# BHA Special Connections Pregnancy/Postpartum Risk Screening Questionnaire - Colorado BHA FHIR Implementation Guide v0.1.0-current

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **BHA Special Connections Pregnancy/Postpartum Risk Screening Questionnaire**

## Questionnaire: BHA Special Connections Pregnancy/Postpartum Risk Screening Questionnaire 

| | | |
| :--- | :--- | :--- |
| *Official URL*:http://bha.colorado.gov/fhir/bha-ig/Questionnaire/BHASCPregnancyPostpartumRiskQuestionnaire | *Version*:0.1.0-current | |
| * Standards status: *[Trial-use](http://hl7.org/fhir/R4/versions.html#std-process) | [Maturity Level](maturity.md): 0 | *Computable Name*:BHASCPregnancyPostpartumRiskQuestionnaire |

 
Behavioral Health Administration Special Connections Pregnancy/Postpartum Risk Screening questionnaire for collecting information about a pregnant or postpartum person's risk factors 

### Example Questionnaire Responses

* [BHA Special Connections Pregnancy/Postpartum Risk Screening Questionnaire Response](QuestionnaireResponse-BHASCPregnancyQuestionnaireResponseExample.md)



## Resource Content

```json
{
  "resourceType" : "Questionnaire",
  "id" : "BHASCPregnancyPostpartumRiskQuestionnaire",
  "meta" : {
    "profile" : ["http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire|3.0.0"]
  },
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 0,
    "_valueInteger" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical" : "http://bha.colorado.gov/fhir/bha-ig/ImplementationGuide/bha-ig"
      }]
    }
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode" : "trial-use",
    "_valueCode" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical" : "http://bha.colorado.gov/fhir/bha-ig/ImplementationGuide/bha-ig"
      }]
    }
  }],
  "url" : "http://bha.colorado.gov/fhir/bha-ig/Questionnaire/BHASCPregnancyPostpartumRiskQuestionnaire",
  "version" : "0.1.0-current",
  "name" : "BHASCPregnancyPostpartumRiskQuestionnaire",
  "title" : "BHA Special Connections Pregnancy/Postpartum Risk Screening Questionnaire",
  "status" : "active",
  "subjectType" : ["Patient"],
  "date" : "2025-12-17",
  "publisher" : "Colorado Behavioral Health Administration",
  "contact" : [{
    "name" : "Colorado Behavioral Health Administration",
    "telecom" : [{
      "system" : "url",
      "value" : "https://bha.colorado.gov"
    },
    {
      "system" : "email",
      "value" : "FHIRFeedback@state.co.us"
    }]
  }],
  "description" : "Behavioral Health Administration Special Connections Pregnancy/Postpartum Risk Screening questionnaire for collecting information about a pregnant or postpartum person's risk factors",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "code" : "840"
    }]
  }],
  "item" : [{
    "linkId" : "EVALUATION_DATE",
    "text" : "Evaluation Date",
    "type" : "date",
    "required" : true
  },
  {
    "linkId" : "PREGNANCY_POSTPARTUM_STATUS",
    "text" : "Pregnancy/Postpartum Status",
    "type" : "choice",
    "required" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-pregnancy-postpartum-status-vs"
  },
  {
    "linkId" : "PREGNANCY_POSTPARTUM_CARE_STATUS",
    "text" : "Pregnancy/Postpartum Care Status",
    "type" : "choice",
    "required" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-pregnancy-postpartum-care-status-vs"
  },
  {
    "linkId" : "DRUG_ALCOHOL_TREATMENT_ACCESS",
    "text" : "Access to other drug/alcohol treatment",
    "type" : "choice",
    "required" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-access-to-other-treatment-vs"
  },
  {
    "linkId" : "FAMILY_SOCIAL_SUPPORT",
    "text" : "Family/Social Support",
    "type" : "choice",
    "required" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-family-social-support-vs"
  },
  {
    "linkId" : "FAMILY_SUD_HISTORY",
    "text" : "Family substance use disorder history",
    "type" : "choice",
    "required" : true,
    "repeats" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-family-substance-use-disorder-vs"
  },
  {
    "linkId" : "FAMILY_SUD_CURRENT",
    "text" : "Family substance use disorder current",
    "type" : "choice",
    "required" : true,
    "repeats" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-family-substance-use-disorder-vs"
  },
  {
    "linkId" : "DRUG_USING_PARTNER",
    "text" : "Drug using partner",
    "type" : "choice",
    "required" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-drug-using-partner-vs"
  },
  {
    "linkId" : "HIV_RISK",
    "text" : "HIV Risk",
    "type" : "choice",
    "required" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-hiv-risk-vs"
  },
  {
    "linkId" : "HOME_STABILITY_SAFETY",
    "text" : "Home Stability and Safety",
    "type" : "choice",
    "required" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-home-stability-safety-vs"
  },
  {
    "linkId" : "PERSONAL_SAFETY",
    "text" : "Personal Safety",
    "type" : "choice",
    "required" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-personal-safety-vs"
  },
  {
    "linkId" : "PRIOR_CRIMINAL_RECORD",
    "text" : "Prior Criminal Record",
    "type" : "choice",
    "required" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-prior-criminal-record-vs"
  },
  {
    "linkId" : "MENTAL_HEALTH_HISTORY",
    "text" : "Mental Health History",
    "type" : "choice",
    "required" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-mental-health-history-vs"
  },
  {
    "linkId" : "PRIOR_ALCOHOL_DRUG_TREATMENT",
    "text" : "Prior alcohol/drug treatment",
    "type" : "choice",
    "required" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-prior-alcohol-drug-treatment-vs"
  },
  {
    "linkId" : "CHILDREN_LIVING_WITH_CLIENT",
    "text" : "Children Living in home with you",
    "type" : "boolean",
    "required" : true
  },
  {
    "linkId" : "CHILDREN_AGES_LIVING_WITH_CLIENT",
    "text" : "Children Ages living in home with you",
    "type" : "choice",
    "enableWhen" : [{
      "question" : "CHILDREN_LIVING_WITH_CLIENT",
      "operator" : "=",
      "answerBoolean" : true
    }],
    "required" : true,
    "repeats" : true,
    "answerValueSet" : "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-children-ages-living-in-home-vs"
  }]
}

```
