Advance Healthcare Directive Interoperability (cda-adi), published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cda-adi/ and changes regularly. See the Directory of published versions
| Official URL: http://hl7.org/cda/us/adi/StructureDefinition/Source.Form.Entry | Version: 0.1.0 | |||
| Draft as of 2026-02-01 | Computable Name: Source_Form_Entry | |||
| Other Identifiers: urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#urn:hl7ii:2.16.840.1.113883.4.823.1.4.24:2026-08-28 | ||||
This entry includes the Source Form document and info about the jurisdiction for the form. If the form is copyrighted by an organization, the organization's name may be included in an author participation.
Usages:
You can also check for usages in the FHIR IG Statistics
Description of Template, Differentials, Snapshots and how the different presentations work.
This structure is derived from ObservationMedia
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
|---|---|---|---|---|
![]() |
1..1 | ObservationMedia | XML Namespace: urn:hl7-org:v3 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) | |
![]() ![]() |
1..* | II | Slice: Unordered, Open by value:root, value:extension | |
![]() ![]() ![]() |
1..1 | II | ||
![]() ![]() ![]() ![]() |
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.4.823.1.4.24 | |
![]() ![]() ![]() ![]() |
1..1 | st | Required Pattern: 2026-08-28 | |
![]() ![]() |
1..* | II | ||
![]() ![]() |
||||
![]() ![]() ![]() |
1..1 | cs | Required Pattern: application/pdf | |
![]() ![]() |
S | 0..* | Author | |
![]() ![]() |
S | 0..* | EntryRelationship | Slice: Unordered, Open by profile:observation |
![]() ![]() ![]() |
S | 0..1 | EntryRelationship | |
![]() ![]() ![]() ![]() |
1..1 | cs | Fixed Value: COMP | |
![]() ![]() ![]() ![]() |
0..1 | bl | Fixed Value: false | |
![]() ![]() ![]() ![]() |
1..1 | Jurisdiction_Part | ||
![]() ![]() ![]() |
S | 0..1 | EntryRelationship | |
![]() ![]() ![]() ![]() |
1..1 | cs | Fixed Value: COMP | |
![]() ![]() ![]() ![]() |
0..1 | bl | Fixed Value: false | |
![]() ![]() ![]() ![]() |
S | 1..1 | Form_Title_Part | |
Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| ObservationMedia.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.templateId:source-form.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.classCode | Base | required | CDAActClassObservation | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.moodCode | Base | required | CDAActMood | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std. |
| ObservationMedia.value.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.value.compression | Base | required | CDACompressionAlgorithm | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.value.integrityCheckAlgorithm | Base | required | IntegrityCheckAlgorithm | 📍2.0.0 | THO v5.2 |
| ObservationMedia.value.mediaType | Base | example | MediaType | 📍3.0.0 | THO v6.5 |
| ObservationMedia.value.representation | Base | required | CDABinaryDataEncoding | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:jurisdiction-part.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:jurisdiction-part.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:jurisdiction-part.typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v6.5 |
| ObservationMedia.entryRelationship:form-title-part.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:form-title-part.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:form-title-part.typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v6.5 |
| Id | Grade | Path(s) | Description | Expression |
| II-1 | error | ObservationMedia.typeId, ObservationMedia.entryRelationship:jurisdiction-part.typeId, ObservationMedia.entryRelationship:form-title-part.typeId | An II instance must have either a root or an nullFlavor. |
root.exists() or nullFlavor.exists()
|
| Path | Status | Usage | ValueSet | Version | Source |
| ObservationMedia.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.templateId:source-form.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.classCode | Base | required | CDAActClassObservation | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.moodCode | Base | required | CDAActMood | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std. |
| ObservationMedia.value.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.value.compression | Base | required | CDACompressionAlgorithm | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.value.integrityCheckAlgorithm | Base | required | IntegrityCheckAlgorithm | 📍2.0.0 | THO v5.2 |
| ObservationMedia.value.mediaType | Base | example | MediaType | 📍3.0.0 | THO v6.5 |
| ObservationMedia.value.representation | Base | required | CDABinaryDataEncoding | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:jurisdiction-part.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:jurisdiction-part.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:jurisdiction-part.typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v6.5 |
| ObservationMedia.entryRelationship:form-title-part.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:form-title-part.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:form-title-part.typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v6.5 |
| Id | Grade | Path(s) | Description | Expression |
| II-1 | error | ObservationMedia.typeId, ObservationMedia.entryRelationship:jurisdiction-part.typeId, ObservationMedia.entryRelationship:form-title-part.typeId | An II instance must have either a root or an nullFlavor. |
