Structured Data Capture
4.0.0-ci-build - STU 4 CI-build
Structured Data Capture
4.0.0-ci-build - STU 4 CI-build
Structured Data Capture, published by HL7 International / FHIR Infrastructure. This guide is not an authorized publication; it is the continuous build for version 4.0.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/sdc/ and changes regularly. See the Directory of published versions
| Page standards status: Trial-use | Maturity Level: 4 |
@prefix fhir: <http://hl7.org/fhir/> . @prefix loinc: <http://loinc.org/rdf#> . @prefix owl: <http://www.w3.org/2002/07/owl#> . @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> . @prefix sct: <http://snomed.info/id/> . @prefix xsd: <http://www.w3.org/2001/XMLSchema#> . # - resource ------------------------------------------------------------------- <http://hl7.org/fhir/Questionnaire/CardiologyForm> a fhir:Questionnaire ; fhir:nodeRole fhir:treeRoot ; fhir:Resource.id [ fhir:value "CardiologyForm"] ; fhir:Resource.language [ fhir:value "en"] ; fhir:DomainResource.text [ fhir:Narrative.status [ fhir:value "extensions" ] ; fhir:Narrative.div "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><p class=\"res-header-id\"><b>Generated Narrative: Questionnaire CardiologyForm</b></p><a name=\"CardiologyForm\"> </a><a name=\"hcCardiologyForm\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Language: en</p></div><b>Structure</b><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The linkID for the item\">LinkID</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the item can appear in the instance\">Cardinality</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Type</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Other attributes of the item\">Flags</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the item\">Description & Constraints</a><span style=\"float: right\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3goXBCwdPqAP0wAAAldJREFUOMuNk0tIlFEYhp9z/vE2jHkhxXA0zJCMitrUQlq4lnSltEqCFhFG2MJFhIvIFpkEWaTQqjaWZRkp0g26URZkTpbaaOJkDqk10szoODP//7XIMUe0elcfnPd9zsfLOYplGrpRwZaqTtw3K7PtGem7Q6FoidbGgqHVy/HRb669R+56zx7eRV1L31JGxYbBtjKK93cxeqfyQHbehkZbUkK20goELEuIzEd+dHS+qz/Y8PTSif0FnGkbiwcAjHaU1+QWOptFiyCLp/LnKptpqIuXHx6rbR26kJcBX3yLgBfnd7CxwJmflpP2wUg0HIAoUUpZBmKzELGWcN8nAr6Gpu7tLU/CkwAaoKTWRSQyt89Q8w6J+oVQkKnBoblH7V0PPvUOvDYXfopE/SJmALsxnVm6LbkotrUtNowMeIrVrBcBpaMmdS0j9df7abpSuy7HWehwJdt1lhVwi/J58U5beXGAF6c3UXLycw1wdFklArBn87xdh0ZsZtArghBdAA3+OEDVubG4UEzP6x1FOWneHh2VDAHBAt80IbdXDcesNoCvs3E5AFyNSU5nbrDPZpcUEQQTFZiEVx+51fxMhhyJEAgvlriadIJZZksRuwBYMOPBbO3hePVVqgEJhFeUuFLhIPkRP6BQLIBrmMenujm/3g4zc398awIe90Zb5A1vREALqneMcYgP/xVQWlG+Ncu5vgwwlaUNx+3799rfe96u9K0JSDXcOzOTJg4B6IgmXfsygc7/Bvg9g9E58/cDVmGIBOP/zT8Bz1zqWqpbXIsd0O9hajXfL6u4BaOS6SeWAAAAAElFTkSuQmCC\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireRoot\" class=\"hierarchy\"/> </td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">http://hl7.org/fhir/uv/sdc/Questionnaire/CardiologyForm#4.0.0-ci-build</td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" id=\"item.patient_header\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> patient_header</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Patient Information</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.patient_surname\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> patient_surname</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Surname:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.patient_firstname\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> patient_firstname</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">First Name:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.patient_date_of_birth\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-date.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"date\" class=\"hierarchy\"/> patient_date_of_birth</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">DOB:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date\">date</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.patient_gender\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> patient_gender</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Gender:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.patient_gender\">3 options</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111.png)\" id=\"item.patient_hc_pc\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> patient_hc_pc</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">HN PC:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Max Length: 2</td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.patient_hc_number\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> patient_hc_number</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">HN:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Max Length: 10</td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1100.png)\" id=\"item.patient_hc_vc\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> patient_hc_vc</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">HN VC:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111.png)\" id=\"item.patient_address_line1\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> patient_address_line1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Address (Line 1):</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.patient_address_line2\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> patient_address_line2</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Address (Line 2):</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.patient_address_city\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> patient_address_city</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">City:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.patient_address_province\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> patient_address_province</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Province:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Max Length: 2</td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1100.png)\" id=\"item.patient_address_postalcode\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> patient_address_postalcode</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Postal Code:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.patient_phone_mobile\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> patient_phone_mobile</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Mobile #:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.patient_phone_home\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> patient_phone_home</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Home #:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.patient_phone_business\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> patient_phone_business</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Business #:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" id=\"item.patient_email\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> patient_email</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Email:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" id=\"item.additionalinfo_header\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> additionalinfo_header</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">[Optional] Additional Patient Information</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.additionalinfo_sexassignedatbirth\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> additionalinfo_sexassignedatbirth</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Sex assigned at birth:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.additionalinfo_sexassignedatbirth\">4 options</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111.png)\" id=\"item.additionalinfo_pronouns\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> additionalinfo_pronouns</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Pronouns:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.additionalinfo_pronouns\">4 options</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1100.png)\" id=\"item.additionalinfo_pronouns_other\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additionalinfo_pronouns_other</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Other pronouns:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.additionalinfo_pronouns\">additionalinfo_pronouns</a> = other (NullFlavor#OTH)</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111.png)\" id=\"item.additionalinfo_preferredlanguage\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> additionalinfo_preferredlanguage</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Preferred language:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.additionalinfo_preferredlanguage\">3 options</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.additionalinfo_preferredlanguage_specify\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additionalinfo_preferredlanguage_specify</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Specify:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.additionalinfo_preferredlanguage\">additionalinfo_preferredlanguage</a> = other (NullFlavor#OTH)</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1100.png)\" id=\"item.additionalinfo_preferredlanguage_translatorrequired\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additionalinfo_preferredlanguage_translatorrequired</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Translator required</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.additionalinfo_preferredlanguage\">additionalinfo_preferredlanguage</a> = other (NullFlavor#OTH)</span><br/>Options: <a href=\"#opt-item.additionalinfo_preferredlanguage_translatorrequired\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111.png)\" id=\"item.additionalinfo_bestmethodofcontact\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> additionalinfo_bestmethodofcontact</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Best method of contact:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.additionalinfo_bestmethodofcontact\">4 options</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1100.png)\" id=\"item.additionalinfo_bestmethodofcontact_voicemails\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additionalinfo_bestmethodofcontact_voicemails</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Voicemails acceptable</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.additionalinfo_bestmethodofcontact\">additionalinfo_bestmethodofcontact</a> = Mobile (ContactPointUse#mobile)</span><br/>Options: <a href=\"#opt-item.additionalinfo_bestmethodofcontact_voicemails\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.additionalinfo_preferredname_select\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additionalinfo_preferredname_select</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Preferred name</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.additionalinfo_preferredname_select\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.additionalinfo_preferredname\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additionalinfo_preferredname</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Prefered name String</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.additionalinfo_preferredname_select\">additionalinfo_preferredname_select</a> = Preferred Name</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.additionalinfo_alternatecontact_select\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additionalinfo_alternatecontact_select</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Alternate contact</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.additionalinfo_alternatecontact_select\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.additionalinfo_alternatecontact_name\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additionalinfo_alternatecontact_name</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Name:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.additionalinfo_alternatecontact_select\">additionalinfo_alternatecontact_select</a> = Alternate contact</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.additionalinfo_alternatecontact_phone\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additionalinfo_alternatecontact_phone</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Alternate contact phone #:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.additionalinfo_alternatecontact_select\">additionalinfo_alternatecontact_select</a> = Alternate contact</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.additionalinfo_alternatecontact_relationship\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additionalinfo_alternatecontact_relationship</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Relationship:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.additionalinfo_alternatecontact_select\">additionalinfo_alternatecontact_select</a> = Alternate contact</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.additionalinfo_alternatecontact_bookingcontact\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> additionalinfo_alternatecontact_bookingcontact</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Is Alternate contact the appointment booking contact?:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.additionalinfo_alternatecontact_select\">additionalinfo_alternatecontact_select</a> = Alternate contact</span><br/>Options: <a href=\"#opt-item.additionalinfo_alternatecontact_bookingcontact\">2 options</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.additionalinfo_unsafecontacts_select\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additionalinfo_unsafecontacts_select</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Unsafe contact persons (do not speak with)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.additionalinfo_unsafecontacts_select\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.additionalinfo_unsafecontacts_speakwithpatientdirectly\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additionalinfo_unsafecontacts_speakwithpatientdirectly</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Only speak with patient directly</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.additionalinfo_unsafecontacts_select\">additionalinfo_unsafecontacts_select</a> = Unsafe contact persons (do not speak with)</span><br/>Options: <a href=\"#opt-item.additionalinfo_unsafecontacts_speakwithpatientdirectly\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.additionalinfo_unsafecontacts_donotspeakwith\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additionalinfo_unsafecontacts_donotspeakwith</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Do not speak with:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.additionalinfo_unsafecontacts_select\">additionalinfo_unsafecontacts_select</a> = Unsafe contact persons (do not speak with)</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.additionalinfo_accessibilityconcernsordisability_selectt\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additionalinfo_accessibilityconcernsordisability_selectt</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Accessibility concerns or disability</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.additionalinfo_accessibilityconcernsordisability_selectt\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.additionalinfo_accessibilityconcernsordisability\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> additionalinfo_accessibilityconcernsordisability</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Accessibility concerns Options</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.additionalinfo_accessibilityconcernsordisability_selectt\">additionalinfo_accessibilityconcernsordisability_selectt</a> = Accessibility concerns or disability</span><br/>Options: <a href=\"#opt-item.additionalinfo_accessibilityconcernsordisability\">4 options</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.additionalinfo_specialconsiderations_select\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additionalinfo_specialconsiderations_select</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Special considerations (e.g. barriers, tips for care delivery, 3rd party insurance, patient requires escort, cognitive issues)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.additionalinfo_specialconsiderations_select\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.additionalinfo_specialconsiderations\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> additionalinfo_specialconsiderations</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Details of special considerations:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.additionalinfo_specialconsiderations_select\">additionalinfo_specialconsiderations_select</a> = Special considerations (e.g. barriers, tips for care delivery, 3rd party insurance, patient requires escort, cognitive issues)</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.additionalinfo_sendcopiestoadditionalproviders\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additionalinfo_sendcopiestoadditionalproviders</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Send copies of reports to additional providers</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.additionalinfo_sendcopiestoadditionalproviders\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck101.png)\" id=\"item.additionalinfo_sendcopiestoadditionalproviders_names\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additionalinfo_sendcopiestoadditionalproviders_names</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Name(s):</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.additionalinfo_sendcopiestoadditionalproviders\">additionalinfo_sendcopiestoadditionalproviders</a> = Send copies of reports to additional providers</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1010.png)\" id=\"item.additionalinfo_sendcopiestoadditionalproviders_contactinfo\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additionalinfo_sendcopiestoadditionalproviders_contactinfo</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Contact information:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.additionalinfo_sendcopiestoadditionalproviders\">additionalinfo_sendcopiestoadditionalproviders</a> = Send copies of reports to additional providers</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1000.png)\" id=\"item.additionalinfo_sendcopiestoadditionalproviders_ispcp\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additionalinfo_sendcopiestoadditionalproviders_ispcp</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">This is the Primary Care Provider</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.additionalinfo_sendcopiestoadditionalproviders\">additionalinfo_sendcopiestoadditionalproviders</a> = Send copies of reports to additional providers</span><br/>Options: <a href=\"#opt-item.additionalinfo_sendcopiestoadditionalproviders_ispcp\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" id=\"item.102173268919\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> 102173268919</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Referral Details</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111.png)\" id=\"item.cardio_triagecons\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> cardio_triagecons</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Triage Considerations</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1111.png)\" id=\"item.referral_requestedpriority\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> referral_requestedpriority</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Requested Priority:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.referral_requestedpriority\">2 options</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11100.png)\" id=\"item.referral_requestedpriority_urgentreason\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> referral_requestedpriority_urgentreason</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Reason for urgent triage</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.referral_requestedpriority\">referral_requestedpriority</a> = Urgent (RequestPriority#urgent)</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.referral_secondopinion\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> referral_secondopinion</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Second Opinion</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.referral_secondopinion\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1100.png)\" id=\"item.referral_secondopinion_reason\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> referral_secondopinion_reason</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Reason for second opinion:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.referral_secondopinion\">referral_secondopinion</a> = Second or third medical opinion (SNOMED CT#77406008)</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111.png)\" id=\"item.695991571585\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> 695991571585</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Service(s) Requested Select all that apply:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.referralService\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> referralService</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">HSCs Assigned:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/questionnaire-definitions.html#Questionnaire.item.readOnly\" title=\"Is Read Only\"><img src=\"icon-qi-readonly.png\" alt=\"icon\"/></a><img src=\"icon-qi-readonly.png\" alt=\"icon\"/><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-hidden.html\" title=\"Is a hidden item\"><img src=\"icon-qi-hidden.png\" alt=\"icon\"/></a><img src=\"icon-qi-hidden.