<status value="draft"/><subjectType value="Patient"/><date value="2016-11-14"/><publisher value="HL7 International / FHIR Infrastructure"/><contact><telecom><system value="url"/><value value="http://www.hl7.org/Special/committees/fiwg"/></telecom></contact><description value="Example questionnaire to assess Zika virus exposure potential."/><effectivePeriod><start value="2016-11-14"/></effectivePeriod><item><extension url="http://example.org/additional-information"><valueAttachment><url value="http://www.cdc.gov/zika/geo/index.html"/><title value="Areas with active Zika virus transmission/exposure risk"/></valueAttachment></extension><linkId value="1"/><code><system value="http://example.org/questionnaires"/><code value="CDE: Resident of or Frequent Traveler to Zika Area"/></code><text value="Are you a resident of, or do you travel frequently to, an area with active Zika transmission?"/><type value="boolean"/></item><item><extension url="http://example.org/additional-information"><valueAttachment><url value="http://www.cdc.gov/zika/geo/index.html"/><title value="Areas with active Zika virus transmission/exposure risk"/></valueAttachment></extension><linkId value="2"/><code><system value="http://example.org/questionnaires"/><code value="CDE: Recent Travel to Zika Area"/></code><text value="Have you recently traveled to an area with active Zika transmission?"/><type value="boolean"/><enableWhen><question value="1"/><operator value="="/><answerBoolean value="false"/></enableWhen></item><item><linkId value="3"/><code><system value="http://example.org/questionnaires"/><code value="CDE: Time Since Returned From Travel"/></code><text value="How long has it been since you returned?"/><type value="quantity"/><enableWhen><question value="2"/><operator value="="/><answerBoolean value="true"/></enableWhen></item><item><extension url="http://example.org/additional-information"><valueAttachment><url value="http://www.cdc.gov/zika/geo/index.html"/><title value="Areas with active Zika virus transmission/exposure risk"/></valueAttachment></extension><linkId value="4"/><code><system value="http://example.org/questionnaires"/><code value="CDE: Recent Sexual Encounter with Traveler to Zika Area"/></code><text value="Have you recently had condomless sex with a partner that has travelled in an area with active Zika transmission?"/><type value="boolean"/><enableWhen><question value="2"/><operator value="="/><answerBoolean value="false"/></enableWhen></item><item><linkId value="5"/><code><system value="http://example.org/questionnaires"/><code value="CDE: Time Since Sexual Encounter"/></code><text value="How long has it been since your last condomless sexual encounter?"/><type value="quantity"/><enableWhen><question value="4"/><operator value="="/><answerBoolean value="true"/></enableWhen></item><item><extension url="http://example.org/additional-information"><valueAttachment><url value="http://www.cdc.gov/zika/geo/index.html"/><title value="Areas with active Zika virus transmission/exposure risk"/></valueAttachment></extension><linkId value="6"/><code><system value="http://example.org/questionnaires"/><code value="CDE: Planned Travel to Zika Area"/></code><text value="Do you plan to travel to an area with active Zika transmission?"/><type value="boolean"/><enableWhen><question value="4"/><operator value="="/><answerBoolean value="false"/></enableWhen></item></Questionnaire>