GP Chronic Condition Management Plan
0.1.0 - CI Build

GP Chronic Condition Management Plan, published by AEHRC CSIRO. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/aehrc/gpccmp-fhir-ig/ and changes regularly. See the Directory of published versions

Example QuestionnaireResponse: QuestionnaireResponse - GP Chronic Care Form

GP Chronic Condition Management Plan

Patient: Caterina FOREMAN
Author: Dr Peter Primary
Date Authored: 25/05/2026 11:39

Patient details

Consent

Consent given to proceed with plan after discussion of the purpose, benefits, process and costs
Yes

Name
Caterina FOREMAN

Preferred pronouns
she/her/her/hers/herself

Date of birth
24/07/1970

Age
55

Sex assigned at birth
Female

Gender identity
Identifies as female gender

Aboriginal and/or Torres Strait Islander status
Neither Aboriginal nor Torres Strait Islander origin

My Aged Care

Registered for My Aged Care
No

National Disability Insurance Scheme

Registered for NDIS
No

Medicare card number

Number	Reference number	Expiry
3951333701	1	2028-08

Contact information

Home phone

0370109077

Mobile phone

0491576801

Email

caterina.foreman@my-own-personal-domain.com

Home address

Street address	City	State	Postcode
149 Farmer Cnr	Sunshine	Victoria	3020

Carers and key contacts

Preferred contact	Role	Name	Phone	Email	Relationship to patient	Present at appointment
Yes	Contact person	Mia LEANNE BANKS	0270107520
	Emergency Contact	Heather MACKAY	0370108075

Practitioner details

Name
Peter Primary

Phone

(08) 7010 5556

Email

PPP@example.org

Medicare provider number

2426621B

Clinic details

Name
Quinninup Medical Clinic

Address

Street address
24 Grande Pl

City
Quinninup

State
Western Australia

Postcode
6258

Clinical details

Problems/Diagnoses

Recorded problems/diagnoses

Condition	Clinical status	Onset date	Abatement date
Chronic lower back pain	Active	01/01/2021
Gastro-oesophageal reflux disease	Active	01/08/2013

New problems/diagnoses

Condition	Onset date	Comment
Uncontrolled type 2 diabetes	25/01/2026
Peripheral neuropathy due to diabetes	20/02/2026
Overweight	25/11/2025

Adverse reaction risks

Recorded adverse reaction risks

Substance	Status	Manifestation	Comment
Latex	Active	Rash	Has reacted soon after exposure as well as a delayed reaction to latex, with a rash appearing 24 hours after exposure.

Medications (current)

Recorded medications

Medication	Status	Dosage	Indication	Comment
Panadol Osteo 665 mg modified release tablet	Active	2 tabs PRN/TDS	Chronic lower back pain
Esomeprazole 20 mg enteric capsule	Active	1 tab daily	Gastro-oesophageal reflux disease	Gastroscopy 2013 - mild reflux esophagitis, H pylori negative

New medications

Medication	Dosage	Indication	Comment
Metformin hydrochloride 500 mg tablet	1 tab BD	Uncontrolled type 2 diabetes
Fish oil	2 caps daily		Self-initiated for heart health