:
  v: false
answer option:
  value: Coding
    type: LA30189-7
    system:
      v: http://loinc.org
    code:
      v: LA30189-7
    display:
      v: I have housing
answer option:
  value: Coding
    type: LA30190-5
    system:
      v: http://loinc.org
    code:
      v: LA30190-5
    display:
      v: I do not have housing (staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, or in a park)
answer option:
  value: Coding
    type: LA30122-8
    system:
      v: http://loinc.org
    code:
      v: LA30122-8
    display:
      v: I choose not to answer this question
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
      text:
        v: Help-Button
  link id:
    v: /93042-0/71802-3-help
  text:
    v: Describes patients living arrangement
  type:
    v: display

v: help

v: Help-Button

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
      code:
        v: drop-down
      display:
        v: Drop down
    text:
      v: Drop down
link id:
  v: /93042-0/93033-9
code: https://loinc.org/rdf/93033-9
  system:
    v: http://loinc.org
  code:
    v: 93033-9
  display:
    v: Are you worried about losing your housing [PRAPARE]
text:
  v: Are you worried about losing your housing?
type:
  v: choice
required:
  v: false
answer option:
  value: Coding
    type: LA33-6
    system:
      v: http://loinc.org
    code:
      v: LA33-6
    display:
      v: Yes
answer option:
  value: Coding
    type: LA32-8
    system:
      v: http://loinc.org
    code:
      v: LA32-8
    display:
      v: No
answer option:
  value: Coding
    type: LA30122-8
    system:
      v: http://loinc.org
    code:
      v: LA30122-8
    display:
      v: I choose not to answer this question

link id:
  v: /93042-0/56799-0
code: https://loinc.org/rdf/56799-0
  system:
    v: http://loinc.org
  code:
    v: 56799-0
  display:
    v: Address
text:
  v: Address
type:
  v: string
required:
  v: false

link id:
  v: /93041-2
code: https://loinc.org/rdf/93041-2
  system:
    v: http://loinc.org
  code:
    v: 93041-2
  display:
    v: Money and resources [PRAPARE]
text:
  v: Money and resources
type:
  v: group
required:
  v: false
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
      text:
        v: Drop down
  link id:
    v: /93041-2/82589-3
  code: https://loinc.org/rdf/82589-3
    system:
      v: http://loinc.org
    code:
      v: 82589-3
    display:
      v: Highest level of educ
  text:
    v: Highest level of educ
  type:
    v: choice
  required:
    v: false
  answer option:
    value: Coding
      type: LA30191-3
      system:
        v: http://loinc.org
      code:
        v: LA30191-3
      display:
        v: Less than high school degree
  answer option:
    value: Coding
      type: LA30192-1
      system:
        v: http://loinc.org
      code:
        v: LA30192-1
      display:
        v: High school diploma or GED
  answer option:
    value: Coding
      type: LA30193-9
      system:
        v: http://loinc.org
      code:
        v: LA30193-9
      display:
        v: More than high school
  answer option:
    value: Coding
      type: LA30122-8
      system:
        v: http://loinc.org
      code:
        v: LA30122-8
      display:
        v: I choose not to answer this question
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
      text:
        v: Drop down
  link id:
    v: /93041-2/67875-5
  code: https://loinc.org/rdf/67875-5
    system:
      v: http://loinc.org
    code:
      v: 67875-5
    display:
      v: Employment status current
  text:
    v: Employment status current
  type:
    v: choice
  required:
    v: false
  answer option:
    value: Coding
      type: LA17956-6
      system:
        v: http://loinc.org
      code:
        v: LA17956-6
      display:
        v: Unemployed
  answer option:
    value: Coding
      type: LA30138-4
      system:
        v: http://loinc.org
      code:
        v: LA30138-4
      display:
        v: Part-time or temporary work
  answer option:
    value: Coding
      type: LA30136-8
      system:
        v: http://loinc.org
      code:
        v: LA30136-8
      display:
        v: Full-time work
  answer option:
    value: Coding
      type: LA30137-6
      system:
        v: http://loinc.org
      code:
        v: LA30137-6
      display:
        v: Otherwise unemployed but not seeking work (ex: student, retired, disabled, unpaid primary care giver)
  answer option:
    value: Coding
      type: LA30122-8
      system:
        v: http://loinc.org
      code:
        v: LA30122-8
      display:
        v: I choose not to answer this question
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
      text:
        v: Drop down
  link id:
    v: /93041-2/76437-3
  code: https://loinc.org/rdf/76437-3
    system:
      v: http://loinc.org
    code:
      v: 76437-3
    display:
      v: Primary insurance
  text:
    v: Primary insurance
  type:
    v: choice
  required:
    v: false
  answer option:
    value: Coding
      type: LA30194-7
      system:
        v: http://loinc.org
      code:
        v: LA30194-7
      display:
        v: None/uninsured
  answer option:
    value: Coding
      type: LA17849-3
      system:
        v: http://loinc.org
      code:
        v: LA17849-3
      display:
        v: Medicaid
  answer option:
    value: Coding
      type: LA30195-4
      system:
        v: http://loinc.org
      code:
        v: LA30195-4
      display:
        v: CHIP Medicaid
  answer option:
    value: Coding
      type: LA15652-3
      system:
        v: http://loinc.org
      code:
        v: LA15652-3
      display:
        v: Medicare
  answer option:
    value: Coding
      type: LA30196-2
      system:
        v: http://loinc.org

v: drop-down

v: Drop down

v: drop-down

v: Drop down

v: drop-down

v: Drop down

v: LA30196-2

v: Other public insurance (not CHIP)

value: Coding
  type: LA30197-0
  system:
    v: http://loinc.org
  code:
    v: LA30197-0
  display:
    v: Other public insurance (CHIP)

value: Coding
  type: LA6350-8
  system:
    v: http://loinc.org
  code:
    v: LA6350-8
  display:
    v: Private insurance

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-unit
  value: Coding
    system:
      v: http://unitsofmeasure.org
    code:
      v: /a
    display:
      v: /a
link id:
  v: /93041-2/63586-2
code: https://loinc.org/rdf/63586-2
  system:
    v: http://loinc.org
  code:
    v: 63586-2
  display:
    v: What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]
text:
  v: What was your best estimate of the total income of all family members from all sources, before taxes, in last year?
type:
  v: decimal
required:
  v: false

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
      code:
        v: drop-down
      display:
        v: Drop down
    text:
      v: Drop down
link id:
  v: /93041-2/93031-3
code: https://loinc.org/rdf/93031-3
  system:
    v: http://loinc.org
  code:
    v: 93031-3
  display:
    v: Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]
text:
  v: In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?
type:
  v: choice
required:
  v: false
repeats:
  v: true
answer option:
  value: Coding
    type: LA30125-1
    system:
      v: http://loinc.org
    code:
      v: LA30125-1
    display:
      v: Food
answer option:
  value: Coding
    type: LA30126-9
    system:
      v: http://loinc.org
    code:
      v: LA30126-9
    display:
      v: Clothing
answer option:
  value: Coding
    type: LA30124-4
    system:
      v: http://loinc.org
    code:
      v: LA30124-4
    display:
      v: Utilities
answer option:
  value: Coding
    type: LA30127-7
    system:
      v: http://loinc.org
    code:
      v: LA30127-7
    display:
      v: Child care
answer option:
  value: Coding
    type: LA30128-5
    system:
      v: http://loinc.org
    code:
      v: LA30128-5
    display:
      v: Medicine or Any Health Care (Medical, Dental, Mental Health, Vision)
answer option:
  value: Coding
    type: LA30129-3
    system:
      v: http://loinc.org
    code:
      v: LA30129-3
    display:
      v: Phone
answer option:
  value: Coding
    type: LA46-8
    system:
      v: http://loinc.org
    code:
      v: LA46-8
    display:
      v: Other
answer option:
  value: Coding
    type: LA30122-8
    system:
      v: http://loinc.org
    code:
      v: LA30122-8
    display:
      v: I choose not to answer this question

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
      code:
        v: drop-down
      display:
        v: Drop down
    text:
      v: Drop down
link id:
  v: /93041-2/93030-5
code: https://loinc.org/rdf/93030-5
  system:
    v: http://loinc.org
  code:
    v: 93030-5
  display:
    v: Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living
text:
  v: Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living?
type:
  v: choice
required:
  v: false
repeats:
  v: true
answer option:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix
    value: string
      v: A
  value: Coding
    type: LA30133-5
    system:
      v: http://loinc.org
    code:
      v: LA30133-5
    display:
      v: Yes, it has kept me from medical appointments or from getting my medications
answer option:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix
    value: string
      v: B
  value: Coding
    type: LA30134-3
    system:
      v: http://loinc.org
    code:
      v: LA30134-3
    display:
      v: Yes, it has kept me from non-medical meetings, appointments, work, or from getting things that I need
answer option:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix
    value: string
      v: C
  value: Coding
    type: LA32-8
    system:
      v: http://loinc.org
    code:
      v: LA32-8
    display:
      v: No
answer option:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix
    value: string
      v: X
  value: Coding
    type: LA30257-2
    system:
      v: http://loinc.org
    code:
      v: LA30257-2
    display:
      v: Patient unable to respond

link id:
  v: /93040-4
code: https://loinc.org/rdf/93040-4
  system:
    v: http://loinc.org
  code:
    v: 93040-4
  display:
    v: Social and emotional health [PRAPARE]
text:
  v: Social and emotional health
type:
  v: group
required:
  v: false
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
      text:
        v: Drop down
  link id:
    v: /93040-4/93029-7
  code: https://loinc.org/rdf/93029-7
    system:
      v: http://loinc.org
    code:
      v: 93029-7
    display:
      v: How often do you see or talk to people that you care about and feel close to [PRAPARE]
  text:
    v: How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?
  type:
    v: choice
  required:
    v: false
  answer option:
    value: Coding
      type: LA27722-0
      system:
        v: http://loinc.org
      code:
        v: LA27722-0
      display:
        v: Less than once a week
  answer option:
    value: Coding
      type: LA30130-1
      system:
        v: http://loinc.org
      code:
        v: LA30130-1
      display:
        v: 1 or 2 times a week
  answer option:
    value: Coding
      type: LA30131-9
      system:
        v: http://loinc.org
      code:
        v: LA30131-9
      display:
        v: 3 to 5 times a week
  answer option:
    value: Coding
      type: LA30132-7
      system:
        v: http://loinc.org
      code:
        v: LA30132-7
      display:
        v: 5 or more times a week
  answer option:
    value: Coding
      type: LA30122-8
      system:
        v: http://loinc.org
      code:
        v: LA30122-8
      display:
        v: I choose not to answer this question
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
      text:
        v: Drop down
  link id:
    v: /93040-4/93038-8
  code: https://loinc.org/rdf/93038-8
    system:
      v: http://loinc.org
    code:
      v: 93038-8
    display:
      v: Stress level
  text:
    v: Stress is when someone feels tense, nervous, anxious or can't sleep at night because their mind is troubled. How stressed are you?
  type:
    v: choice
  required:
    v: false
  answer option:
    value: Coding
      type: LA6568-5
      system:
        v: http://loinc.org
      code:
        v: LA6568-5
      display:
        v: Not at all
  answer option:
    value: Coding
      type: LA13863-8
      system:
        v: http://loinc.org
      code:
        v: LA13863-8
      display:
        v: A little bit
  answer option:
    value: Coding
      type: LA13909-9
      system:
        v: http://loinc.org
      code:
        v: LA13909-9
      display:
        v: Somewhat
  answer option:
    value: Coding
      type: LA13902-4
      system:
        v: http://loinc.org
      code:
        v: LA13902-4
      display:
        v: Quite a bit
  answer option:
    value: Coding
      type: LA13914-9
      system:
        v: http://loinc.org
      code:
        v: LA13914-9
      display:
        v: Very much
  answer option:
    value: Coding
      type: LA30122-8
      system:
        v: http://loinc.org
      code:
        v: LA30122-8
      display:
        v: I choose not to answer this question

v: drop-down

v: Drop down

v: drop-down

v: Drop down

link id:
  v: /93039-6
code: https://loinc.org/rdf/93039-6
  system:
    v: http://loinc.org
  code:
    v: 93039-6
  display:
    v: Optional additional questions [PRAPARE]
text:
  v: Optional additional questions
type:
  v: group
required:
  v: false
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
      text:
        v: Drop down
  link id:
    v: /93039-6/93028-9
  code: https://loinc.org/rdf/93028-9
    system:
      v: http://loinc.org
    code:
      v: 93028-9
    display:
      v: Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]
  text:
    v: In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?
  type:
    v: choice
  required:
    v: false
  answer option:
    value: Coding
      type: LA33-6
      system:
        v: http://loinc.org
      code:
        v: LA33-6
      display:
        v: Yes
  answer option:
    value: Coding
      type: LA32-8
      system:
        v: http://loinc.org
      code:
        v: LA32-8
      display:
        v: No
  answer option:
    value: Coding
      type: LA30122-8
      system:
        v: http://loinc.org
      code:
        v: LA30122-8
      display:
        v: I choose not to answer this question
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
      text:
        v: Drop down
  link id:
    v: /93039-6/93027-1
  code: https://loinc.org/rdf/93027-1
    system:
      v: http://loinc.org
    code:
      v: 93027-1
    display:
      v: Are you a refugee
  text:
    v: Are you a refugee?
  type:
    v: choice
  required:
    v: false
  answer option:
    value: Coding
      type: LA33-6
      system:
        v: http://loinc.org
      code:
        v: LA33-6
      display:
        v: Yes
  answer option:
    value: Coding
      type: LA32-8
      system:
        v: http://loinc.org
      code:
        v: LA32-8
      display:
        v: No
  answer option:
    value: Coding
      type: LA30122-8
      system:
        v: http://loinc.org
      code:
        v: LA30122-8
      display:
        v: I choose not to answer this question
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
      text:
        v: Drop down
  link id:
    v: /93039-6/93026-3
  code: https://loinc.org/rdf/93026-3
    system:
      v: http://loinc.org
    code:
      v: 93026-3
    display:
      v: Do you feel physically and emotionally safe where you currently live [PRAPARE]
  text:
    v: Do you feel physically and emotionally safe where you currently live?
  type:
    v: choice
  required:
    v: false
  answer option:
    value: Coding
      type: LA33-6
      system:
        v: http://loinc.org
      code:
        v: LA33-6
      display:
        v: Yes
  answer option:
    value: Coding
      type: LA32-8
      system:
        v: http://loinc.org
      code:
        v: LA32-8
      display:
        v: No
  answer option:
    value: Coding
      type: LA14072-5
      system:
        v: http://loinc.org
      code:
        v: LA14072-5
      display:
        v: Unsure
  answer option:
    value: Coding
      type: LA30122-8
      system:
        v: http://loinc.org
      code:
        v: LA30122-8
      display:
        v: I choose not to answer this question
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
      text:
        v: Drop down
  link id:
    v: /93039-6/76501-6
  code: https://loinc.org/rdf/76501-6
    system:
      v: http://loinc.org
    code:
      v: 76501-6
    display:
      v: Within the last year, have you been afraid of your partner or ex-partner
  text:
    v: Within the last year, have you been afraid of your partner or ex-partner?
  type:
    v: choice
  required:
    v: false
  answer option:
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix
      value: string
        v: 1
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/itemWeight
      value: decimal
        v: 1
    value: Coding

v: drop-down

v: Drop down

v: drop-down

v: Drop down

v: drop-down

v: Drop down

v: drop-down

v: Drop down

Coding
type: LA33-6
system:
  v: http://loinc.org
code:
  v: LA33-6
display:
  v: Yes

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix
  value: string
    v: 0
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/itemWeight
  value: decimal
    v: 0
value: Coding
  type: LA32-8
  system:
    v: http://loinc.org
  code:
    v: LA32-8
  display:
    v: No