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.223886162384\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 223886162384</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Cardiac Testing</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.223886162384\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1111.png)\" id=\"item.660331267409\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> 660331267409</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Exam(s) Requested</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.223886162384\">223886162384</a> = Cardiac Testing (standardized-referral-form-codes#20001)</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11110.png)\" id=\"item.720409326878\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 720409326878</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">24 Hour Ambulatory Blood Pressure Monitoring</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.720409326878\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11110.png)\" id=\"item.960455115596\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 960455115596</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Coronary Angiogram</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.960455115596\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11110.png)\" id=\"item.297634898828\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 297634898828</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Echocardiogram - Resting</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.297634898828\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11111.png)\" id=\"item.443484577720\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> 443484577720</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">sub Echocardiogram - Resting</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.297634898828\">297634898828</a> = Echocardiogram - Resting (standardized-referral-form-codes#20005)</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111110.png)\" id=\"item.165530569567\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 165530569567</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Echocardiogram (2D)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.165530569567\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111110.png)\" id=\"item.286552421895\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 286552421895</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Echocardiogram with Contrast</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.286552421895\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111110.png)\" id=\"item.910527687300\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 910527687300</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Echocardiogram with Saline (Bubble)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.910527687300\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111110.png)\" id=\"item.657824763133\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 657824763133</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Pediatric Echocardiogram</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.657824763133\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111100.png)\" id=\"item.992743200182\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 992743200182</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Transesophageal Echocardiogram (TEE)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.992743200182\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11110.png)\" id=\"item.894277763438\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 894277763438</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Electrocardiogram (ECG)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.894277763438\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11110.png)\" id=\"item.279226023495\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 279226023495</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Holter Monitoring</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.279226023495\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11111.png)\" id=\"item.440449731882\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> 440449731882</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">sub holter monitoring</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.279226023495\">279226023495</a> = Holter Monitoring (standardized-referral-form-codes#20007)</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111110.png)\" id=\"item.671328703851\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 671328703851</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">24 Hours</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.671328703851\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111110.png)\" id=\"item.423992261841\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 423992261841</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">48 Hours</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.423992261841\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111110.png)\" id=\"item.419924239187\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 419924239187</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">72 Hours</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.419924239187\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111110.png)\" id=\"item.731054417270\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 731054417270</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">7 Days</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.731054417270\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111100.png)\" id=\"item.235876421044\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 235876421044</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">14 Days</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.235876421044\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11110.png)\" id=\"item.374742834400\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 374742834400</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Loop / Event Monitor</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.374742834400\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11110.png)\" id=\"item.159161544747\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 159161544747</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Cardiovascular stress testing</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.159161544747\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11111.png)\" id=\"item.370275060390\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> 370275060390</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Sub Stress Testing</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.159161544747\">159161544747</a> = Stress Testing (standardized-referral-form-codes#20009)</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111110.png)\" id=\"item.814218498309\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 814218498309</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">ECG - Exercise Stress Test</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.814218498309\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111110.png)\" id=\"item.307107493993\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 307107493993</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">ECG - Dobutamine/Persantine Stress Test</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.307107493993\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111110.png)\" id=\"item.805303414102\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 805303414102</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Echocardiogram - Exercise Stress Test</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.805303414102\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111100.png)\" id=\"item.193586908489\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 193586908489</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Echocardiogram - Dobutamine/Persantine Stress Test</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.193586908489\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11110.png)\" id=\"item.918517139023\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 918517139023</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Nuclear Medicine</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.918517139023\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11111.png)\" id=\"item.222686221935\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> 222686221935</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">sub Nuclear Medicine</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.918517139023\">918517139023</a> = Nuclear Medicine (standardized-referral-form-codes#20010)</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111110.png)\" id=\"item.924189648184\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 924189648184</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">MUGA - Resting</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.924189648184\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111110.png)\" id=\"item.857163514910\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 857163514910</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Cardiac Pyrophosphate</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.857163514910\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111110.png)\" id=\"item.892165959617\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 892165959617</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Myocardial perfusion scan</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.892165959617\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111101.png)\" id=\"item.538288549138\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> 538288549138</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">sub MIBI</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.892165959617\">892165959617</a> = MIBI Scans / Myocardial Perfusion Imaging (MPI): (standardized-referral-form-codes#20028)</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1111010.png)\" id=\"item.373435981917\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> 373435981917</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">MIBI Scan - Exercise Stress Test</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.373435981917\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1111010.png)\" id=\"item.434394942688\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> 434394942688</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">MIBI Scan - Dobutamine/Persantine Stress Test</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.434394942688\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1111000.png)\" id=\"item.913594478162\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> 913594478162</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Thallium Viability Test</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.913594478162\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11110.png)\" id=\"item.992682216482\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 992682216482</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Tilt Table Testing</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.992682216482\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11110.png)\" id=\"item.cardiology_referral_services_cardiactesting_other\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> cardiology_referral_services_cardiactesting_other</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Other</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.cardiology_referral_services_cardiactesting_other\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11100.png)\" id=\"item.cardiology_referral_services_cardiactesting_other_specify\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> cardiology_referral_services_cardiactesting_other_specify</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Specify</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.cardiology_referral_services_cardiactesting_other\">cardiology_referral_services_cardiactesting_other</a> = other (NullFlavor#OTH)</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1100.png)\" id=\"item.785727177547\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 785727177547</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Cardiology Consultation</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.785727177547\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111.png)\" id=\"item.186952778859\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> 186952778859</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Concern(s) / Indication(s) Triggering Referral Select all that apply:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.219569805461\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 219569805461</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Arrhythmias or Palpitations</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.219569805461\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.571934328499\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 571934328499</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Cardiovascular Risk Assessment</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.571934328499\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.459737733395\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 459737733395</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Chest Pain or Angina</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.459737733395\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.929919815516\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 929919815516</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Congenital Heart Disease</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.929919815516\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.832263816528\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 832263816528</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Congestive Heart Failure</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.832263816528\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.803760213460\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 803760213460</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Coronary Artery Disease</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.803760213460\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.129767162379\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 129767162379</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Dyspnea</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.129767162379\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.116150628533\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 116150628533</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Hypertension</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.116150628533\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.513825527027\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 513825527027</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Murmur</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.513825527027\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.975075898688\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 975075898688</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Pericardial Disease</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.975075898688\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.704148928571\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 704148928571</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Peripheral Edema</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.704148928571\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.886489617115\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 886489617115</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Post-Myocardial Infarction</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.886489617115\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.621745958993\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 621745958993</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Pre-operative Consultation</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.621745958993\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.873024527134\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-date.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"date\" class=\"hierarchy\"/> 873024527134</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Procedure Date (if known)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date\">date</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.621745958993\">621745958993</a> = Pre-operative Consultation (standardized-referral-form-codes#20044)</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.197975129599\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 197975129599</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Syncope</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.197975129599\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.675849150752\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 675849150752</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Valvular Heart Disease or Prosthetic Heart Valve</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.675849150752\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.721982740516\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 721982740516</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Other</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/extension-questionnaire-choiceorientation.html\" title=\"Orientation: horizontal \"><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></a><img src=\"icon-qi-horizontal.png\" alt=\"icon\"/></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.721982740516\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1100.png)\" id=\"item.720594942482\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> 720594942482</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Specify</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.721982740516\">721982740516</a> = other (NullFlavor#OTH)</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" id=\"item.Descriptionofclinicalquestion\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> Descriptionofclinicalquestion</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Clinical Question / Goal(s) of Referral with Relevant History, Management and Investigations</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" id=\"item.cpp_header\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> cpp_header</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Cumulative Patient Profile Please delete any sensitive information you do not intend to share from the CPP</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.cpp_separate\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> cpp_separate</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">CPP attached separately (if not entered below)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.cpp_separate\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.cpp_currentprob\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> cpp_currentprob</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Current Problem List:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.cpp_separate\">cpp_separate</a> exists false</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.cpp_pastmedicalhistory\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> cpp_pastmedicalhistory</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Past Medical History:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.cpp_separate\">cpp_separate</a> exists false</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.cpp_currentmedications\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> cpp_currentmedications</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Current Medications :</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.cpp_separate\">cpp_separate</a> exists false</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.cpp_familyhistory\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> cpp_familyhistory</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Family History:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.cpp_separate\">cpp_separate</a> exists false</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" id=\"item.cpp_allergies\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> cpp_allergies</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Allergies:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.cpp_separate\">cpp_separate</a> exists false</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" id=\"item.preferredconsultlocation_header\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> preferredconsultlocation_header</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Preferred Consultant or Location All patients will be triaged to the shortest wait time unless a preferred consultant or location is entered.