# Claims Form 2 - NHDR Implementation Guide Release 1.0 v0.1.0

* [**Table of Contents**](toc.md)
* **Claims Form 2**

## Claims Form 2

This is a sample representation of the **Use Case** implementation guide for **Claims Form 2**

This can be viewed as an instance [CF2 Bundle](Bundle-ClaimsForm2.md) to also see downloadable XML, JSON, and TTL formats.

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### Implementation Rules

* name.given is an array that captures the first name and middle name. 
1. name.`given[0]`is used to capture a person's**first name**.
1. name.`given[1]`is used to capture a person's**middle name**.
 

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### Questionnaire Sample in CF2:

```
    {
        "resourceType": "Questionnaire",
        "id": "CF2-Questionnaire",
        "meta": {
            "profile": [
                "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Questionnaire"
            ]
        },
        "item": [
            {
                "linkId": "1",
                "text": "A. Certification of Consumption of Benefits",
                "type": "boolean"
            }
        ],
        "status": "active"
    }


```

### Questionnaire Response Sample in CF2:

```

```
{
"resourceType": "QuestionnaireResponse",
"meta": {
    "profile": [
    "https://nhdr.gov.ph/fhir/StructureDefinition/PH-QuestionnaireResponse"
    ]
},
"status": "completed",
"item": [
    {
    "linkId": "CF2-Q1",
    "answer": [
        {
        "valueBoolean": true
        }
    ]
    }
]
} ---

```

