An example of an order for home physiotherapy (id = "physiotherapy")

<?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>