</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.preferredconsultlocation_selector\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> preferredconsultlocation_selector</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Preferred consultant or location</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.preferredconsultlocation_selector\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111.png)\" id=\"item.preferredconsultlocation_specify\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> preferredconsultlocation_specify</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Please specify either a preferred consultant or location</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.preferredconsultlocation_selector\">preferredconsultlocation_selector</a> = Preferred consultant or location</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)\" id=\"item.preferredconsultlocation_consultant\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> preferredconsultlocation_consultant</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Consultant:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1100.png)\" id=\"item.preferredconsultlocation_location\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> preferredconsultlocation_location</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Location:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.preferredconsultlocation_willingtotravel\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> preferredconsultlocation_willingtotravel</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Patient willing to travel for shorter wait time</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.preferredconsultlocation_willingtotravel\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" id=\"item.preferredconsultlocation_otherconsiderations\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> preferredconsultlocation_otherconsiderations</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Other considerations:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" id=\"item.supportingdocumentation_header\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> supportingdocumentation_header</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Supporting Documentation Please attach all relevant laboratory and diagnostic investigations.</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" id=\"item.supportingdocumentation_details\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> supportingdocumentation_details</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Personal Health Information that is medically relevant has not been disclosed at the request of the patient.</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.supportingdocumentation_details\">1 option</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.supportingdocumentation_attachment\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-attachment.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"attachment\" class=\"hierarchy\"/> supportingdocumentation_attachment</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Add Attachments</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-attachment\">attachment</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.feedbacksurvey_cardiology\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-display.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"display\" class=\"hierarchy\"/> feedbacksurvey_cardiology</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Click here to provide feedback on this form</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display\">display</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)\" id=\"item.referrer_header\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> referrer_header</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Referrer's Information</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" id=\"item.referrer_sitename\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> referrer_sitename</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Site Name:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)\" id=\"item.referrer_address_line1\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> referrer_address_line1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Address (Line 1):</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item.referrer_address_line2\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> referrer_address_line2</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Address (Line 2):</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item.referrer_address_city\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> referrer_address_city</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">City:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" id=\"item.referrer_address_province\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> referrer_address_province</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Province:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Max Length: 2</td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0100.png)\" id=\"item.referrer_address_postalcode\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> referrer_address_postalcode</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Postal Code:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" id=\"item.referrer_phone\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> referrer_phone</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Phone #:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" id=\"item.referrer_fax\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> referrer_fax</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Fax #:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" id=\"item.referrer_billing\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> referrer_billing</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Billing Number:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" id=\"item.referrer_professionalid\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> referrer_professionalid</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Professional ID:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" id=\"item.referrer_signature\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> referrer_signature</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Signed:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)\" id=\"item.referrer_role\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> referrer_role</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Role:</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.referrer_role\">9 options</a></td></tr>#xD;\n<tr><td colspan=\"6\" class=\"hierarchy\"><br/><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name=\"opt-item.patient_gender\"> </a><p><b>Answer options for patient_gender </b></p><ul><li style=\"font-size: 11px\">http://hl7.org/fhir/administrative-gender#male (\"Male\")</li><li style=\"font-size: 11px\">http://hl7.org/fhir/administrative-gender#female (\"Female\")</li><li style=\"font-size: 11px\">http://hl7.org/fhir/administrative-gender#other (\"Other\")</li></ul><a name=\"opt-item.additionalinfo_sexassignedatbirth\"> </a><p><b>Answer options for additionalinfo_sexassignedatbirth </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA3-6 (\"Female\")</li><li style=\"font-size: 11px\">http://loinc.org#LA2-8 (\"Male\")</li><li style=\"font-size: 11px\">http://example.com/CodeSystem/exampleCS#Intersex (\"Intersex\")</li><li style=\"font-size: 11px\">http://loinc.org#LA4489-6 (\"Unknown\")</li></ul><a name=\"opt-item.additionalinfo_pronouns\"> </a><p><b>Answer options for additionalinfo_pronouns </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA29519-8 (\"She/Her\")</li><li style=\"font-size: 11px\">http://loinc.org#LA29518-0 (\"He/Him\")</li><li style=\"font-size: 11px\">http://loinc.org#LA29519-8 (\"They/Them\")</li><li style=\"font-size: 11px\">http://terminology.hl7.org/CodeSystem/v3-NullFlavor#OTH (\"other\")</li></ul><a name=\"opt-item.additionalinfo_preferredlanguage\"> </a><p><b>Answer options for additionalinfo_preferredlanguage </b></p><ul><li style=\"font-size: 11px\">urn:ietf:bcp:47#en (\"English\")</li><li style=\"font-size: 11px\">urn:ietf:bcp:47#fr (\"French\")</li><li style=\"font-size: 11px\">http://terminology.hl7.org/CodeSystem/v3-NullFlavor#OTH (\"other\")</li></ul><a name=\"opt-item.additionalinfo_preferredlanguage_translatorrequired\"> </a><p><b>Answer options for additionalinfo_preferredlanguage_translatorrequired </b></p><ul><li style=\"font-size: 11px\">Translator Required</li></ul><a name=\"opt-item.additionalinfo_bestmethodofcontact\"> </a><p><b>Answer options for additionalinfo_bestmethodofcontact </b></p><ul><li style=\"font-size: 11px\">http://hl7.org/fhir/contact-point-use#mobile (\"Mobile\")</li><li style=\"font-size: 11px\">http://hl7.org/fhir/contact-point-use#home (\"Home\")</li><li style=\"font-size: 11px\">http://hl7.org/fhir/contact-point-use#work (\"Work\")</li><li style=\"font-size: 11px\">http://hl7.org/fhir/contact-point-system#email (\"Email\")</li></ul><a name=\"opt-item.additionalinfo_bestmethodofcontact_voicemails\"> </a><p><b>Answer options for additionalinfo_bestmethodofcontact_voicemails </b></p><ul><li style=\"font-size: 11px\"> Voicemails acceptable</li></ul><a name=\"opt-item.additionalinfo_preferredname_select\"> </a><p><b>Answer options for additionalinfo_preferredname_select </b></p><ul><li style=\"font-size: 11px\">Preferred Name</li></ul><a name=\"opt-item.additionalinfo_alternatecontact_select\"> </a><p><b>Answer options for additionalinfo_alternatecontact_select </b></p><ul><li style=\"font-size: 11px\">Alternate contact</li></ul><a name=\"opt-item.additionalinfo_alternatecontact_bookingcontact\"> </a><p><b>Answer options for additionalinfo_alternatecontact_bookingcontact </b></p><ul><li style=\"font-size: 11px\">http://terminology.hl7.org/CodeSystem/v2-0532#Y (\"Yes\")</li><li style=\"font-size: 11px\">http://terminology.hl7.org/CodeSystem/v2-0532#N (\"No\")</li></ul><a name=\"opt-item.additionalinfo_unsafecontacts_select\"> </a><p><b>Answer options for additionalinfo_unsafecontacts_select </b></p><ul><li style=\"font-size: 11px\">Unsafe contact persons (do not speak with)</li></ul><a name=\"opt-item.additionalinfo_unsafecontacts_speakwithpatientdirectly\"> </a><p><b>Answer options for additionalinfo_unsafecontacts_speakwithpatientdirectly </b></p><ul><li style=\"font-size: 11px\">Only speak with patient directly</li></ul><a name=\"opt-item.additionalinfo_accessibilityconcernsordisability_selectt\"> </a><p><b>Answer options for additionalinfo_accessibilityconcernsordisability_selectt </b></p><ul><li style=\"font-size: 11px\">Accessibility concerns or disability</li></ul><a name=\"opt-item.additionalinfo_accessibilityconcernsordisability\"> </a><p><b>Answer options for additionalinfo_accessibilityconcernsordisability </b></p><ul><li style=\"font-size: 11px\">http://snomed.info/sct#129839007 (\"Falls risk\")</li><li style=\"font-size: 11px\">http://snomed.info/sct#301621006 (\"Patient requires lift\")</li><li style=\"font-size: 11px\">http://snomed.info/sct#105503008 (\"Wheelchair\")</li><li style=\"font-size: 11px\">http://snomed.info/sct#15188001 (\"Hearing impaired\")</li></ul><a name=\"opt-item.additionalinfo_specialconsiderations_select\"> </a><p><b>Answer options for additionalinfo_specialconsiderations_select </b></p><ul><li style=\"font-size: 11px\">Special considerations (e.g. barriers, tips for care delivery, 3rd party insurance, patient requires escort, cognitive issues)</li></ul><a name=\"opt-item.additionalinfo_sendcopiestoadditionalproviders\"> </a><p><b>Answer options for additionalinfo_sendcopiestoadditionalproviders </b></p><ul><li style=\"font-size: 11px\">Send copies of reports to additional providers</li></ul><a name=\"opt-item.additionalinfo_sendcopiestoadditionalproviders_ispcp\"> </a><p><b>Answer options for additionalinfo_sendcopiestoadditionalproviders_ispcp </b></p><ul><li style=\"font-size: 11px\">This is the Primary Care Provider</li></ul><a name=\"opt-item.referral_requestedpriority\"> </a><p><b>Answer options for referral_requestedpriority </b></p><ul><li style=\"font-size: 11px\">http://hl7.org/fhir/request-priority#routine (\"Routine\")</li><li style=\"font-size: 11px\">http://hl7.org/fhir/request-priority#urgent (\"Urgent\")</li></ul><a name=\"opt-item.referral_secondopinion\"> </a><p><b>Answer options for referral_secondopinion </b></p><ul><li style=\"font-size: 11px\">http://snomed.info/sct#77406008 (\"Second or third medical opinion\")</li></ul><a name=\"opt-item.223886162384\"> </a><p><b>Answer options for 223886162384 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20001 (\"Cardiac Testing\")</li></ul><a name=\"opt-item.720409326878\"> </a><p><b>Answer options for 720409326878 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20003 (\"24 Hour Ambulatory Blood Pressure Monitoring\")</li></ul><a name=\"opt-item.960455115596\"> </a><p><b>Answer options for 960455115596 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20004 (\"Coronary Angiogram\")</li></ul><a name=\"opt-item.297634898828\"> </a><p><b>Answer options for 297634898828 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20005 (\"Echocardiogram - Resting\")</li></ul><a name=\"opt-item.165530569567\"> </a><p><b>Answer options for 165530569567 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20012 (\"Echocardiogram (2D)\")</li></ul><a name=\"opt-item.286552421895\"> </a><p><b>Answer options for 286552421895 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20013 (\"Echocardiogram with Contrast\")</li></ul><a name=\"opt-item.910527687300\"> </a><p><b>Answer options for 910527687300 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20014 (\"Echocardiogram with Saline (Bubble)\")</li></ul><a name=\"opt-item.657824763133\"> </a><p><b>Answer options for 657824763133 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20015 (\"Pediatric Echocardiogram\")</li></ul><a name=\"opt-item.992743200182\"> </a><p><b>Answer options for 992743200182 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20016 (\"Transesophageal Echocardiogram (TEE)\")</li></ul><a name=\"opt-item.894277763438\"> </a><p><b>Answer options for 894277763438 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20006 (\"Electrocardiogram (ECG)\")</li></ul><a name=\"opt-item.279226023495\"> </a><p><b>Answer options for 279226023495 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20007 (\"Holter Monitoring\")</li></ul><a name=\"opt-item.671328703851\"> </a><p><b>Answer options for 671328703851 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20017 (\"24 Hours\")</li></ul><a name=\"opt-item.423992261841\"> </a><p><b>Answer options for 423992261841 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20018 (\"48 Hours\")</li></ul><a name=\"opt-item.419924239187\"> </a><p><b>Answer options for 419924239187 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20019 (\"72 Hours\")</li></ul><a name=\"opt-item.731054417270\"> </a><p><b>Answer options for 731054417270 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20020 (\"7 Days\")</li></ul><a name=\"opt-item.235876421044\"> </a><p><b>Answer options for 235876421044 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20021 (\"14 Days\")</li></ul><a name=\"opt-item.374742834400\"> </a><p><b>Answer options for 374742834400 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20008 (\"Loop / Event Monitor\")</li></ul><a name=\"opt-item.159161544747\"> </a><p><b>Answer options for 159161544747 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20009 (\"Stress Testing\")</li></ul><a name=\"opt-item.814218498309\"> </a><p><b>Answer options for 814218498309 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20022 (\"ECG - Exercise Stress Test\")</li></ul><a name=\"opt-item.307107493993\"> </a><p><b>Answer options for 307107493993 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20023 (\"ECG - Dobutamine/Persantine Stress Test\")</li></ul><a name=\"opt-item.805303414102\"> </a><p><b>Answer options for 805303414102 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20024 (\"Echocardiogram - Exercise Stress Test\")</li></ul><a name=\"opt-item.193586908489\"> </a><p><b>Answer options for 193586908489 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20025 (\"Echocardiogram - Dobutamine/Persantine Stress Test\")</li></ul><a name=\"opt-item.918517139023\"> </a><p><b>Answer options for 918517139023 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20010 (\"Nuclear Medicine\")</li></ul><a name=\"opt-item.924189648184\"> </a><p><b>Answer options for 924189648184 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20026 (\"MUGA - Resting\")</li></ul><a name=\"opt-item.857163514910\"> </a><p><b>Answer options for 857163514910 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20027 (\"Cardiac Pyrophosphate\")</li></ul><a name=\"opt-item.892165959617\"> </a><p><b>Answer options for 892165959617 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20028 (\"MIBI Scans / Myocardial Perfusion Imaging (MPI):\")</li></ul><a name=\"opt-item.373435981917\"> </a><p><b>Answer options for 373435981917 </b></p><ul><li style=\"font-size: 11px\">MIBI Scan - Exercise Stress Test</li></ul><a name=\"opt-item.434394942688\"> </a><p><b>Answer options for 434394942688 </b></p><ul><li style=\"font-size: 11px\">MIBI Scan - Dobutamine/Persantine Stress Test</li></ul><a name=\"opt-item.913594478162\"> </a><p><b>Answer options for 913594478162 </b></p><ul><li style=\"font-size: 11px\">Thallium Viability Test</li></ul><a name=\"opt-item.992682216482\"> </a><p><b>Answer options for 992682216482 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20011 (\"Tilt Table Testing\")</li></ul><a name=\"opt-item.cardiology_referral_services_cardiactesting_other\"> </a><p><b>Answer options for cardiology_referral_services_cardiactesting_other </b></p><ul><li style=\"font-size: 11px\">http://terminology.hl7.org/CodeSystem/v3-NullFlavor#OTH (\"other\")</li></ul><a name=\"opt-item.785727177547\"> </a><p><b>Answer options for 785727177547 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20002 (\"Cardiology Consultation\")</li></ul><a name=\"opt-item.219569805461\"> </a><p><b>Answer options for 219569805461 </b></p><ul><li style=\"font-size: 11px\">http://snomed.info/sct#698247007 (\"Arrhythmias or Palpitations\")</li></ul><a name=\"opt-item.571934328499\"> </a><p><b>Answer options for 571934328499 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20033 (\"Cardiovascular Risk Assessment\")</li></ul><a name=\"opt-item.459737733395\"> </a><p><b>Answer options for 459737733395 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20034 (\"Chest Pain or Angina\")</li></ul><a name=\"opt-item.929919815516\"> </a><p><b>Answer options for 929919815516 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20035 (\"Congenital Heart Disease\")</li></ul><a name=\"opt-item.832263816528\"> </a><p><b>Answer options for 832263816528 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20036 (\"Congestive Heart Failure\")</li></ul><a name=\"opt-item.803760213460\"> </a><p><b>Answer options for 803760213460 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20037 (\"Coronary Artery Disease\")</li></ul><a name=\"opt-item.129767162379\"> </a><p><b>Answer options for 129767162379 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20038 (\"Dyspnea\")</li></ul><a name=\"opt-item.116150628533\"> </a><p><b>Answer options for 116150628533 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20039 (\"Hypertension\")</li></ul><a name=\"opt-item.513825527027\"> </a><p><b>Answer options for 513825527027 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20040 (\"Murmur\")</li></ul><a name=\"opt-item.975075898688\"> </a><p><b>Answer options for 975075898688 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20041 (\"Pericardial Disease\")</li></ul><a name=\"opt-item.704148928571\"> </a><p><b>Answer options for 704148928571 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20042 (\"Peripheral Edema\")</li></ul><a name=\"opt-item.886489617115\"> </a><p><b>Answer options for 886489617115 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20043 (\"Post-Myocardial Infarction\")</li></ul><a name=\"opt-item.621745958993\"> </a><p><b>Answer options for 621745958993 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20044 (\"Pre-operative Consultation\")</li></ul><a name=\"opt-item.197975129599\"> </a><p><b>Answer options for 197975129599 </b></p><ul><li style=\"font-size: 11px\">http://example.com/CodeSystem/standardized-referral-form-codes#20045 (\"Syncope\")</li></ul><a name=\"opt-item.675849150752\"> </a><p><b>Answer options for 675849150752 </b></p><ul><li style=\"font-size: 11px\">http://snomed.info/sct#368009 (\"Valvular Heart Disease or Prosthetic Heart Valve\")</li></ul><a name=\"opt-item.721982740516\"> </a><p><b>Answer options for 721982740516 </b></p><ul><li style=\"font-size: 11px\">http://terminology.hl7.org/CodeSystem/v3-NullFlavor#OTH (\"other\")</li></ul><a name=\"opt-item.cpp_separate\"> </a><p><b>Answer options for cpp_separate </b></p><ul><li style=\"font-size: 11px\">CPP attached separately (if not entered below)</li></ul><a name=\"opt-item.preferredconsultlocation_selector\"> </a><p><b>Answer options for preferredconsultlocation_selector </b></p><ul><li style=\"font-size: 11px\">Preferred consultant or location</li></ul><a name=\"opt-item.preferredconsultlocation_willingtotravel\"> </a><p><b>Answer options for preferredconsultlocation_willingtotravel </b></p><ul><li style=\"font-size: 11px\">Patient willing to travel for shorter wait time</li></ul><a name=\"opt-item.supportingdocumentation_details\"> </a><p><b>Answer options for supportingdocumentation_details </b></p><ul><li style=\"font-size: 11px\">Personal Health Information that is medically relevant has not been disclosed at the request of the patient.</li></ul><a name=\"opt-item.referrer_role\"> </a><p><b>Answer options for referrer_role </b></p><ul><li style=\"font-size: 11px\">http://snomed.info/sct#309398001 (\"Allied Health Professional\")</li><li style=\"font-size: 11px\">http://snomed.info/sct#62247001 (\"Family Physician\")</li><li style=\"font-size: 11px\">http://snomed.info/sct#449161006 (\"Physician Assistant\")</li><li style=\"font-size: 11px\">http://snomed.info/sct#398130009 (\"Medical Student\")</li><li style=\"font-size: 11px\">http://snomed.info/sct#106292003 (\"Nurse\")</li><li style=\"font-size: 11px\">http://snomed.info/sct#224571005 (\"Nurse Practitioner\")</li><li style=\"font-size: 11px\">http://snomed.info/sct#405277009 (\"Resident\")</li><li style=\"font-size: 11px\">http://snomed.info/sct#69280009 (\"Specialist\")</li><li style=\"font-size: 11px\">http://terminology.hl7.org/CodeSystem/v3-NullFlavor#OTH (\"other\")</li></ul><h2>Contained Resources</h2><hr/>\n <table class=\"narrative-table\">\n <tbody>\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Metadata</th>\n\n\n</tr>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Description</th>\n\n\n\n<td class=\"content-container\">HTML with embedded [FHIRPath Liquid](https://confluence.hl7.org/spaces/FHIR/pages/66938964/FHIR+Liquid+Profile) that is intended to be executed against QuestionnaireResponses based on this Questionnaire.</td>\n\n\n</tr>\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Type</th>\n\n\n\n<td class=\"content-container\">\n logic-library from <a href=\"http://hl7.terminology.org/CodeSystem/library-types\">http://hl7.terminology.org/CodeSystem/library-types</a> \n\n\n</td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"parameters\"> </a>Parameters</th>\n\n\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Parameter</th>\n\n\n\n<td class=\"content-container\">None</td>\n\n\n</tr>\n\n\n\n\n\n\n\n <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Library Content</th>\n\n\n</tr>\n \n \n <tr>\n <th scope=\"row\" class=\"row-header\">text/htmlContent</th>\n <td>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code>Encoded data </code></pre>\n </td>\n </tr>\n \n \n\n<tr>\n <th colspan=\"2\" scope=\"row\" class=\"row-header\">Generated using version 0.5.4 of the sample-content-ig Liquid templates</th>\n</tr>\n\n </tbody>\n </table>\n</div>" ] ; fhir:DomainResource.contained [ a fhir:Library ; fhir:index -1 ; fhir:Resource.id [ fhir:value "liquid" ] ; fhir:Library.status [ fhir:value "active" ] ; fhir:Library.experimental [ fhir:value "false"^^xsd:boolean ] ; fhir:Library.type [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.terminology.org/CodeSystem/library-types" ] ; fhir:Coding.code [ fhir:value "logic-library" ] ] ] ; fhir:Library.description [ fhir:value "HTML with embedded [FHIRPath Liquid](https://confluence.hl7.org/spaces/FHIR/pages/66938964/FHIR+Liquid+Profile) that is intended to be executed against QuestionnaireResponses based on this Questionnaire." ] ; fhir:Library.content [ fhir:index -1 ; fhir:Attachment.contentType [ fhir:value "text/html" ] ; fhir:Attachment.data [ fhir:value "<div><!--ReleaseHeader--><p id="publish-box">Structured Data Capture - Local Development build (v4.0.0-ci-build) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the <a href='http://hl7.org/fhir/uv/sdc/history.html'>Directory of published versions</a></p><!--EndReleaseHeader-->{% for currentItem in QuestionnaireResponse.item.where((linkId = '102173268919') or (linkId = 'patient_header') or (linkId = 'additionalinfo_header') or (linkId = 'cpp_header') or (linkId = 'preferredconsultlocation_header') or (linkId = 'supportingdocumentation_header') or (linkId = 'supportingdocumentation_attachment' and answer.exists()) or (linkId = 'referrer_header')) %}{% if currentItem.linkId = '102173268919' %}<br/>Referral Details<br/> {% for currentItem in currentItem.item.where((linkId = 'cardio_triagecons') or (linkId = '695991571585') or (linkId = '186952778859') or (linkId = 'Descriptionofclinicalquestion' and answer.exists())) %}{% if currentItem.linkId = 'cardio_triagecons' %}Triage Considerations {% for currentItem in currentItem.item.where((linkId = 'referral_requestedpriority' and answer.exists()) or (linkId = 'referral_secondopinion' and answer.exists()) or (linkId = 'referral_secondopinion_reason' and answer.exists())) %}{% if currentItem.linkId = 'referral_requestedpriority' %}{% if currentItem.answer.exists() %}Requested Priority: <br/><span style="font-weight:bold;color:#EE6B00;">{% for answer in currentItem.answer %}{% if answer.value.code = 'routine' %}Routine<br/>{% endif %}{% if answer.value.code = 'urgent' %}Urgent{% endif %}{% endfor %}</span>{% endif %}{% endif %}{% if currentItem.linkId = 'referral_secondopinion' %}{% if currentItem.answer.exists() %}Second Opinion {% for answer in currentItem.answer %}{% if answer.value.code = '77406008' %}Second or third medical opinion{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'referral_secondopinion_reason' %}{% if currentItem.answer.exists() %}Reason for second opinion: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = '695991571585' %}Service(s) Requested {% for currentItem in currentItem.item.where((linkId = 'referralService' and answer.exists()) or (linkId = '223886162384' and answer.exists()) or (linkId = '660331267409') or (linkId = '785727177547' and answer.exists())) %}{% if currentItem.linkId = 'referralService' %}{% if currentItem.answer.exists() %}<span style="font-weight:bold;">HSCs Assigned:</span> {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '223886162384' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20001' %}Cardiac Testing{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '660331267409' %}Exam(s) Requested<br/><br/><br/> {% for currentItem in currentItem.item.where((linkId = '720409326878' and answer.exists()) or (linkId = '960455115596' and answer.exists()) or (linkId = '297634898828' and answer.exists()) or (linkId = '443484577720') or (linkId = '894277763438' and answer.exists()) or (linkId = '279226023495' and answer.exists()) or (linkId = '440449731882') or (linkId = '374742834400' and answer.exists()) or (linkId = '159161544747' and answer.exists()) or (linkId = '370275060390') or (linkId = '918517139023' and answer.exists()) or (linkId = '222686221935') or (linkId = '992682216482' and answer.exists()) or (linkId = 'cardiology_referral_services_cardiactesting_other' and answer.exists()) or (linkId = 'cardiology_referral_services_cardiactesting_other_specify' and answer.exists())) %}{% if currentItem.linkId = '720409326878' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20003' %}24 Hour Ambulatory Blood Pressure Monitoring (Not OHIP Covered){% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '960455115596' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20004' %}Coronary Angiogram{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '297634898828' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20005' %}Echocardiogram - Resting{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '443484577720' %}<br/><br/> {% for currentItem in currentItem.item.where((linkId = '165530569567' and answer.exists()) or (linkId = '286552421895' and answer.exists()) or (linkId = '910527687300' and answer.exists()) or (linkId = '657824763133' and answer.exists()) or (linkId = '992743200182' and answer.exists())) %}{% if currentItem.linkId = '165530569567' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20012' %}Echocardiogram (2D){% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '286552421895' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20013' %}Echocardiogram with Contrast{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '910527687300' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20014' %}Echocardiogram with Saline (Bubble){% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '657824763133' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20015' %}Pediatric Echocardiogram{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '992743200182' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20016' %}Transesophageal Echocardiogram (TEE){% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = '894277763438' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20006' %}Electrocardiogram (ECG){% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '279226023495' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20007' %}Holter Monitoring{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '440449731882' %}<br/><br/> {% for currentItem in currentItem.item.where((linkId = '671328703851' and answer.exists()) or (linkId = '423992261841' and answer.exists()) or (linkId = '419924239187' and answer.exists()) or (linkId = '731054417270' and answer.exists()) or (linkId = '235876421044' and answer.exists())) %}{% if currentItem.linkId = '671328703851' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20017' %}24 Hours{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '423992261841' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20018' %}48 Hours{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '419924239187' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20019' %}72 Hours{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '731054417270' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20020' %}7 Days{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '235876421044' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20021' %}14 Days{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = '374742834400' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20008' %}Loop / Event Monitor{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '159161544747' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20009' %}Stress Testing{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '370275060390' %}<br/><br/> {% for currentItem in currentItem.item.where((linkId = '814218498309' and answer.exists()) or (linkId = '307107493993' and answer.exists()) or (linkId = '805303414102' and answer.exists()) or (linkId = '193586908489' and answer.exists())) %}{% if currentItem.linkId = '814218498309' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20022' %}ECG - Exercise Stress Test{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '307107493993' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20023' %}ECG - Dobutamine/Persantine Stress Test{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '805303414102' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20024' %}Echocardiogram - Exercise Stress Test{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '193586908489' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20025' %}Echocardiogram - Dobutamine/Persantine Stress Test{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = '918517139023' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20010' %}Nuclear Medicine{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '222686221935' %}<br/><br/> {% for currentItem in currentItem.item.where((linkId = '924189648184' and answer.exists()) or (linkId = '857163514910' and answer.exists()) or (linkId = '892165959617' and answer.exists()) or (linkId = '538288549138')) %}{% if currentItem.linkId = '924189648184' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20026' %}MUGA - Resting{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '857163514910' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20027' %}Cardiac Pyrophosphate{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '892165959617' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20028' %}MIBI Scans / Myocardial Perfusion Imaging (MPI):{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '538288549138' %}<br/><br/> {% for currentItem in currentItem.item.where((linkId = '373435981917' and answer.exists()) or (linkId = '434394942688' and answer.exists()) or (linkId = '913594478162' and answer.exists())) %}{% if currentItem.linkId = '373435981917' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'MIBI Scan - Exercise Stress Test' %}MIBI Scan - Exercise Stress Test{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '434394942688' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'MIBI Scan - Dobutamine/Persantine Stress Test' %}MIBI Scan - Dobutamine/Persantine Stress Test{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '913594478162' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Thallium Viability Test' %}Thallium Viability Test{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = '992682216482' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20011' %}Tilt Table Testing{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'cardiology_referral_services_cardiactesting_other' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = 'OTH' %}other{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'cardiology_referral_services_cardiactesting_other_specify' %}{% if currentItem.answer.exists() %}Specify {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = '785727177547' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20002' %}Cardiology Consultation{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = '186952778859' %}<b>Concern(s) / Indication(s) Triggering Referral</b><br/><i>Select all that apply:</i><br/><br/> {% for currentItem in currentItem.item.where((linkId = '219569805461' and answer.exists()) or (linkId = '571934328499' and answer.exists()) or (linkId = '459737733395' and answer.exists()) or (linkId = '929919815516' and answer.exists()) or (linkId = '832263816528' and answer.exists()) or (linkId = '803760213460' and answer.exists()) or (linkId = '129767162379' and answer.exists()) or (linkId = '116150628533' and answer.exists()) or (linkId = '513825527027' and answer.exists()) or (linkId = '975075898688' and answer.exists()) or (linkId = '704148928571' and answer.exists()) or (linkId = '886489617115' and answer.exists()) or (linkId = '621745958993' and answer.exists()) or (linkId = '873024527134' and answer.exists()) or (linkId = '197975129599' and answer.exists()) or (linkId = '675849150752' and answer.exists()) or (linkId = '721982740516' and answer.exists()) or (linkId = '720594942482' and answer.exists())) %}{% if currentItem.linkId = '219569805461' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '698247007' %}Arrhythmias or Palpitations{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '571934328499' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20033' %}Cardiovascular Risk Assessment{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '459737733395' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20034' %}Chest Pain or Angina{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '929919815516' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20035' %}Congenital Heart Disease{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '832263816528' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20036' %}Congestive Heart Failure{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '803760213460' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20037' %}Coronary Artery Disease{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '129767162379' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20038' %}Dyspnea{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '116150628533' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20039' %}Hypertension{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '513825527027' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20040' %}Murmur{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '975075898688' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20041' %}Pericardial Disease{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '704148928571' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20042' %}Peripheral Edema{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '886489617115' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20043' %}Post-Myocardial Infarction{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '621745958993' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20044' %}Pre-operative Consultation{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '873024527134' %}{% if currentItem.answer.exists() %}Procedure Date (if known) {% for answer in currentItem.answer %}{{ answer.value.ofType(date) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '197975129599' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '20045' %}Syncope{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '675849150752' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = '368009' %}Valvular Heart Disease or Prosthetic Heart Valve{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '721982740516' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value.code = 'OTH' %}other{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = '720594942482' %}{% if currentItem.answer.exists() %}Specify {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = 'Descriptionofclinicalquestion' %}{% if currentItem.answer.exists() %}<span style="font-weight:bold;">Clinical Question / Goal(s) of Referral with Relevant History, Management and Investigations<br/></span> {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = 'patient_header' %}Patient Information<br/> {% for currentItem in currentItem.item.where((linkId = 'patient_surname' and answer.exists()) or (linkId = 'patient_firstname' and answer.exists()) or (linkId = 'patient_date_of_birth' and answer.exists()) or (linkId = 'patient_gender' and answer.exists()) or (linkId = 'patient_hc_pc' and answer.exists()) or (linkId = 'patient_address_line1' and answer.exists()) or (linkId = 'patient_phone_mobile' and answer.exists()) or (linkId = 'patient_phone_home' and answer.exists()) or (linkId = 'patient_phone_business' and answer.exists()) or (linkId = 'patient_email' and answer.exists())) %}{% if currentItem.linkId = 'patient_surname' %}{% if currentItem.answer.exists() %}Surname: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'patient_firstname' %}{% if currentItem.answer.exists() %}First Name: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'patient_date_of_birth' %}{% if currentItem.answer.exists() %}DOB: {% for answer in currentItem.answer %}{{ answer.value.ofType(date) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'patient_gender' %}{% if currentItem.answer.exists() %}Gender: {% for answer in currentItem.answer %}{% if answer.value.code = 'male' %}Male{% endif %}{% if answer.value.code = 'female' %}Female{% endif %}{% if answer.value.code = 'other' %}Other{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'patient_hc_pc' %}{% if currentItem.answer.exists() %}HN PC: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'patient_address_line1' %}{% if currentItem.answer.exists() %}Address (Line 1): {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'patient_phone_mobile' %}{% if currentItem.answer.exists() %}Mobile #: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'patient_phone_home' %}{% if currentItem.answer.exists() %}Home #: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'patient_phone_business' %}{% if currentItem.answer.exists() %}Business #: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'patient_email' %}{% if currentItem.answer.exists() %}Email: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = 'additionalinfo_header' %}[Optional] Additional Patient Information<br/><br/> {% for currentItem in currentItem.item.where((linkId = 'additionalinfo_sexassignedatbirth' and answer.exists()) or (linkId = 'additionalinfo_pronouns' and answer.exists()) or (linkId = 'additionalinfo_preferredlanguage' and answer.exists()) or (linkId = 'additionalinfo_bestmethodofcontact' and answer.exists()) or (linkId = 'additionalinfo_preferredname_select' and answer.exists()) or (linkId = 'additionalinfo_preferredname' and answer.exists()) or (linkId = 'additionalinfo_alternatecontact_select' and answer.exists()) or (linkId = 'additionalinfo_alternatecontact_name' and answer.exists()) or (linkId = 'additionalinfo_alternatecontact_phone' and answer.exists()) or (linkId = 'additionalinfo_alternatecontact_relationship' and answer.exists()) or (linkId = 'additionalinfo_alternatecontact_bookingcontact' and answer.exists()) or (linkId = 'additionalinfo_unsafecontacts_select' and answer.exists()) or (linkId = 'additionalinfo_unsafecontacts_speakwithpatientdirectly' and answer.exists()) or (linkId = 'additionalinfo_unsafecontacts_donotspeakwith' and answer.exists()) or (linkId = 'additionalinfo_accessibilityconcernsordisability_selectt' and answer.exists()) or (linkId = 'additionalinfo_accessibilityconcernsordisability' and answer.exists()) or (linkId = 'additionalinfo_specialconsiderations_select' and answer.exists()) or (linkId = 'additionalinfo_specialconsiderations' and answer.exists()) or (linkId = 'additionalinfo_sendcopiestoadditionalproviders' and answer.exists()) or (linkId = 'additionalinfo_sendcopiestoadditionalproviders_names' and answer.exists())) %}{% if currentItem.linkId = 'additionalinfo_sexassignedatbirth' %}{% if currentItem.answer.exists() %}Sex assigned at birth: {% for answer in currentItem.answer %}{% if answer.value.code = 'LA3-6' %}Female{% endif %}{% if answer.value.code = 'LA2-8' %}Male{% endif %}{% if answer.value.code = 'Intersex' %}Intersex{% endif %}{% if answer.value.code = 'LA4489-6' %}Unknown{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_pronouns' %}{% if currentItem.answer.exists() %}Pronouns: {% for answer in currentItem.answer %}{% if answer.value.code = 'LA29519-8' %}She/Her{% endif %}{% if answer.value.code = 'LA29518-0' %}He/Him{% endif %}{% if answer.value.code = 'LA29519-8' %}They/Them{% endif %}{% if answer.value.code = 'OTH' %}other{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_preferredlanguage' %}{% if currentItem.answer.exists() %}Preferred language: {% for answer in currentItem.answer %}{% if answer.value.code = 'en' %}English{% endif %}{% if answer.value.code = 'fr' %}French{% endif %}{% if answer.value.code = 'OTH' %}other{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_bestmethodofcontact' %}{% if currentItem.answer.exists() %}Best method of contact: {% for answer in currentItem.answer %}{% if answer.value.code = 'mobile' %}Mobile{% endif %}{% if answer.value.code = 'home' %}Home{% endif %}{% if answer.value.code = 'work' %}Work{% endif %}{% if answer.value.code = 'email' %}Email{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_preferredname_select' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Preferred Name' %}Preferred Name{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_preferredname' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_alternatecontact_select' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Alternate contact' %}Alternate contact{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_alternatecontact_name' %}{% if currentItem.answer.exists() %}Name: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_alternatecontact_phone' %}{% if currentItem.answer.exists() %}Alternate contact phone #: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_alternatecontact_relationship' %}{% if currentItem.answer.exists() %}Relationship: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_alternatecontact_bookingcontact' %}{% if currentItem.answer.exists() %}Is Alternate contact the appointment booking contact?: {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_unsafecontacts_select' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Unsafe contact persons (do not speak with)' %}Unsafe contact persons (do not speak with){% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_unsafecontacts_speakwithpatientdirectly' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Only speak with patient directly' %}Only speak with patient directly{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_unsafecontacts_donotspeakwith' %}{% if currentItem.answer.exists() %}Do not speak with: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_accessibilityconcernsordisability_selectt' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Accessibility concerns or disability' %}Accessibility concerns or disability{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_accessibilityconcernsordisability' %}{% if currentItem.answer.exists() %}<br/>{% for answer in currentItem.answer %}{% if answer.value.code = '129839007' %}Falls risk{% endif %}{% if answer.value.code = '301621006' %}Patient requires lift{% endif %}{% if answer.value.code = '105503008' %}Wheelchair{% endif %}{% if answer.value.code = '15188001' %}Hearing impaired{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_specialconsiderations_select' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Special considerations (e.g. barriers, tips for care delivery, 3rd party insurance, patient requires escort, cognitive issues)' %}Special considerations (e.g. barriers, tips for care delivery, 3rd party insurance, patient requires escort, cognitive issues){% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_specialconsiderations' %}{% if currentItem.answer.exists() %}Details of special considerations: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_sendcopiestoadditionalproviders' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Send copies of reports to additional providers' %}Send copies of reports to additional providers{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'additionalinfo_sendcopiestoadditionalproviders_names' %}{% if currentItem.answer.exists() %}Name(s): {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = 'cpp_header' %}Cumulative Patient Profile<br/><br/><i>Please delete any sensitive information you do not intend to share from the CPP</i><br/> {% for currentItem in currentItem.item.where((linkId = 'cpp_separate' and answer.exists()) or (linkId = 'cpp_currentprob' and answer.exists()) or (linkId = 'cpp_pastmedicalhistory' and answer.exists()) or (linkId = 'cpp_currentmedications' and answer.exists()) or (linkId = 'cpp_familyhistory' and answer.exists()) or (linkId = 'cpp_allergies' and answer.exists())) %}{% if currentItem.linkId = 'cpp_separate' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'CPP attached separately (if not entered below)' %}CPP attached separately (if not entered below){% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'cpp_currentprob' %}{% if currentItem.answer.exists() %}Current Problem List: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'cpp_pastmedicalhistory' %}{% if currentItem.answer.exists() %}Past Medical History: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'cpp_currentmedications' %}{% if currentItem.answer.exists() %}Current Medications : {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'cpp_familyhistory' %}{% if currentItem.answer.exists() %}Family History: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'cpp_allergies' %}{% if currentItem.answer.exists() %}Allergies: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = 'preferredconsultlocation_header' %}<b>Preferred Consultant or Location</b><br/><br/>All patients will be triaged to the shortest wait time unless a preferred consultant or location is entered.<br/> {% for currentItem in currentItem.item.where((linkId = 'preferredconsultlocation_selector' and answer.exists()) or (linkId = 'preferredconsultlocation_specify') or (linkId = 'preferredconsultlocation_willingtotravel' and answer.exists()) or (linkId = 'preferredconsultlocation_otherconsiderations' and answer.exists())) %}{% if currentItem.linkId = 'preferredconsultlocation_selector' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Preferred consultant or location' %}Preferred consultant or location{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'preferredconsultlocation_specify' %}Please specify either a <b>preferred</b> consultant or location<br/> {% for currentItem in currentItem.item.where((linkId = 'preferredconsultlocation_consultant' and answer.exists()) or (linkId = 'preferredconsultlocation_location' and answer.exists())) %}{% if currentItem.linkId = 'preferredconsultlocation_consultant' %}{% if currentItem.answer.exists() %}Consultant: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'preferredconsultlocation_location' %}{% if currentItem.answer.exists() %}Location: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = 'preferredconsultlocation_willingtotravel' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Patient willing to travel for shorter wait time' %}Patient willing to travel for shorter wait time{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'preferredconsultlocation_otherconsiderations' %}{% if currentItem.answer.exists() %}Other considerations: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = 'supportingdocumentation_header' %}<b>Supporting Documentation</b><br/>Please attach all <b><span style="text-decoration: underline">relevant</span></b> laboratory and diagnostic investigations.<br/><br/> {% for currentItem in currentItem.item.where((linkId = 'supportingdocumentation_details' and answer.exists())) %}{% if currentItem.linkId = 'supportingdocumentation_details' %}{% if currentItem.answer.exists() %}<span style="display:none;"><br/></span> {% for answer in currentItem.answer %}{% if answer.value = 'Personal Health Information that is medically relevant has not been disclosed at the request of the patient.' %}Personal Health Information that is medically relevant has not been disclosed at the request of the patient.{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if currentItem.linkId = 'supportingdocumentation_attachment' %}{% if currentItem.answer.exists() %}Add Attachments {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'referrer_header' %}Referrer's Information<br/> {% for currentItem in currentItem.item.where((linkId = 'referrer_sitename' and answer.exists()) or (linkId = 'referrer_address_line1' and answer.exists()) or (linkId = 'referrer_phone' and answer.exists()) or (linkId = 'referrer_fax' and answer.exists()) or (linkId = 'referrer_billing' and answer.exists()) or (linkId = 'referrer_professionalid' and answer.exists()) or (linkId = 'referrer_signature' and answer.exists()) or (linkId = 'referrer_role' and answer.exists())) %}{% if currentItem.linkId = 'referrer_sitename' %}{% if currentItem.answer.exists() %}Site Name: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'referrer_address_line1' %}{% if currentItem.answer.exists() %}Address (Line 1): {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'referrer_phone' %}{% if currentItem.answer.exists() %}Phone #: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'referrer_fax' %}{% if currentItem.answer.exists() %}Fax #: {% for answer in currentItem.answer %}{{ answer.value.ofType(string) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'referrer_billing' %}{% if currentItem.answer.exists() %}Billing Number: {% for answer in currentItem.answer %}{{ answer.value.ofType(integer) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'referrer_professionalid' %}{% if currentItem.answer.exists() %}Professional ID: {% for answer in currentItem.answer %}{{ answer.value.ofType(integer) }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'referrer_signature' %}{% if currentItem.answer.exists() %}Signed: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endif %}{% if currentItem.linkId = 'referrer_role' %}{% if currentItem.answer.exists() %}Role: {% for answer in currentItem.answer %}{% if answer.value.code = '309398001' %}Allied Health Professional{% endif %}{% if answer.value.code = '62247001' %}Family Physician{% endif %}{% if answer.value.code = '449161006' %}Physician Assistant{% endif %}{% if answer.value.code = '398130009' %}Medical Student{% endif %}{% if answer.value.code = '106292003' %}Nurse{% endif %}{% if answer.value.code = '224571005' %}Nurse Practitioner{% endif %}{% if answer.value.code = '405277009' %}Resident{% endif %}{% if answer.value.code = '69280009' %}Specialist{% endif %}{% if answer.value.code = 'OTH' %}other{% endif %}{% endfor %}{% endif %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}</div>"^^xsd:base64Binary ] ] ] ; fhir:DomainResource.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm" ] ; fhir:Extension.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/version-algorithm" ] ; fhir:Coding.code [ fhir:value "semver" ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-entryMode" ] ; fhir:Extension.valueCode [ fhir:value "random" ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "purpose" ] ; fhir:Extension.valueCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/rendering-purpose" ] ; fhir:Coding.code [ fhir:value "narrative" ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "template" ] ; fhir:Extension.valueReference [ fhir:Reference.reference [ fhir:value "#liquid" ] ] ] ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/instance-rendering" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg" ] ; fhir:Extension.valueCode [ fhir:value "fhir" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm" ] ; fhir:Extension.valueInteger [ fhir:value "4"^^xsd:integer ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom" ] ; fhir:Extension.valueCanonical [ fhir:value "http://hl7.org/fhir/uv/sdc/ImplementationGuide/hl7.fhir.uv.sdc" ; fhir:link <http://hl7.org/fhir/uv/sdc/ImplementationGuide/hl7.fhir.uv.sdc> ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status" ] ; fhir:Extension.valueCode [ fhir:value "trial-use" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom" ] ; fhir:Extension.valueCanonical [ fhir:value "http://hl7.org/fhir/uv/sdc/ImplementationGuide/hl7.fhir.uv.sdc" ; fhir:link <http://hl7.org/fhir/uv/sdc/ImplementationGuide/hl7.fhir.uv.sdc> ] ] ] ] ; fhir:Questionnaire.url [ fhir:value "http://hl7.org/fhir/uv/sdc/Questionnaire/CardiologyForm"] ; fhir:Questionnaire.identifier [ fhir:index -1 ; fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ] ; fhir:Identifier.value [ fhir:value "urn:oid:2.16.840.1.113883.4.642.40.17.35.43" ] ] ; fhir:Questionnaire.version [ fhir:value "4.0.0-ci-build"] ; fhir:Questionnaire.title [ fhir:value "Cardiology Form"] ; fhir:Questionnaire.status [ fhir:value "active"] ; fhir:Questionnaire.experimental [ fhir:value "false"^^xsd:boolean] ; fhir:Questionnaire.subjectType [ fhir:value "Patient" ; fhir:index -1 ] ; fhir:Questionnaire.date [ fhir:value "2026-01-20T15:05:51.993+00:00"^^xsd:dateTime] ; fhir:Questionnaire.publisher [ fhir:value "HL7 International / FHIR Infrastructure"] ; fhir:Questionnaire.contact [ fhir:index -1 ; fhir:ContactDetail.name [ fhir:value "HL7 International / FHIR Infrastructure" ] ; fhir:ContactDetail.telecom [ fhir:index -1 ; fhir:ContactPoint.system [ fhir:value "url" ] ; fhir:ContactPoint.value [ fhir:value "http://www.hl7.org/Special/committees/fiwg" ] ] ], [ fhir:index -1 ; fhir:ContactDetail.telecom [ fhir:index -1 ; fhir:ContactPoint.system [ fhir:value "url" ] ; fhir:ContactPoint.value [ fhir:value "http://www.hl7.org/Special/committees/fiwg" ] ] ] ; fhir:Questionnaire.jurisdiction [ fhir:index -1 ; fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://unstats.un.org/unsd/methods/m49/m49.htm" ] ; fhir:Coding.code [ fhir:value "001" ] ; fhir:Coding.display [ fhir:value "World" ] ] ] ; fhir:Questionnaire.effectivePeriod [ fhir:Period.start [ fhir:value "2025-02-03"^^xsd:date ] ] ; fhir:Questionnaire.code [ fhir:index -1 ; a sct:789718008 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "789718008" ] ; fhir:Coding.display [ fhir:value "Cardiology service" ] ] ; fhir:Questionnaire.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "list" ] ; fhir:Coding.display [ fhir:value "List" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:grey;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "patient_header" ] ; fhir:Questionnaire.item.text [ fhir:value "Patient Information" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "font-weight:bold;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "patient_surname" ] ; fhir:Questionnaire.item.text [ fhir:value "Surname:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "patient_firstname" ] ; fhir:Questionnaire.item.text [ fhir:value "First Name:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/entryFormat" ] ; fhir:Extension.valueString [ fhir:value "yyyy/MM/dd" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "patient_date_of_birth" ] ; fhir:Questionnaire.item.text [ fhir:value "DOB:" ] ; fhir:Questionnaire.item.type [ fhir:value "date" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "radio-button" ] ; fhir:Coding.display [ fhir:value "Radio Button" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "patient_gender" ] ; fhir:Questionnaire.item.text [ fhir:value "Gender:" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/administrative-gender" ] ; fhir:Coding.code [ fhir:value "male" ] ; fhir:Coding.display [ fhir:value "Male" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/administrative-gender" ] ; fhir:Coding.code [ fhir:value "female" ] ; fhir:Coding.display [ fhir:value "Female" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/administrative-gender" ] ; fhir:Coding.code [ fhir:value "other" ] ; fhir:Coding.display [ fhir:value "Other" ] ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "patient_hc_pc" ] ; fhir:Questionnaire.item.text [ fhir:value "HN PC:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.maxLength [ fhir:value "2"^^xsd:integer ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "patient_hc_number" ] ; fhir:Questionnaire.item.text [ fhir:value "HN:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.maxLength [ fhir:value "10"^^xsd:integer ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/minLength" ] ; fhir:Extension.valueInteger [ fhir:value "2"^^xsd:integer ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "patient_hc_vc" ] ; fhir:Questionnaire.item.text [ fhir:value "HN VC:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "patient_address_line1" ] ; fhir:Questionnaire.item.text [ fhir:value "Address (Line 1):" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "patient_address_line2" ] ; fhir:Questionnaire.item.text [ fhir:value "Address (Line 2):" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "patient_address_city" ] ; fhir:Questionnaire.item.text [ fhir:value "City:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "patient_address_province" ] ; fhir:Questionnaire.item.text [ fhir:value "Province:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.maxLength [ fhir:value "2"^^xsd:integer ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "key" ] ; fhir:Extension.valueId [ fhir:value "pat-pcode" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "severity" ] ; fhir:Extension.valueCode [ fhir:value "error" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "expression" ] ; fhir:Extension.valueExpression [ fhir:Expression.language [ fhir:value "text/fhirpath" ] ; fhir:Expression.expression [ fhir:value "%resource.repeat(item).where(linkId='patient_address_postalcode').answer.all(value.matches('^(?!.*[DFIOQU])[A-VXY][0-9][A-Z] ?[0-9][A-Z][0-9]$'))" ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "human" ] ; fhir:Extension.valueString [ fhir:value "Must be a valid Canadian postal-code" ] ] ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/targetConstraint" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "patient_address_postalcode" ] ; fhir:Questionnaire.item.text [ fhir:value "Postal Code:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "key" ] ; fhir:Extension.valueId [ fhir:value "mobilephone" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "severity" ] ; fhir:Extension.valueCode [ fhir:value "error" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "expression" ] ; fhir:Extension.valueExpression [ fhir:Expression.language [ fhir:value "text/fhirpath" ] ; fhir:Expression.expression [ fhir:value "%resource.repeat(item).where(linkId='patient_phone_mobile').answer.all(value.matches('^(\\+\\d{1,2}\\s?)?\\(?\\d{3}\\)?[\\s.-]?\\d{3}[\\s.-]?\\d{4}$'))" ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "human" ] ; fhir:Extension.valueString [ fhir:value "Must be a valid phone number" ] ] ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/targetConstraint" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "patient_phone_mobile" ] ; fhir:Questionnaire.item.text [ fhir:value "Mobile #:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "key" ] ; fhir:Extension.valueId [ fhir:value "homephone" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "severity" ] ; fhir:Extension.valueCode [ fhir:value "error" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "expression" ] ; fhir:Extension.valueExpression [ fhir:Expression.language [ fhir:value "text/fhirpath" ] ; fhir:Expression.expression [ fhir:value "%resource.repeat(item).where(linkId='patient_phone_home').answer.all(value.matches('^(\\+\\d{1,2}\\s?)?\\(?\\d{3}\\)?[\\s.-]?\\d{3}[\\s.-]?\\d{4}$'))" ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "human" ] ; fhir:Extension.valueString [ fhir:value "Must be a valid phone number" ] ] ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/targetConstraint" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "patient_phone_home" ] ; fhir:Questionnaire.item.text [ fhir:value "Home #:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "key" ] ; fhir:Extension.valueId [ fhir:value "busphone" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "severity" ] ; fhir:Extension.valueCode [ fhir:value "error" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "expression" ] ; fhir:Extension.valueExpression [ fhir:Expression.language [ fhir:value "text/fhirpath" ] ; fhir:Expression.expression [ fhir:value "%resource.repeat(item).where(linkId='patient_phone_business').answer.all(value.matches('^(\\+\\d{1,2}\\s?)?\\(?\\d{3}\\)?[\\s.-]?\\d{3}[\\s.-]?\\d{4}$'))" ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "human" ] ; fhir:Extension.valueString [ fhir:value "Must be a valid phone number" ] ] ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/targetConstraint" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "patient_phone_business" ] ; fhir:Questionnaire.item.text [ fhir:value "Business #:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "key" ] ; fhir:Extension.valueId [ fhir:value "patemail" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "severity" ] ; fhir:Extension.valueCode [ fhir:value "error" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "expression" ] ; fhir:Extension.valueExpression [ fhir:Expression.language [ fhir:value "text/fhirpath" ] ; fhir:Expression.expression [ fhir:value "%resource.repeat(item).where(linkId='patient_email').answer.all(value.matches('(?:[a-z0-9!#$%&'*+/=?^_`{|}~-]+(?:\\.[a-z0-9!#$%&'*+/=?^_`{|}~-]+)*|\"(?:[\\x01-\\x08\\x0b\\x0c\\x0e-\\x1f\\x21\\x23-\\x5b\\x5d-\\x7f]|\\\\[\\x01-\\x09\\x0b\\x0c\\x0e-\\x7f])*\")@(?:(?:[a-z0-9](?:[a-z0-9-]*[a-z0-9])?\\.)+[a-z0-9](?:[a-z0-9-]*[a-z0-9])?|\\[(?:(?:(2(5[0-5]|[0-4][0-9])|1[0-9][0-9]|[1-9]?[0-9]))\\.){3}(?:(2(5[0-5]|[0-4][0-9])|1[0-9][0-9]|[1-9]?[0-9])|[a-z0-9-]*[a-z0-9]:(?:[\\x01-\\x08\\x0b\\x0c\\x0e-\\x1f\\x21-\\x5a\\x53-\\x7f]|\\\\[\\x01-\\x09\\x0b\\x0c\\x0e-\\x7f])+)\\])'))" ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "human" ] ; fhir:Extension.valueString [ fhir:value "Must be a valid email address" ] ] ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/targetConstraint" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "patient_email" ] ; fhir:Questionnaire.item.text [ fhir:value "Email:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:grey;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_header" ] ; fhir:Questionnaire.item.text [ fhir:value "[Optional] Additional Patient Information" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "[Optional] Additional Patient Information<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "font-weight:bold;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/item-controls" ] ; fhir:Coding.code [ fhir:value "push-button" ] ; fhir:Coding.display [ fhir:value "Push Button" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_sexassignedatbirth" ] ; fhir:Questionnaire.item.text [ fhir:value "Sex assigned at birth:" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA3-6 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA3-6" ] ; fhir:Coding.display [ fhir:value "Female" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA2-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA2-8" ] ; fhir:Coding.display [ fhir:value "Male" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/exampleCS" ] ; fhir:Coding.code [ fhir:value "Intersex" ] ; fhir:Coding.display [ fhir:value "Intersex" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA4489-6 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA4489-6" ] ; fhir:Coding.display [ fhir:value "Unknown" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/item-controls" ] ; fhir:Coding.code [ fhir:value "push-button" ] ; fhir:Coding.display [ fhir:value "Push Button" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_pronouns" ] ; fhir:Questionnaire.item.text [ fhir:value "Pronouns:" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA29519-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA29519-8" ] ; fhir:Coding.display [ fhir:value "She/Her" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA29518-0 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA29518-0" ] ; fhir:Coding.display [ fhir:value "He/Him" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA29519-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA29519-8" ] ; fhir:Coding.display [ fhir:value "They/Them" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-NullFlavor" ] ; fhir:Coding.code [ fhir:value "OTH" ] ; fhir:Coding.display [ fhir:value "other" ] ] ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_pronouns_other" ] ; fhir:Questionnaire.item.text [ fhir:value "Other pronouns:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "additionalinfo_pronouns" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-NullFlavor" ] ; fhir:Coding.code [ fhir:value "OTH" ] ; fhir:Coding.display [ fhir:value "other" ] ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "all" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/item-controls" ] ; fhir:Coding.code [ fhir:value "push-button" ] ; fhir:Coding.display [ fhir:value "Push Button" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_preferredlanguage" ] ; fhir:Questionnaire.item.text [ fhir:value "Preferred language:" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "urn:ietf:bcp:47" ] ; fhir:Coding.code [ fhir:value "en" ] ; fhir:Coding.display [ fhir:value "English" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "urn:ietf:bcp:47" ] ; fhir:Coding.code [ fhir:value "fr" ] ; fhir:Coding.display [ fhir:value "French" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-NullFlavor" ] ; fhir:Coding.code [ fhir:value "OTH" ] ; fhir:Coding.display [ fhir:value "other" ] ] ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_preferredlanguage_specify" ] ; fhir:Questionnaire.item.text [ fhir:value "Specify:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "additionalinfo_preferredlanguage" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-NullFlavor" ] ; fhir:Coding.code [ fhir:value "OTH" ] ; fhir:Coding.display [ fhir:value "other" ] ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "all" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_preferredlanguage_translatorrequired" ] ; fhir:Questionnaire.item.text [ fhir:value "Translator required" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "additionalinfo_preferredlanguage" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-NullFlavor" ] ; fhir:Coding.code [ fhir:value "OTH" ] ; fhir:Coding.display [ fhir:value "other" ] ] ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueString [ fhir:value "Translator Required" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/item-controls" ] ; fhir:Coding.code [ fhir:value "push-button" ] ; fhir:Coding.display [ fhir:value "Push Button" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_bestmethodofcontact" ] ; fhir:Questionnaire.item.text [ fhir:value "Best method of contact:" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/contact-point-use" ] ; fhir:Coding.code [ fhir:value "mobile" ] ; fhir:Coding.display [ fhir:value "Mobile" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/contact-point-use" ] ; fhir:Coding.code [ fhir:value "home" ] ; fhir:Coding.display [ fhir:value "Home" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/contact-point-use" ] ; fhir:Coding.code [ fhir:value "work" ] ; fhir:Coding.display [ fhir:value "Work" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/contact-point-system" ] ; fhir:Coding.code [ fhir:value "email" ] ; fhir:Coding.display [ fhir:value "Email" ] ] ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_bestmethodofcontact_voicemails" ] ; fhir:Questionnaire.item.text [ fhir:value "Voicemails acceptable" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "additionalinfo_bestmethodofcontact" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/contact-point-use" ] ; fhir:Coding.code [ fhir:value "mobile" ] ; fhir:Coding.display [ fhir:value "Mobile" ] ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "any" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueString [ fhir:value " Voicemails acceptable" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_preferredname_select" ] ; fhir:Questionnaire.item.text [ fhir:value "Preferred name" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueString [ fhir:value "Preferred Name" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_preferredname" ] ; fhir:Questionnaire.item.text [ fhir:value "Prefered name String" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "additionalinfo_preferredname_select" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerString [ fhir:value "Preferred Name" ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "all" ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_alternatecontact_select" ] ; fhir:Questionnaire.item.text [ fhir:value "Alternate contact" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueString [ fhir:value "Alternate contact" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_alternatecontact_name" ] ; fhir:Questionnaire.item.text [ fhir:value "Name:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "additionalinfo_alternatecontact_select" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerString [ fhir:value "Alternate contact" ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "all" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "key" ] ; fhir:Extension.valueId [ fhir:value "altphone" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "severity" ] ; fhir:Extension.valueCode [ fhir:value "error" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "expression" ] ; fhir:Extension.valueExpression [ fhir:Expression.language [ fhir:value "text/fhirpath" ] ; fhir:Expression.expression [ fhir:value "%resource.repeat(item).where(linkId='additionalinfo_alternatecontact_phone').answer.all(value.matches('^(\\+\\d{1,2}\\s?)?\\(?\\d{3}\\)?[\\s.-]?\\d{3}[\\s.-]?\\d{4}$'))" ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "human" ] ; fhir:Extension.valueString [ fhir:value "Must be a valid phone number" ] ] ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/targetConstraint" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_alternatecontact_phone" ] ; fhir:Questionnaire.item.text [ fhir:value "Alternate contact phone #:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "additionalinfo_alternatecontact_select" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerString [ fhir:value "Alternate contact" ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "all" ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_alternatecontact_relationship" ] ; fhir:Questionnaire.item.text [ fhir:value "Relationship:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "additionalinfo_alternatecontact_select" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerString [ fhir:value "Alternate contact" ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "all" ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "radio-button" ] ; fhir:Coding.display [ fhir:value "Radio Button" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_alternatecontact_bookingcontact" ] ; fhir:Questionnaire.item.text [ fhir:value "Is Alternate contact the appointment booking contact?:" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "additionalinfo_alternatecontact_select" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerString [ fhir:value "Alternate contact" ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "all" ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0532" ] ; fhir:Coding.code [ fhir:value "Y" ] ; fhir:Coding.display [ fhir:value "Yes" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0532" ] ; fhir:Coding.code [ fhir:value "N" ] ; fhir:Coding.display [ fhir:value "No" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_unsafecontacts_select" ] ; fhir:Questionnaire.item.text [ fhir:value "Unsafe contact persons (do not speak with)" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueString [ fhir:value "Unsafe contact persons (do not speak with)" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_unsafecontacts_speakwithpatientdirectly" ] ; fhir:Questionnaire.item.text [ fhir:value "Only speak with patient directly" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "additionalinfo_unsafecontacts_select" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerString [ fhir:value "Unsafe contact persons (do not speak with)" ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "all" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueString [ fhir:value "Only speak with patient directly" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_unsafecontacts_donotspeakwith" ] ; fhir:Questionnaire.item.text [ fhir:value "Do not speak with:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "additionalinfo_unsafecontacts_select" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerString [ fhir:value "Unsafe contact persons (do not speak with)" ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "all" ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_accessibilityconcernsordisability_selectt" ] ; fhir:Questionnaire.item.text [ fhir:value "Accessibility concerns or disability" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueString [ fhir:value "Accessibility concerns or disability" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/item-controls" ] ; fhir:Coding.code [ fhir:value "push-button" ] ; fhir:Coding.display [ fhir:value "Push Button" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_accessibilityconcernsordisability" ] ; fhir:Questionnaire.item.text [ fhir:value "Accessibility concerns Options" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "additionalinfo_accessibilityconcernsordisability_selectt" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerString [ fhir:value "Accessibility concerns or disability" ] ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a sct:129839007 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "129839007" ] ; fhir:Coding.display [ fhir:value "Falls risk" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a sct:301621006 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "301621006" ] ; fhir:Coding.display [ fhir:value "Patient requires lift" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a sct:105503008 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "105503008" ] ; fhir:Coding.display [ fhir:value "Wheelchair" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a sct:15188001 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "15188001" ] ; fhir:Coding.display [ fhir:value "Hearing impaired" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_specialconsiderations_select" ] ; fhir:Questionnaire.item.text [ fhir:value "Special considerations (e.g. barriers, tips for care delivery, 3rd party insurance, patient requires escort, cognitive issues)" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueString [ fhir:value "Special considerations (e.g. barriers, tips for care delivery, 3rd party insurance, patient requires escort, cognitive issues)" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_specialconsiderations" ] ; fhir:Questionnaire.item.text [ fhir:value "Details of special considerations:" ] ; fhir:Questionnaire.item.type [ fhir:value "text" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "additionalinfo_specialconsiderations_select" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerString [ fhir:value "Special considerations (e.g. barriers, tips for care delivery, 3rd party insurance, patient requires escort, cognitive issues)" ] ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_sendcopiestoadditionalproviders" ] ; fhir:Questionnaire.item.text [ fhir:value "Send copies of reports to additional providers" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueString [ fhir:value "Send copies of reports to additional providers" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_sendcopiestoadditionalproviders_names" ] ; fhir:Questionnaire.item.text [ fhir:value "Name(s):" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "additionalinfo_sendcopiestoadditionalproviders" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerString [ fhir:value "Send copies of reports to additional providers" ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "all" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_sendcopiestoadditionalproviders_contactinfo" ] ; fhir:Questionnaire.item.text [ fhir:value "Contact information:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "additionalinfo_sendcopiestoadditionalproviders" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerString [ fhir:value "Send copies of reports to additional providers" ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "all" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "additionalinfo_sendcopiestoadditionalproviders_ispcp" ] ; fhir:Questionnaire.item.text [ fhir:value "This is the Primary Care Provider" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "additionalinfo_sendcopiestoadditionalproviders" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerString [ fhir:value "Send copies of reports to additional providers" ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "all" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueString [ fhir:value "This is the Primary Care Provider" ] ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:grey;border-style:solid;" ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "sortIndex" ] ; fhir:Extension.valuePositiveInt [ fhir:value "1"^^xsd:positiveInteger ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "text" ] ; fhir:Extension.valueString [ fhir:value "Referral Details" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>Referral Details<br/>" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "style" ] ; fhir:Extension.valueString [ fhir:value "font-weight:bold;text-decoration:underline;" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "groupItems" ] ; fhir:Extension.valueBoolean [ fhir:value "false"^^xsd:boolean ] ] ; fhir:Extension.url [ fhir:value "http://example.com/StructureDefinition/group-note-info" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "102173268919" ] ; fhir:Questionnaire.item.text [ fhir:value "Referral Details" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "Referral Details<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "font-weight:bold;color:#202035;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "enableWhenExpression" ] ; fhir:Extension.valueExpression [ fhir:Expression.language [ fhir:value "text/fhirpath" ] ; fhir:Expression.expression [ fhir:value "true" ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "sortIndex" ] ; fhir:Extension.valuePositiveInt [ fhir:value "1"^^xsd:positiveInteger ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "text" ] ; fhir:Extension.valueString [ fhir:value "Triage Considerations" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "style" ] ; fhir:Extension.valueString [ fhir:value "font-weight:bold;" ] ] ; fhir:Extension.url [ fhir:value "http://example.com/StructureDefinition/group-note-info" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "cardio_triagecons" ] ; fhir:Questionnaire.item.text [ fhir:value "Triage Considerations" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "Triage Considerations<br/><br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "font-weight:bold;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/item-controls" ] ; fhir:Coding.code [ fhir:value "push-button" ] ; fhir:Coding.display [ fhir:value "Push Button" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "sortIndex" ] ; fhir:Extension.valuePositiveInt [ fhir:value "1"^^xsd:positiveInteger ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "text" ] ; fhir:Extension.valueString [ fhir:value "Requested Priority:" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "sameLine" ] ; fhir:Extension.valueBoolean [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "answerStyle" ] ; fhir:Extension.valueString [ fhir:value "font-weight:bold;color:#EE6B00;" ] ] ; fhir:Extension.url [ fhir:value "http://example.com/StructureDefinition/question-note-info" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "referral_requestedpriority" ] ; fhir:Questionnaire.item.text [ fhir:value "Requested Priority:" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "text" ] ; fhir:Extension.valueString [ fhir:value "Routine" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "style" ] ; fhir:Extension.valueString [ fhir:value "font-weight:bold;color:#EE6B00;" ] ] ; fhir:Extension.url [ fhir:value "http://example.com/StructureDefinition/option-note-info" ] ] ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/request-priority" ] ; fhir:Coding.code [ fhir:value "routine" ] ; fhir:Coding.display [ fhir:value "Routine" ] ] ; fhir:Questionnaire.item.answerOption.initialSelected [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/request-priority" ] ; fhir:Coding.code [ fhir:value "urgent" ] ; fhir:Coding.display [ fhir:value "Urgent" ] ] ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "referral_requestedpriority_urgentreason" ] ; fhir:Questionnaire.item.text [ fhir:value "Reason for urgent triage" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "referral_requestedpriority" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/request-priority" ] ; fhir:Coding.code [ fhir:value "urgent" ] ; fhir:Coding.display [ fhir:value "Urgent" ] ] ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "sortIndex" ] ; fhir:Extension.valuePositiveInt [ fhir:value "2"^^xsd:positiveInteger ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "text" ] ; fhir:Extension.valueString [ fhir:value "Second Opinion" ] ] ; fhir:Extension.url [ fhir:value "http://example.com/StructureDefinition/question-note-info" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "referral_secondopinion" ] ; fhir:Questionnaire.item.text [ fhir:value "Second Opinion" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a sct:77406008 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "77406008" ] ; fhir:Coding.display [ fhir:value "Second or third medical opinion" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "referral_secondopinion_reason" ] ; fhir:Questionnaire.item.text [ fhir:value "Reason for second opinion:" ] ; fhir:Questionnaire.item.type [ fhir:value "text" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "referral_secondopinion" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerCoding [ a sct:77406008 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "77406008" ] ; fhir:Coding.display [ fhir:value "Second or third medical opinion" ] ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "sortIndex" ] ; fhir:Extension.valuePositiveInt [ fhir:value "2"^^xsd:positiveInteger ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "text" ] ; fhir:Extension.valueString [ fhir:value "Service(s) Requested" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "style" ] ; fhir:Extension.valueString [ fhir:value "font-weight:bold;" ] ] ; fhir:Extension.url [ fhir:value "http://example.com/StructureDefinition/group-note-info" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "695991571585" ] ; fhir:Questionnaire.item.text [ fhir:value "Service(s) Requested Select all that apply:" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<b>Service(s) Requested</b><br/><i>Select all that apply:</i><br/><br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "color:Gray20;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression" ] ; fhir:Extension.valueExpression [ fhir:Expression.description [ fhir:value "Calculates HSC services based on selected checkboxes for cardiac testing and cardiology consult" ] ; fhir:Expression.language [ fhir:value "text/fhirpath" ] ; fhir:Expression.expression [ fhir:value "iif(%resource.item.where(linkId='223886162384').answer.value.exists(), 'CARDIOLOGY_SERVICES', '') + iif(%resource.item.where(linkId='223886162384').answer.value.exists() and %resource.item.where(linkId='785727177547').answer.value.exists(), '|', '') + iif(%resource.item.where(linkId='785727177547').answer.value.exists(), 'CARDIOLOGY', '')" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "text" ] ; fhir:Extension.valueString [ fhir:value "HSCs Assigned:" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "style" ] ; fhir:Extension.valueString [ fhir:value "font-weight:bold;" ] ] ; fhir:Extension.url [ fhir:value "http://example.com/StructureDefinition/question-note-info" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden" ] ; fhir:Extension.valueBoolean [ fhir:value "true"^^xsd:boolean ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "referralService" ] ; fhir:Questionnaire.item.text [ fhir:value "HSCs Assigned:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.readOnly [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "223886162384" ] ; fhir:Questionnaire.item.text [ fhir:value "Cardiac Testing" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20001" ] ; fhir:Coding.display [ fhir:value "Cardiac Testing" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "660331267409" ] ; fhir:Questionnaire.item.text [ fhir:value "Exam(s) Requested" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "Exam(s) Requested<br/><br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "color:Gray20;font-weight:bold;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "223886162384" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20001" ] ; fhir:Coding.display [ fhir:value "Cardiac Testing" ] ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "all" ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "720409326878" ] ; fhir:Questionnaire.item.text [ fhir:value "24 Hour Ambulatory Blood Pressure Monitoring" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20003" ] ; fhir:Coding.display [ fhir:value "24 Hour Ambulatory Blood Pressure Monitoring" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "960455115596" ] ; fhir:Questionnaire.item.text [ fhir:value "Coronary Angiogram" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20004" ] ; fhir:Coding.display [ fhir:value "Coronary Angiogram" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "297634898828" ] ; fhir:Questionnaire.item.text [ fhir:value "Echocardiogram - Resting" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20005" ] ; fhir:Coding.display [ fhir:value "Echocardiogram - Resting" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:grey;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "443484577720" ] ; fhir:Questionnaire.item.text [ fhir:value "sub Echocardiogram - Resting" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "297634898828" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20005" ] ; fhir:Coding.display [ fhir:value "Echocardiogram - Resting" ] ] ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "165530569567" ] ; fhir:Questionnaire.item.text [ fhir:value "Echocardiogram (2D)" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20012" ] ; fhir:Coding.display [ fhir:value "Echocardiogram (2D)" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "286552421895" ] ; fhir:Questionnaire.item.text [ fhir:value "Echocardiogram with Contrast" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20013" ] ; fhir:Coding.display [ fhir:value "Echocardiogram with Contrast" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "910527687300" ] ; fhir:Questionnaire.item.text [ fhir:value "Echocardiogram with Saline (Bubble)" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20014" ] ; fhir:Coding.display [ fhir:value "Echocardiogram with Saline (Bubble)" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "657824763133" ] ; fhir:Questionnaire.item.text [ fhir:value "Pediatric Echocardiogram" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20015" ] ; fhir:Coding.display [ fhir:value "Pediatric Echocardiogram" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "992743200182" ] ; fhir:Questionnaire.item.text [ fhir:value "Transesophageal Echocardiogram (TEE)" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20016" ] ; fhir:Coding.display [ fhir:value "Transesophageal Echocardiogram (TEE)" ] ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "894277763438" ] ; fhir:Questionnaire.item.text [ fhir:value "Electrocardiogram (ECG)" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20006" ] ; fhir:Coding.display [ fhir:value "Electrocardiogram (ECG)" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "279226023495" ] ; fhir:Questionnaire.item.text [ fhir:value "Holter Monitoring" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20007" ] ; fhir:Coding.display [ fhir:value "Holter Monitoring" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:grey;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "440449731882" ] ; fhir:Questionnaire.item.text [ fhir:value "sub holter monitoring" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "279226023495" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20007" ] ; fhir:Coding.display [ fhir:value "Holter Monitoring" ] ] ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "671328703851" ] ; fhir:Questionnaire.item.text [ fhir:value "24 Hours" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20017" ] ; fhir:Coding.display [ fhir:value "24 Hours" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "423992261841" ] ; fhir:Questionnaire.item.text [ fhir:value "48 Hours" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20018" ] ; fhir:Coding.display [ fhir:value "48 Hours" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "419924239187" ] ; fhir:Questionnaire.item.text [ fhir:value "72 Hours" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20019" ] ; fhir:Coding.display [ fhir:value "72 Hours" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "731054417270" ] ; fhir:Questionnaire.item.text [ fhir:value "7 Days" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20020" ] ; fhir:Coding.display [ fhir:value "7 Days" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "235876421044" ] ; fhir:Questionnaire.item.text [ fhir:value "14 Days" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20021" ] ; fhir:Coding.display [ fhir:value "14 Days" ] ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "374742834400" ] ; fhir:Questionnaire.item.text [ fhir:value "Loop / Event Monitor" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20008" ] ; fhir:Coding.display [ fhir:value "Loop / Event Monitor" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "159161544747" ] ; fhir:Questionnaire.item.text [ fhir:value "Cardiovascular stress testing" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20009" ] ; fhir:Coding.display [ fhir:value "Stress Testing" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:grey;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "370275060390" ] ; fhir:Questionnaire.item.text [ fhir:value "Sub Stress Testing" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "159161544747" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20009" ] ; fhir:Coding.display [ fhir:value "Stress Testing" ] ] ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "814218498309" ] ; fhir:Questionnaire.item.text [ fhir:value "ECG - Exercise Stress Test" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20022" ] ; fhir:Coding.display [ fhir:value "ECG - Exercise Stress Test" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "307107493993" ] ; fhir:Questionnaire.item.text [ fhir:value "ECG - Dobutamine/Persantine Stress Test" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20023" ] ; fhir:Coding.display [ fhir:value "ECG - Dobutamine/Persantine Stress Test" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "805303414102" ] ; fhir:Questionnaire.item.text [ fhir:value "Echocardiogram - Exercise Stress Test" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20024" ] ; fhir:Coding.display [ fhir:value "Echocardiogram - Exercise Stress Test" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "193586908489" ] ; fhir:Questionnaire.item.text [ fhir:value "Echocardiogram - Dobutamine/Persantine Stress Test" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20025" ] ; fhir:Coding.display [ fhir:value "Echocardiogram - Dobutamine/Persantine Stress Test" ] ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "918517139023" ] ; fhir:Questionnaire.item.text [ fhir:value "Nuclear Medicine" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20010" ] ; fhir:Coding.display [ fhir:value "Nuclear Medicine" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:grey;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "222686221935" ] ; fhir:Questionnaire.item.text [ fhir:value "sub Nuclear Medicine" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "918517139023" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20010" ] ; fhir:Coding.display [ fhir:value "Nuclear Medicine" ] ] ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "924189648184" ] ; fhir:Questionnaire.item.text [ fhir:value "MUGA - Resting" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20026" ] ; fhir:Coding.display [ fhir:value "MUGA - Resting" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "857163514910" ] ; fhir:Questionnaire.item.text [ fhir:value "Cardiac Pyrophosphate" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20027" ] ; fhir:Coding.display [ fhir:value "Cardiac Pyrophosphate" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "892165959617" ] ; fhir:Questionnaire.item.text [ fhir:value "Myocardial perfusion scan" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20028" ] ; fhir:Coding.display [ fhir:value "MIBI Scans / Myocardial Perfusion Imaging (MPI):" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "radio-button" ] ; fhir:Coding.display [ fhir:value "Radio Button" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "538288549138" ] ; fhir:Questionnaire.item.text [ fhir:value "sub MIBI" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "892165959617" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20028" ] ; fhir:Coding.display [ fhir:value "MIBI Scans / Myocardial Perfusion Imaging (MPI):" ] ] ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "373435981917" ] ; fhir:Questionnaire.item.text [ fhir:value "MIBI Scan - Exercise Stress Test" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueString [ fhir:value "MIBI Scan - Exercise Stress Test" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "434394942688" ] ; fhir:Questionnaire.item.text [ fhir:value "MIBI Scan - Dobutamine/Persantine Stress Test" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueString [ fhir:value "MIBI Scan - Dobutamine/Persantine Stress Test" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "913594478162" ] ; fhir:Questionnaire.item.text [ fhir:value "Thallium Viability Test" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueString [ fhir:value "Thallium Viability Test" ] ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "992682216482" ] ; fhir:Questionnaire.item.text [ fhir:value "Tilt Table Testing" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20011" ] ; fhir:Coding.display [ fhir:value "Tilt Table Testing" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "cardiology_referral_services_cardiactesting_other" ] ; fhir:Questionnaire.item.text [ fhir:value "Other" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-NullFlavor" ] ; fhir:Coding.code [ fhir:value "OTH" ] ; fhir:Coding.display [ fhir:value "other" ] ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "cardiology_referral_services_cardiactesting_other_specify" ] ; fhir:Questionnaire.item.text [ fhir:value "Specify" ] ; fhir:Questionnaire.item.type [ fhir:value "text" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "cardiology_referral_services_cardiactesting_other" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-NullFlavor" ] ; fhir:Coding.code [ fhir:value "OTH" ] ; fhir:Coding.display [ fhir:value "other" ] ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "all" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "785727177547" ] ; fhir:Questionnaire.item.text [ fhir:value "Cardiology Consultation" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20002" ] ; fhir:Coding.display [ fhir:value "Cardiology Consultation" ] ] ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "186952778859" ] ; fhir:Questionnaire.item.text [ fhir:value "Concern(s) / Indication(s) Triggering Referral Select all that apply:" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<b>Concern(s) / Indication(s) Triggering Referral</b><br/><i>Select all that apply:</i><br/>" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "219569805461" ] ; fhir:Questionnaire.item.text [ fhir:value "Arrhythmias or Palpitations" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a sct:698247007 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "698247007" ] ; fhir:Coding.display [ fhir:value "Arrhythmias or Palpitations" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "571934328499" ] ; fhir:Questionnaire.item.text [ fhir:value "Cardiovascular Risk Assessment" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20033" ] ; fhir:Coding.display [ fhir:value "Cardiovascular Risk Assessment" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "459737733395" ] ; fhir:Questionnaire.item.text [ fhir:value "Chest Pain or Angina" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20034" ] ; fhir:Coding.display [ fhir:value "Chest Pain or Angina" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "929919815516" ] ; fhir:Questionnaire.item.text [ fhir:value "Congenital Heart Disease" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20035" ] ; fhir:Coding.display [ fhir:value "Congenital Heart Disease" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "832263816528" ] ; fhir:Questionnaire.item.text [ fhir:value "Congestive Heart Failure" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20036" ] ; fhir:Coding.display [ fhir:value "Congestive Heart Failure" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "803760213460" ] ; fhir:Questionnaire.item.text [ fhir:value "Coronary Artery Disease" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20037" ] ; fhir:Coding.display [ fhir:value "Coronary Artery Disease" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "129767162379" ] ; fhir:Questionnaire.item.text [ fhir:value "Dyspnea" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20038" ] ; fhir:Coding.display [ fhir:value "Dyspnea" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "116150628533" ] ; fhir:Questionnaire.item.text [ fhir:value "Hypertension" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20039" ] ; fhir:Coding.display [ fhir:value "Hypertension" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "513825527027" ] ; fhir:Questionnaire.item.text [ fhir:value "Murmur" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20040" ] ; fhir:Coding.display [ fhir:value "Murmur" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "975075898688" ] ; fhir:Questionnaire.item.text [ fhir:value "Pericardial Disease" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20041" ] ; fhir:Coding.display [ fhir:value "Pericardial Disease" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "704148928571" ] ; fhir:Questionnaire.item.text [ fhir:value "Peripheral Edema" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20042" ] ; fhir:Coding.display [ fhir:value "Peripheral Edema" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "886489617115" ] ; fhir:Questionnaire.item.text [ fhir:value "Post-Myocardial Infarction" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20043" ] ; fhir:Coding.display [ fhir:value "Post-Myocardial Infarction" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "621745958993" ] ; fhir:Questionnaire.item.text [ fhir:value "Pre-operative Consultation" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20044" ] ; fhir:Coding.display [ fhir:value "Pre-operative Consultation" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "873024527134" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a sct:439272007 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "439272007" ] ; fhir:Coding.display [ fhir:value "Date of procedure" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Procedure Date (if known)" ] ; fhir:Questionnaire.item.type [ fhir:value "date" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "621745958993" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20044" ] ; fhir:Coding.display [ fhir:value "Pre-operative Consultation" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "197975129599" ] ; fhir:Questionnaire.item.text [ fhir:value "Syncope" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://example.com/CodeSystem/standardized-referral-form-codes" ] ; fhir:Coding.code [ fhir:value "20045" ] ; fhir:Coding.display [ fhir:value "Syncope" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "675849150752" ] ; fhir:Questionnaire.item.text [ fhir:value "Valvular Heart Disease or Prosthetic Heart Valve" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a sct:368009 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "368009" ] ; fhir:Coding.display [ fhir:value "Valvular Heart Disease or Prosthetic Heart Valve" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation" ] ; fhir:Extension.valueCode [ fhir:value "horizontal" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "721982740516" ] ; fhir:Questionnaire.item.text [ fhir:value "Other" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-NullFlavor" ] ; fhir:Coding.code [ fhir:value "OTH" ] ; fhir:Coding.display [ fhir:value "other" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "720594942482" ] ; fhir:Questionnaire.item.text [ fhir:value "Specify" ] ; fhir:Questionnaire.item.type [ fhir:value "text" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "721982740516" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-NullFlavor" ] ; fhir:Coding.code [ fhir:value "OTH" ] ; fhir:Coding.display [ fhir:value "other" ] ] ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "Descriptionofclinicalquestion" ] ; fhir:Questionnaire.item.text [ fhir:value "Clinical Question / Goal(s) of Referral with Relevant History, Management and Investigations" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "Clinical Question / Goal(s) of Referral with Relevant History, Management and Investigations<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "font-weight:bold;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "text" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:grey;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "cpp_header" ] ; fhir:Questionnaire.item.text [ fhir:value "Cumulative Patient Profile Please delete any sensitive information you do not intend to share from the CPP" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "Cumulative Patient Profile<br/><br/><i>Please delete any sensitive information you do not intend to share from the CPP</i>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "font-weight:bold;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "cpp_separate" ] ; fhir:Questionnaire.item.text [ fhir:value "CPP attached separately (if not entered below)" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueString [ fhir:value "CPP attached separately (if not entered below)" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "cpp_currentprob" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a sct:55607006 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "55607006" ] ; fhir:Coding.display [ fhir:value "Problem" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Current Problem List:" ] ; fhir:Questionnaire.item.type [ fhir:value "text" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "cpp_separate" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "exists" ] ; fhir:Questionnaire.item.enableWhen.answerBoolean [ fhir:value "false"^^xsd:boolean ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "all" ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "cpp_pastmedicalhistory" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a sct:417662000 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "417662000" ] ; fhir:Coding.display [ fhir:value "History of clinical finding in subject" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Past Medical History:" ] ; fhir:Questionnaire.item.type [ fhir:value "text" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "cpp_separate" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "exists" ] ; fhir:Questionnaire.item.enableWhen.answerBoolean [ fhir:value "false"^^xsd:boolean ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "all" ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "cpp_currentmedications" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a sct:129019007 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "129019007" ] ; fhir:Coding.display [ fhir:value "Taking medication" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Current Medications :" ] ; fhir:Questionnaire.item.type [ fhir:value "text" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "cpp_separate" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "exists" ] ; fhir:Questionnaire.item.enableWhen.answerBoolean [ fhir:value "false"^^xsd:boolean ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "all" ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "cpp_familyhistory" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a sct:57177007 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "57177007" ] ; fhir:Coding.display [ fhir:value "Family history with explicit context" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Family History:" ] ; fhir:Questionnaire.item.type [ fhir:value "text" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "cpp_separate" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "exists" ] ; fhir:Questionnaire.item.enableWhen.answerBoolean [ fhir:value "false"^^xsd:boolean ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "all" ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "cpp_allergies" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a sct:609328004 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "609328004" ] ; fhir:Coding.display [ fhir:value "Allergic disposition" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Allergies:" ] ; fhir:Questionnaire.item.type [ fhir:value "text" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "cpp_separate" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "exists" ] ; fhir:Questionnaire.item.enableWhen.answerBoolean [ fhir:value "false"^^xsd:boolean ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "all" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:grey;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "preferredconsultlocation_header" ] ; fhir:Questionnaire.item.text [ fhir:value "Preferred Consultant or Location All patients will be triaged to the shortest wait time unless a preferred consultant or location is entered." ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<b>Preferred Consultant or Location</b><br/><br/>All patients will be triaged to the shortest wait time unless a preferred consultant or location is entered." ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "preferredconsultlocation_selector" ] ; fhir:Questionnaire.item.text [ fhir:value "Preferred consultant or location" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueString [ fhir:value "Preferred consultant or location" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "preferredconsultlocation_specify" ] ; fhir:Questionnaire.item.text [ fhir:value "Please specify either a preferred consultant or location" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "Please specify either a <b>preferred</b> consultant or location" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "preferredconsultlocation_selector" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerString [ fhir:value "Preferred consultant or location" ] ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "preferredconsultlocation_consultant" ] ; fhir:Questionnaire.item.text [ fhir:value "Consultant:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "preferredconsultlocation_location" ] ; fhir:Questionnaire.item.text [ fhir:value "Location:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "preferredconsultlocation_willingtotravel" ] ; fhir:Questionnaire.item.text [ fhir:value "Patient willing to travel for shorter wait time" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueString [ fhir:value "Patient willing to travel for shorter wait time" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:white;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "preferredconsultlocation_otherconsiderations" ] ; fhir:Questionnaire.item.text [ fhir:value "Other considerations:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:grey;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "supportingdocumentation_header" ] ; fhir:Questionnaire.item.text [ fhir:value "Supporting Documentation Please attach all relevant laboratory and diagnostic investigations." ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<b>Supporting Documentation</b><br/>Please attach all <b><span style=\"text-decoration: underline\">relevant</span></b> laboratory and diagnostic investigations.<br/>" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "check-box" ] ; fhir:Coding.display [ fhir:value "Check-box" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "supportingdocumentation_details" ] ; fhir:Questionnaire.item.text [ fhir:value "Personal Health Information that is medically relevant has not been disclosed at the request of the patient." ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<br/>" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "display:none;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueString [ fhir:value "Personal Health Information that is medically relevant has not been disclosed at the request of the patient." ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/mimeType" ] ; fhir:Extension.valueCode [ fhir:value "application/pdf" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/mimeType" ] ; fhir:Extension.valueCode [ fhir:value "image/gif" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/mimeType" ] ; fhir:Extension.valueCode [ fhir:value "image/bmp" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/mimeType" ] ; fhir:Extension.valueCode [ fhir:value "application/vnd.openxmlformats-officedocument.spreadsheetml.sheet" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/mimeType" ] ; fhir:Extension.valueCode [ fhir:value "video/mp4" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/mimeType" ] ; fhir:Extension.valueCode [ fhir:value "text/csv" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/mimeType" ] ; fhir:Extension.valueCode [ fhir:value "image/jpeg" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/mimeType" ] ; fhir:Extension.valueCode [ fhir:value "application/msword" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/mimeType" ] ; fhir:Extension.valueCode [ fhir:value "image/png" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/mimeType" ] ; fhir:Extension.valueCode [ fhir:value "application/vnd.openxmlformats-officedocument.wordprocessingml.document" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/mimeType" ] ; fhir:Extension.valueCode [ fhir:value "application/vnd.ms-excel" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/mimeType" ] ; fhir:Extension.valueCode [ fhir:value "text/plain" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/mimeType" ] ; fhir:Extension.valueCode [ fhir:value "audio/mp4" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/mimeType" ] ; fhir:Extension.valueCode [ fhir:value "audio/mpeg" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/mimeType" ] ; fhir:Extension.valueCode [ fhir:value "image/tiff" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/maxSize" ] ; fhir:Extension.valueDecimal [ fhir:value "5000000"^^xsd:decimal ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:grey;border-style:solid;" ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "positiveText" ] ; fhir:Extension.valueString [ fhir:value "Attachment Provided" ] ] ; fhir:Extension.url [ fhir:value "http://example.com/StructureDefinition/question-note-info" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "supportingdocumentation_attachment" ] ; fhir:Questionnaire.item.text [ fhir:value "Add Attachments" ] ; fhir:Questionnaire.item.type [ fhir:value "attachment" ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:grey;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "feedbacksurvey_cardiology" ] ; fhir:Questionnaire.item.text [ fhir:value "Click here to provide feedback on this form" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-xhtml" ] ; fhir:Extension.valueString [ fhir:value "<a href=\"https://www.surveymonkey.com/r/cardioSRF\" rel=\"noopener noreferrer\" target=\"_blank\">Click here to provide feedback on this form</a><br/>" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "display" ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "background-color:grey;border-style:solid;" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "referrer_header" ] ; fhir:Questionnaire.item.text [ fhir:value "Referrer's Information" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/rendering-style" ] ; fhir:Extension.valueString [ fhir:value "font-weight:bold;" ] ] ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "referrer_sitename" ] ; fhir:Questionnaire.item.text [ fhir:value "Site Name:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "referrer_address_line1" ] ; fhir:Questionnaire.item.text [ fhir:value "Address (Line 1):" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "referrer_address_line2" ] ; fhir:Questionnaire.item.text [ fhir:value "Address (Line 2):" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "referrer_address_city" ] ; fhir:Questionnaire.item.text [ fhir:value "City:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "referrer_address_province" ] ; fhir:Questionnaire.item.text [ fhir:value "Province:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.maxLength [ fhir:value "2"^^xsd:integer ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "key" ] ; fhir:Extension.valueId [ fhir:value "ref-pcode" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "severity" ] ; fhir:Extension.valueCode [ fhir:value "error" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "expression" ] ; fhir:Extension.valueExpression [ fhir:Expression.language [ fhir:value "text/fhirpath" ] ; fhir:Expression.expression [ fhir:value "%resource.repeat(item).where(linkId='referrer_address_postalcode').answer.all(value.matches('^(?!.*[DFIOQU])[A-VXY][0-9][A-Z] ?[0-9][A-Z][0-9]$'))" ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "human" ] ; fhir:Extension.valueString [ fhir:value "Must be a valid Canadian postal-code" ] ] ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/targetConstraint" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "referrer_address_postalcode" ] ; fhir:Questionnaire.item.text [ fhir:value "Postal Code:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "key" ] ; fhir:Extension.valueId [ fhir:value "refphone" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "severity" ] ; fhir:Extension.valueCode [ fhir:value "error" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "expression" ] ; fhir:Extension.valueExpression [ fhir:Expression.language [ fhir:value "text/fhirpath" ] ; fhir:Expression.expression [ fhir:value "%resource.repeat(item).where(linkId='referrer_phone').answer.all(value.matches('^(\\+\\d{1,2}\\s?)?\\(?\\d{3}\\)?[\\s.-]?\\d{3}[\\s.-]?\\d{4}$'))" ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "human" ] ; fhir:Extension.valueString [ fhir:value "Must be a valid phone number" ] ] ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/targetConstraint" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "referrer_phone" ] ; fhir:Questionnaire.item.text [ fhir:value "Phone #:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "key" ] ; fhir:Extension.valueId [ fhir:value "reffax" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "severity" ] ; fhir:Extension.valueCode [ fhir:value "error" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "expression" ] ; fhir:Extension.valueExpression [ fhir:Expression.language [ fhir:value "text/fhirpath" ] ; fhir:Expression.expression [ fhir:value "%resource.repeat(item).where(linkId='referrer_fax').answer.all(value.matches('^(\\+\\d{1,2}\\s?)?\\(?\\d{3}\\)?[\\s.-]?\\d{3}[\\s.-]?\\d{4}$'))" ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "human" ] ; fhir:Extension.valueString [ fhir:value "Must be a valid phone number" ] ] ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/targetConstraint" ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "referrer_fax" ] ; fhir:Questionnaire.item.text [ fhir:value "Fax #:" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "referrer_billing" ] ; fhir:Questionnaire.item.text [ fhir:value "Billing Number:" ] ; fhir:Questionnaire.item.type [ fhir:value "integer" ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "referrer_professionalid" ] ; fhir:Questionnaire.item.text [ fhir:value "Professional ID:" ] ; fhir:Questionnaire.item.type [ fhir:value "integer" ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "referrer_signature" ] ; fhir:Questionnaire.item.text [ fhir:value "Signed:" ] ; fhir:Questionnaire.item.type [ fhir:value "text" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "drop-down" ] ; fhir:Coding.display [ fhir:value "Drop down" ] ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "referrer_role" ] ; fhir:Questionnaire.item.text [ fhir:value "Role:" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a sct:309398001 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "309398001" ] ; fhir:Coding.display [ fhir:value "Allied Health Professional" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a sct:62247001 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "62247001" ] ; fhir:Coding.display [ fhir:value "Family Physician" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a sct:449161006 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "449161006" ] ; fhir:Coding.display [ fhir:value "Physician Assistant" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a sct:398130009 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "398130009" ] ; fhir:Coding.display [ fhir:value "Medical Student" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a sct:106292003 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "106292003" ] ; fhir:Coding.display [ fhir:value "Nurse" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a sct:224571005 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "224571005" ] ; fhir:Coding.display [ fhir:value "Nurse Practitioner" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a sct:405277009 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "405277009" ] ; fhir:Coding.display [ fhir:value "Resident" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a sct:69280009 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "69280009" ] ; fhir:Coding.display [ fhir:value "Specialist" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-NullFlavor" ] ; fhir:Coding.code [ fhir:value "OTH" ] ; fhir:Coding.display [ fhir:value "other" ] ] ] ] ] . # - ontology header ------------------------------------------------------------ <http://hl7.org/fhir/Questionnaire/CardiologyForm.ttl> a owl:Ontology ; owl:imports fhir:fhir.ttl ; owl:versionIRI <http://build.fhir.org/Questionnaire/CardiologyForm.ttl> .
IG © 2022+ HL7 International / FHIR Infrastructure.
Package hl7.fhir.uv.sdc#4.0.0-ci-build based on FHIR 4.0.1.
Generated
2026-07-15
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