root.exists() or nullFlavor.exists()
|
This structure is derived from ObservationMedia
Summary
Mandatory: 6 elements(2 nested mandatory elements)
Must-Support: 5 elements
Fixed: 4 elements
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Differential View
This structure is derived from ObservationMedia
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
|---|---|---|---|---|
![]() |
1..1 | ObservationMedia | XML Namespace: urn:hl7-org:v3 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) | |
![]() ![]() |
1..* | II | Slice: Unordered, Open by value:root, value:extension | |
![]() ![]() ![]() |
1..1 | II | ||
![]() ![]() ![]() ![]() |
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.4.823.1.4.24 | |
![]() ![]() ![]() ![]() |
1..1 | st | Required Pattern: 2026-08-28 | |
![]() ![]() |
1..* | II | ||
![]() ![]() |
||||
![]() ![]() ![]() |
1..1 | cs | Required Pattern: application/pdf | |
![]() ![]() |
S | 0..* | Author | |
![]() ![]() |
S | 0..* | EntryRelationship | Slice: Unordered, Open by profile:observation |
![]() ![]() ![]() |
S | 0..1 | EntryRelationship | |
![]() ![]() ![]() ![]() |
1..1 | cs | Fixed Value: COMP | |
![]() ![]() ![]() ![]() |
0..1 | bl | Fixed Value: false | |
![]() ![]() ![]() ![]() |
1..1 | Jurisdiction_Part | ||
![]() ![]() ![]() |
S | 0..1 | EntryRelationship | |
![]() ![]() ![]() ![]() |
1..1 | cs | Fixed Value: COMP | |
![]() ![]() ![]() ![]() |
0..1 | bl | Fixed Value: false | |
![]() ![]() ![]() ![]() |
S | 1..1 | Form_Title_Part | |
Documentation for this format | ||||
Key Elements View
| Path | Status | Usage | ValueSet | Version | Source |
| ObservationMedia.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.templateId:source-form.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.classCode | Base | required | CDAActClassObservation | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.moodCode | Base | required | CDAActMood | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std. |
| ObservationMedia.value.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.value.compression | Base | required | CDACompressionAlgorithm | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.value.integrityCheckAlgorithm | Base | required | IntegrityCheckAlgorithm | 📍2.0.0 | THO v5.2 |
| ObservationMedia.value.mediaType | Base | example | MediaType | 📍3.0.0 | THO v6.5 |
| ObservationMedia.value.representation | Base | required | CDABinaryDataEncoding | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:jurisdiction-part.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:jurisdiction-part.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:jurisdiction-part.typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v6.5 |
| ObservationMedia.entryRelationship:form-title-part.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:form-title-part.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:form-title-part.typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v6.5 |
| Id | Grade | Path(s) | Description | Expression |
| II-1 | error | ObservationMedia.typeId, ObservationMedia.entryRelationship:jurisdiction-part.typeId, ObservationMedia.entryRelationship:form-title-part.typeId | An II instance must have either a root or an nullFlavor. |
root.exists() or nullFlavor.exists()
|
Snapshot View
| Path | Status | Usage | ValueSet | Version | Source |
| ObservationMedia.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.templateId:source-form.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.classCode | Base | required | CDAActClassObservation | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.moodCode | Base | required | CDAActMood | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std. |
| ObservationMedia.value.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.value.compression | Base | required | CDACompressionAlgorithm | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.value.integrityCheckAlgorithm | Base | required | IntegrityCheckAlgorithm | 📍2.0.0 | THO v5.2 |
| ObservationMedia.value.mediaType | Base | example | MediaType | 📍3.0.0 | THO v6.5 |
| ObservationMedia.value.representation | Base | required | CDABinaryDataEncoding | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:jurisdiction-part.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:jurisdiction-part.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:jurisdiction-part.typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v6.5 |
| ObservationMedia.entryRelationship:form-title-part.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:form-title-part.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
| ObservationMedia.entryRelationship:form-title-part.typeCode | Base | required | x_ActRelationshipEntryRelationship | 📍3.0.0 | THO v6.5 |
| Id | Grade | Path(s) | Description | Expression |
| II-1 | error | ObservationMedia.typeId, ObservationMedia.entryRelationship:jurisdiction-part.typeId, ObservationMedia.entryRelationship:form-title-part.typeId | An II instance must have either a root or an nullFlavor. |
root.exists() or nullFlavor.exists()
|
This structure is derived from ObservationMedia
Summary
Mandatory: 6 elements(2 nested mandatory elements)
Must-Support: 5 elements
Fixed: 4 elements
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices: