Smart Health Checks
0.4.0 - CI Build
Smart Health Checks, published by AEHRC CSIRO. This guide is not an authorized publication; it is the continuous build for version 0.4.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/aehrc/smart-forms-ig/ and changes regularly. See the Directory of published versions
| Official URL: http://www.health.gov.au/assessments/mbs/715 | Version: 0.4.0-assembled | ||||
| Draft as of 2025-03-14 | Computable Name: AboriginalTorresStraitIslanderHealthCheck | ||||
Copyright/Legal: Copyright © 2022+ Australian Government Department of Health, Disability and Ageing - All rights reserved. This content is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. See https://creativecommons.org/licenses/by-sa/4.0/. |
|||||
The long-term vision for effective Aboriginal and Torres Strait Islander health checks is of a standards-based health check template that is consistent and interoperable across different systems and applications whilst allowing for local adaptation.
The NACCHO and RACGP established a working group to review the Aboriginal and Torres Strait Islander annual health check templates and have produced five new templates that span the life course:
These example templates can be downloaded from the RACGP.
This resource is FHIR Questionnaire representation of the templates above.
| LinkID | Text | Cardinality | Type | Flags | Description & Constraints![]() |
|---|---|---|---|---|---|
![]() |
Questionnaire | http://www.health.gov.au/assessments/mbs/715#0.4.0-assembled | |||
![]() ![]() |
null | 0..1 | group | Value Set: | |
![]() ![]() ![]() |
About the health check | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Eligible for health check | 0..1 | choice | Value Set: Yes/No/NA | |
![]() ![]() ![]() ![]() ![]() |
not claimed 715 or 228 in past nine months | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Health check already in progress? | 0..1 | boolean | Value Set: | |
![]() ![]() ![]() ![]() |
Date of last completed health check | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() |
Date this health check commenced | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Consent | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Consent given after discussion of process and benefits of a health check | 0..1 | choice | Value Set: Yes/No/NA | |
![]() ![]() ![]() ![]() |
Consent given by parent/primary carer after discussion of process and benefits of a health check | 0..1 | choice | Value Set: Yes/No/NA | |
![]() ![]() ![]() ![]() |
Parent/primary caregiver present | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Parent/primary caregiver is present for health check? | 0..1 | choice | Value Set: Yes/No/NA | |
![]() ![]() ![]() ![]() ![]() |
Relationship to child | 0..* | string | Enable When: c72933c7-349f-4fef-94ff-c424c69da6f3 = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Consent for sharing of information | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Consent given for sharing of information with relevant healthcare providers? | 0..1 | choice | Value Set: Yes/No/NA | |
![]() ![]() ![]() ![]() ![]() |
Who/details | 0..* | text | Enable When: 057483ce-f265-46df-a1c5-7a18d492c1ba = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() |
Doctor | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() |
Nurse | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() |
Aboriginal and/or Torres Strait Islander Health Worker / Health Practitioner | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() |
Location of health check | 0..1 | open-choice | Value Set: Options: 3 options | |
![]() ![]() ![]() ![]() |
Location of health check | 0..1 | open-choice | Value Set: Options: 3 options | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Patient details | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
This section contains several read only, non-editable items. Updates to these items will need to be done in the patient record. The form can be repopulated to include any updates. | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Name | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() |
Preferred name | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() |
Preferred pronouns | 0..1 | choice | Value Set: Australian Pronouns | |
![]() ![]() ![]() ![]() |
Gender identity | 0..1 | choice | Value Set: Gender Identity Response | |
![]() ![]() ![]() ![]() |
Administrative gender | 0..1 | choice | Value Set: AdministrativeGender | |
![]() ![]() ![]() ![]() |
Sex assigned at birth | 0..1 | choice | Value Set: Biological Sex | |
![]() ![]() ![]() ![]() |
Date of birth | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() |
Age | 0..1 | integer | Value Set: | |
![]() ![]() ![]() ![]() |
Aboriginal and/or Torres Strait Islander status | 0..1 | choice | Value Set: Aboriginal and/or Torres Strait Islander | |
![]() ![]() ![]() ![]() |
Parents/primary carer/s | 0..* | choice | Value Set: Primary Carer Of Parent Or Grandparent | |
![]() ![]() ![]() ![]() |
Other family | 0..* | string | Value Set: | |
![]() ![]() ![]() ![]() |
Other | 0..* | string | Value Set: | |
![]() ![]() ![]() ![]() |
Parents/primary carer/s details | 0..* | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Name of parent/primary carer | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Relationship to child | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() |
Home address | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
No fixed address | 0..1 | boolean | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Home address | 0..* | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Street address | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
City | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
State | 0..1 | choice | Value Set: Australian States and Territories | |
![]() ![]() ![]() ![]() ![]() ![]() |
Postcode | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() |
Postal address | 0..* | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Purpose of use | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Street address | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
City | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
State | 0..1 | choice | Value Set: Australian States and Territories | |
![]() ![]() ![]() ![]() ![]() |
Postcode | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() |
Home phone | 0..* | string | Value Set: | |
![]() ![]() ![]() ![]() |
Mobile phone | 0..* | string | Value Set: | |
![]() ![]() ![]() ![]() |
Emergency contact | 0..* | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Name | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Relationship to child | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Relationship to patient | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Phone | 0..* | string | Value Set: | |
![]() ![]() ![]() ![]() |
Medicare number | 0..* | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Number | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Reference number | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Expiry | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() |
Pensioner Card Number | 0..1 | string | Max Length: 10 Value Set: | |
![]() ![]() ![]() ![]() |
Health Care Card Number | 0..1 | string | Max Length: 10 Value Set: | |
![]() ![]() ![]() ![]() |
Registered for Closing the Gap PBS Co-payment Measure (CTG) | 0..1 | boolean | Value Set: | |
![]() ![]() ![]() ![]() |
Child has a birth certificate | 0..1 | choice | Value Set: Yes/No/NA | |
![]() ![]() ![]() ![]() |
My Aged Care | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Registered for My Aged Care | 0..1 | choice | Value Set: Yes/No/NA | |
![]() ![]() ![]() ![]() ![]() |
My Aged Care Number | 0..1 | string | Enable When: 7165c072-e3d8-4564-9d1d-d17f6807787c = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
National Disability Insurance Scheme | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Registered for NDIS | 0..1 | choice | Value Set: Yes/No/NA | |
![]() ![]() ![]() ![]() ![]() |
NDIS Number | 0..1 | string | Enable When: 924b4500-53ac-4c4e-831b-7ab5569ff981 = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Children | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Do you have children? | 0..1 | choice | Value Set: Yes/No/NA | |
![]() ![]() ![]() ![]() ![]() |
Number of children | 0..1 | integer | Enable When: e90b436b-2751-4e07-a40c-adfe951b6528 = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Number of children in your care | 0..1 | integer | Enable When: e90b436b-2751-4e07-a40c-adfe951b6528 = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Someone's carer | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Are you responsible for caring for someone else? | 0..1 | choice | Value Set: Yes/No/NA | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: a08271f1-194b-4fe9-91f9-4f3398858eb0 = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Your carer | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Do you have a carer? | 0..1 | choice | Value Set: Yes/No/NA | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: d05558fb-a3cc-4bd6-b803-b672b36b9c51 = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Providers | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Are name and contact details of other key providers (eg case workers, support services) up to date? | 0..1 | choice | Value Set: Yes/No/NA | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Advance care planning | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Enduring Power of Attorney | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Enduring Power of Attorney | 0..1 | choice | Value Set: Yes/No/NA | |
![]() ![]() ![]() ![]() ![]() ![]() |
Discussed today | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Advance Health Directive | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Advance Health Directive | 0..1 | choice | Value Set: Yes/No/NA | |
![]() ![]() ![]() ![]() ![]() ![]() |
Discussed today | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Current health/patient priorities | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
What are the important things for you in this health check today? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Is there anything you are worried about? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Is there anything that you are worried about with your child's health or wellbeing? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Child Health Book | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Does your child have a Child Health Book? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Is it up to date? | 0..1 | choice | Enable When: 2655e0e1-fe4b-431e-87af-30d4ff1aca76 = Yes (v2 Y/N Indicator#Y) Value Set: Yes/No | |
![]() ![]() ![]() ![]() |
Do you have any specific health goals? Is there anything in particular about your health and wellbeing that you would like to improve? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Medical history and current problems | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Birth history | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Gestation at birth | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
weeks | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Birth weight | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
kg | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Medical history summary | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Recorded problems/diagnoses | 0..* | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
null | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Condition | 0..1 | open-choice | Value Set: Clinical Condition | |
![]() ![]() ![]() ![]() ![]() ![]() |
Clinical status | 0..1 | choice | Value Set: Condition Clinical Status Minimal | |
![]() ![]() ![]() ![]() ![]() ![]() |
null | 0..1 | choice | Value Set: Condition Clinical Status Minimal | |
![]() ![]() ![]() ![]() ![]() ![]() |
Onset date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Abatement date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
null | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
New problems/diagnoses | 0..* | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Condition | 1..1 | open-choice | Value Set: Clinical Condition | |
![]() ![]() ![]() ![]() ![]() ![]() |
Onset date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Comment | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Regular medications | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Check medications are still required, appropriate dose, understanding of medication and adherence | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Medication summary | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Recorded medications | 0..* | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
null | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Medication | 0..1 | open-choice | Value Set: Smart Health Checks Medicine Products | |
![]() ![]() ![]() ![]() ![]() ![]() |
Status | 1..1 | choice | Value Set: Medication Statement Status Limited | |
![]() ![]() ![]() ![]() ![]() ![]() |
null | 0..1 | choice | Value Set: Medication Statement Status Limited | |
![]() ![]() ![]() ![]() ![]() ![]() |
Dosage | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
null | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Clinical indication | 0..* | open-choice | Value Set: Medication Reason Taken | |
![]() ![]() ![]() ![]() ![]() ![]() |
Comment | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
null | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
New medications | 0..* | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Medication | 1..1 | open-choice | Value Set: Smart Health Checks Medicine Products | |
![]() ![]() ![]() ![]() ![]() ![]() |
Dosage | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Clinical indication | 0..* | open-choice | Value Set: Medication Reason Taken | |
![]() ![]() ![]() ![]() ![]() ![]() |
Comment | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Does your child take any regular medications (prescribed, over-the-counter, traditional, complementary and alternative)? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() |
Do you take any regular medications (prescribed, over-the-counter, traditional, complementary and alternative)? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() |
Check the health record is up to date | 0..1 | boolean | Value Set: | |
![]() ![]() ![]() ![]() |
Check medication understanding and adherence with patient | 0..1 | boolean | Enable When:
Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Allergies/adverse reactions | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Adverse reaction risk summary | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Recorded adverse reaction risks | 0..* | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
null | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Substance | 0..1 | open-choice | Value Set: Adverse Reaction Agent | |
![]() ![]() ![]() ![]() ![]() ![]() |
Status | 0..1 | choice | Value Set: Allergy Intolerance Clinical Status Minimal | |
![]() ![]() ![]() ![]() ![]() ![]() |
null | 0..1 | choice | Value Set: Allergy Intolerance Clinical Status Minimal | |
![]() ![]() ![]() ![]() ![]() ![]() |
Manifestation | 0..* | open-choice | Value Set: Clinical Finding | |
![]() ![]() ![]() ![]() ![]() ![]() |
Comment | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
null | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
New adverse reaction risks | 0..* | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Substance | 1..1 | open-choice | Value Set: Adverse Reaction Agent | |
![]() ![]() ![]() ![]() ![]() ![]() |
Manifestation | 0..* | open-choice | Value Set: Clinical Finding | |
![]() ![]() ![]() ![]() ![]() ![]() |
Comment | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Family history | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Provide relevant family history information | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Provide relevant family history information (including diabetes, heart disease, cancer, mental health) | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Social and emotional wellbeing | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Stressful life events | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Have there been any particular stressful life events that are impacting on you/your health lately? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: e7297156-cfed-4437-b877-c345f744168b = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Social and emotional wellbeing assessment: consider tools such as Aboriginal and Torres Strait Islander Youth Social Emotional Wellbeing assessment question guide or HEEADSSS | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Consider conversation about social connection, which could include questions about sports/hobbies/clubs/other activities | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Social history: Information about family and child's living arrangements | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Who lives in your household? / Who does the child live with? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Stressful life events | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Have there been any stressful life events that would cause you or your child to be upset? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: 062f5234-686a-4bf3-afcd-3fcd988afd6c = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
If indicated, ask about depression and other mental health concerns | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Home and family | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Who do you live with? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Housing stability | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Do you have stable housing? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: a7542da8-aad6-4a80-8b5b-806ca11d68d2 = No (v2 Y/N Indicator#N) Value Set: | |
![]() ![]() ![]() ![]() |
Home safety | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Do you feel safe at home? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: 6f73d1ee-dd8e-419a-9142-ede367200e3b = No (v2 Y/N Indicator#N) Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Learning and development | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Is there anything that you are worried about with your child's development? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Is there anything that you are worried about with your child's learning? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Is there anything that you are worried about with your child's behaviour? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Is there anything that you are worried about with your child's sleep? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
What childcare/early learning centre/kindergarten does your child go to? How often? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
How often does your child miss childcare/early learning centre/kindergarten? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Is there anything you are worried about at school? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
How often does your child miss school? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Is your child having any difficulties making friends? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Are there any other concerns about your child's learning and development? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Learning and work | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Learning | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Are you studying at school/uni? | 0..1 | choice | Value Set: Yes/No/NA | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Learning | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Are you studying? | 0..1 | choice | Value Set: Yes/No/NA | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Work | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Are you working? | 0..1 | choice | Value Set: Yes/No/NA | |
![]() ![]() ![]() ![]() ![]() |
Details (occupation including occupational hazards, study, training, disability, etc) | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Work | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Work | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Are you working? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details (occupation including occupational hazards, study, training, disability, etc) | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Mood | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
How have you been feeling lately? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
If indicated, ask about depression (consider screening tools, eg aPHQ-9, K5 or K10) and complete risk assessment | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Explore other mental health concerns as indicated | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Memory and thinking | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Personal concerns about your memory or thinking | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Do you have any worries about your memory or thinking? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: e29701be-2b79-471d-a42e-7e3830459080 = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Family concerns about your memory or thinking | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Does anyone in your family have any worries about your memory or thinking? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: 06a67326-9e3d-4c4c-b271-af5b168d077c = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
If any concerns are raised and/or high risk for cognitive impairment identified, follow up with cognitive screening (eg clock test, GPCOG, KICA-Cog, MMSE) | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Chronic disease associated with ageing | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
For older people with chronic disease and/or conditions associated with ageing, consider assessing: Osteoporosis risk; Falls risk; Balance, coordination and mobility; Pain; Nutrition; Regularity of chronic disease management and review | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Participation in screening programs | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Cervical screening (age <=74 years) | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Cervical screening status | 0..1 | choice | Value Set: Options: 5 options | |
![]() ![]() ![]() ![]() ![]() |
Cervical screening next due | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Cervical screening details | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Breast screening (age <=74 years) | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Breast screening status | 0..1 | choice | Value Set: Options: 5 options | |
![]() ![]() ![]() ![]() ![]() |
Breast screening next due | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Breast screening details | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Bowel cancer screening (age <=74 years) | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Bowel cancer screening status | 0..1 | choice | Value Set: Options: 5 options | |
![]() ![]() ![]() ![]() ![]() |
Bowel cancer screening next due | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Bowel cancer screening details | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Healthy eating | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Child eating concerns | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Is there anything that you are worried about with your child's feeding/eating? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Is there anything that you are worried about with your child's eating? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When:
Value Set: | |
![]() ![]() ![]() ![]() |
Breastfeeding history | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Bottle feeding history | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Diet or weight concerns | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Do you have any worries about your diet or weight? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: 646302e9-d384-4943-99bc-11e638641703 = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Unintended weight loss | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Have you lost weight without trying to in the last three months? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: 6dc96b26-cbc5-4434-8f6b-0260196311c2 = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Document conversation about age-appropriate healthy eating, which could include: current diet; transition to solids; dietary recommendations re fruit and vegetable intake, iron-rich foods, avoiding sugary drinks | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Document conversation about healthy eating which could include: current diet including food and drinks; recommendations about fruit and vegetable intake, water as the main drink, avoiding sugary drinks, avoiding highly processed foods (including supermarket-bought and take-away like KFC, Maccas, etc) | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Food availability issues | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Are there any issues about availability of food? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: 12a41538-5dbd-4c1d-af69-52c59c48b1a9 = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Physical activity and screen time | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Physical activity concerns | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Is there anything that you are worried about with your child's level of physical activity? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: 304d0332-9bfd-42dc-a4be-a5122596fb89 = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Screen time concerns | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Is there anything that you are worried about with your child's level of screen time? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: 465eacce-f9ee-4022-9186-89065cf01ce2 = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Physical activity or screen time concerns | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Do you have any worries about physical activity or screen time? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: 08320c7a-831b-4237-95e2-d79aee155b90 = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Document conversation about age-appropriate recommendations re physical activity and screen time | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Document conversation about social connection, which could include questions about sports/hobbies/clubs/other activities | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Physical activity | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Physical activity concerns | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Do you have any worries about physical activity? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: b30d5d21-c6d6-4bb3-aab4-0fdee80b3093 = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Document conversation about recommendations re physical activity | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Red flags early identification guide for children | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
This is based on material from the The State of Queensland, Red flags early identification guide (for children aged birth to five years). 2nd edn. South Brisbane, Qld: Child Development Program, Queensland Health, 2016. Available at www.childrens.health.qld.gov.au/wp-content/uploads/PDF/red-flags-a3.pdf [Accessed 2 December 2019]. © Developed by the Child Development Program in conjunction with Brisbane North Primary Health Network. Updated: July 2016. | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
What age group is the child closest to? | 0..1 | choice | Value Set: Options: 8 options | |
![]() ![]() ![]() ![]() |
Red flags | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Social Emotional | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 6 months Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() ![]() |
Social Emotional | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 9 months Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() ![]() |
Social Emotional | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 12 months Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Social Emotional | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 18 months Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() ![]() |
Social Emotional | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 2 years Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() ![]() |
Social Emotional | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 3 years Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Social Emotional | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 4 years Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() ![]() |
Social Emotional | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 5 years Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() ![]() |
Communication | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 6 months Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() ![]() |
Communication | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 9 months Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Communication | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 12 months Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Communication | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 18 months Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Communication | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 2 years Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Communication | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 3 years Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Communication | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 4 years Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Communication | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 5 years Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Cognition, fine motor and self care | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 6 months Value Set: Options: 4 options | |
![]() ![]() ![]() ![]() ![]() |
Cognition, fine motor and self care | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 9 months Value Set: Options: 3 options | |
![]() ![]() ![]() ![]() ![]() |
Cognition, fine motor and self care | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 12 months Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Cognition, fine motor and self care | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 18 months Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Cognition, fine motor and self care | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 2 years Value Set: Options: 1 option | |
![]() ![]() ![]() ![]() ![]() |
Cognition, fine motor and self care | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 3 years Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Cognition, fine motor and self care | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 4 years Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Cognition, fine motor and self care | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 5 years Value Set: Options: 3 options | |
![]() ![]() ![]() ![]() ![]() |
Gross motor | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 6 months Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Gross motor | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 9 months Value Set: Options: 4 options | |
![]() ![]() ![]() ![]() ![]() |
Gross motor | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 12 months Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Gross motor | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 18 months Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Gross motor | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 2 years Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Gross motor | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 3 years Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Gross motor | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 4 years Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Gross motor | 0..* | choice | Enable When: 0b520b20-98df-4024-b25d-2986f6b96e77 = 5 years Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Red flags at any age | 0..* | choice | Value Set: Options: 7 options | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Substance use, including tobacco | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Smoking | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Smoking status | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Smoking status | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
Last status | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
Last status value | 0..1 | choice | Value Set: Tobacco Use Status | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
Last status date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
New status | 0..1 | choice | Value Set: Tobacco Use Status | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
New date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Quit status | 0..1 | choice | Value Set: Smoking Quit Status | |
![]() ![]() ![]() ![]() ![]() |
How many? | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
How long as a smoker? | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() |
Alcohol and other substance use | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Quantity and frequency of: alcohol; caffeine (coffee, soft drinks, iced coffee); cannabis/yarndi/gunja; other substance use: IVDU, methamphetamine, opiates, solvents, other | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Gambling | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Gambling issues | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Have you or someone close to you ever had issues with gambling? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: a233c01e-a72e-474b-9a26-bab1504491fa = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Sexual health (sexual activity, contraception, safe sex/protection, sexual orientation, gender identity, pressure to have sex, STIs) | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Puberty and sexual health concerns | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Is there anything that you are worried about in relation to puberty/your sexual health? | 0..1 | choice | Value Set: Yes/No/Not Asked/Asked But Declined | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: 1d20138a-caf3-4c43-9693-04c08d37a84a = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Consider discussing as relevant to age/sex/gender: menstruation (including risk of anaemia); current sexual activity; contraception; safe sex practice (eg use of condoms); sexually transmitted infection symptoms and screening; blood-borne virus screening | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Genitourinary and sexual health | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Sexual health concerns | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Is there anything that you are worried about in relation to your sexual health? | 0..1 | choice | Value Set: Yes/No/Not Asked/Asked But Declined | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: e56e79e5-8fbb-43f0-b2a3-018b55750bd0 = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Cervical screening | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Cervical screening status | 0..1 | choice | Value Set: Cervical Screening Status | |
![]() ![]() ![]() ![]() ![]() |
Next due | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Consider discussing as relevant to age/sex/gender: contraception; menstruation; sexually transmitted infection symptoms and screening; blood-borne virus screening; continence; menopause; erectile dysfunction | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Genitourinary and sexual health | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Sexual health concerns | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Consider asking when appropriate: Is there anything that you are worried about in relation to your sexual health? | 0..1 | choice | Value Set: Yes/No/Not Asked/Asked But Declined | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: 1c40a720-bdb7-4386-a9f6-be82b7349bf7 = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Continence issues | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Do you have problems with urine leaking? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: 64fd0f79-7e09-4934-905d-9bff6715f9ba = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Consider discussing as relevant to age/sex/gender: menopause; erectile dysfunction; prostatic symptoms | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Eye health | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Vision concerns | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Is there anything that you are worried about with your child's vision? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Is there anything that you are worried about with your vision? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When:
Value Set: | |
![]() ![]() ![]() ![]() |
Eye examination | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Red reflex (up to six months) | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Left eye | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Right eye | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Evidence of squint or other abnormality | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Left eye | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Right eye | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Visual acuity | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Left eye | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Right eye | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Trachoma Check (endemic areas) | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Left eye | 0..1 | choice | Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() ![]() |
Right eye | 0..1 | choice | Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Ear health and hearing | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Child listening concerns | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Is there anything that you are worried about with your child's listening? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: f982c374-f023-4e68-8968-1f1f5d3969ae = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Child language concerns | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Is there anything you are worried about with your child's language/talking? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: 06c150f8-4d54-4d10-aeff-2ef7567b6812 = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Child snoring | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Do you notice snoring/noisy breathing at night/while your child is sleeping? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: b326271b-e9b1-45a0-b899-125364833702 = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Hearing concerns | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Is there anything that you are worried about with your hearing? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When: 3e53edc7-c90e-4681-a006-b7a05b91a02c = Yes (v2 Y/N Indicator#Y) Value Set: | |
![]() ![]() ![]() ![]() |
Last hearing test (audiology) | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() |
Ear examination | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Otoscopy | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Video otoscopy procedure recommended where possible as it allows for parental education and for images to be saved for tracking over time. | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Otoscopy findings | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
Left ear | 0..* | open-choice | Value Set: Options: 10 options | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
Right ear | 0..* | open-choice | Value Set: Options: 10 options | |
![]() ![]() ![]() ![]() ![]() ![]() |
Otoscopy findings | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
Left ear | 0..* | open-choice | Value Set: Options: 6 options | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
Right ear | 0..* | open-choice | Value Set: Options: 6 options | |
![]() ![]() ![]() ![]() ![]() |
Tympanometry | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Left ear | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Right ear | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Oral and dental health | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Dental concerns | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Is there anything that you are worried about with your child's teeth or mouth? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Is there anything that you are worried about with your teeth? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When:
Value Set: | |
![]() ![]() ![]() ![]() |
Last dental checkup | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() |
Dentures? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() |
Teeth and mouth check | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Examination findings | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Document conversation about oral health and care of teeth | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Skin | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Skin problems | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Does your child have any skin problems? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Is there anything that you are worried about with your skin? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() ![]() |
Details | 0..1 | text | Enable When:
Value Set: | |
![]() ![]() ![]() ![]() |
Do you use sun protection? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() |
Document conversation about sun protection as appropriate (ie sunscreen, hats, shade). | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
General skin examination findings | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Immunisation | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Check Child Health Record/Book and Australian Immunisation Register | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Eligibility for funded vaccines may vary across jurisdictions | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Check Australian Immunisation Register | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Check recommended primary vaccinations completed and provide catch-up if required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Vaccines previously given | 0..* | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Vaccine | 0..1 | open-choice | Value Set: Australian Medicines Terminology Vaccine | |
![]() ![]() ![]() ![]() ![]() |
Batch number | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Administration date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Comment | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() |
Immunisations are up to date? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() |
Immunisations due | 0..* | open-choice | Value Set: Australian Medicines Terminology Vaccine | |
![]() ![]() ![]() ![]() |
Vaccines given today | 0..* | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Vaccine | 1..1 | open-choice | Value Set: Australian Medicines Terminology Vaccine | |
![]() ![]() ![]() ![]() ![]() |
Batch number | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Administration date | 1..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Comment | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() |
Have all vaccines been recorded on the Australian Immunisation Register? | 0..1 | choice | Value Set: Yes/No | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Examination | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Growth measures recorded on Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) growth charts for centile and tracking overtime | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
The tabled observations will display the most recent results available from the patient record. New observations may be added. | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Length/Height | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result value | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
New result | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
cm | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
New result date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Height | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result value | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
New result | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
cm | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
New result date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Weight | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result value | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
New result | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
kg | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
New result date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
BMI (calculated) | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result value | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
New result | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
kg/m2 | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Head circumference | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result value | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
New result | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
cm | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
New result date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Waist circumference | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result value | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
New result | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
cm | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
New result date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Heart rate | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result value | 0..1 | integer | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
New result | 0..1 | integer | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
/min | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
New result date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Heart rhythm | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result value | 0..1 | choice | Value Set: Heart Rhythm | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
New result | 0..1 | choice | Value Set: Heart Rhythm | |
![]() ![]() ![]() ![]() ![]() ![]() |
New result date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() |
Blood pressure | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Blood pressure | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result value systolic | 0..1 | integer | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result value diastolic | 0..1 | integer | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Last result date | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Systolic | 0..1 | integer | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
mm Hg | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Diastolic | 0..1 | integer | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
mm Hg | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Date performed | 0..1 | date | Value Set: | |
![]() ![]() ![]() ![]() |
Cardiac auscultation | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Abdominal examination | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Gait examination (musculoskeletal structure, balance, coordination) | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Newborn examination (if indicated, infant aged <=6 weeks) | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Haemoglobin (children at risk of iron deficiency anaemia) | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Absolute cardiovascular disease risk calculation | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
The Australian guideline for assessing and managing cardiovascular disease risk recommends the use of the Aus CVD Risk calculator. | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
CVD risk result | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Latest available result | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
A previous CVD risk result has been found. Do you want to perform a new assessment? | 0..1 | boolean | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Do you have access to the Aus CVD Risk-i application from your clinical system? | 0..1 | boolean | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Using the Aus CVD Risk-i application, calculate the CVD risk result and save it to the patient record. This form can then be repopulated to retrieve and include the result above. | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Do you need to manually enter a new CVD risk result instead of repopulating? | 0..1 | boolean | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
New CVD risk result | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Use the online Australian CVD risk calculator - https://www.cvdcheck.org.au/calculator | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Risk result score | 0..1 | integer | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
% | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Assessed risk category | 0..1 | choice | Value Set: CVD Risk Category | |
![]() ![]() ![]() ![]() |
CVD risk calculator variables | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Age | 0..1 | integer | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
years | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Sex at birth | 0..1 | choice | Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() ![]() |
Smoking status | 0..1 | choice | Value Set: CVD Risk Smoking Status | |
![]() ![]() ![]() ![]() ![]() |
Systolic blood pressure | 0..1 | integer | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
mm Hg | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Cholesterol | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Ratio of total cholesterol to HDL cholesterol | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Total Cholesterol | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
mmol/L | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
HDL Cholesterol | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
mmol/L | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Use of CVD medicines within last 6 months | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Blood pressure-lowering medicines | 0..1 | boolean | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Lipid-modifying medicines | 0..1 | boolean | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Antithrombotic medicines | 0..1 | boolean | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
History of atrial fibrillation | 0..1 | boolean | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Postcode | 0..1 | string | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Diabetes | 0..1 | boolean | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Additional diabetes details | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Years since diabetes diagnosis | 0..1 | integer | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
years | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Glycated haemoglobin (HbA1c) | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
mmol/mol | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
uACR | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
mg/mmol | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
eGFR | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
mL/min/1.73 m² | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Body mass index (BMI) | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
Weight | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() |
kg | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
Height | 0..1 | decimal | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() |
m | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Use of insulin within last 6 months | 0..1 | boolean | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Investigations | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Full blood count, HbA1c or blood glucose level, serum lipids, Kidney function including eGFR, Liver function tests, ACR | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Chlamydia, gonorrhoea: <=30, first void urine (male and female) and/or endocervical swab or self-administered vaginal swab (female) or throat and anal swab (men who have sex with men [MSM]) | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Syphilis (endemic areas, MSM, others at high risk) | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Trichomoniasis (<=30, male and female, remote areas and other endemic areas, first void urine and/or endocervical swab or self-administered vaginal swab) | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Blood-borne virus screening: HBV if status not known/not recorded on file, HCV if risk factors, HIV if risk factors | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Health priorities, actions and follow-up | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() |
Health Priorities, Actions And Follow-Up Summary | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
The following information is a read-only collection of the 'Health priorities, actions and follow-up' sections entered in the previous tabs. Only sections where previous information entered will be displayed here. | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Current health/patient priorities | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Medical history and current problems | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Regular medications | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Allergies/adverse reactions | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Family history | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Social and emotional wellbeing | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Social history | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Home and family | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Learning and development | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Learning and work | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Work | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Mood | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Memory and thinking | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Chronic disease associated with ageing | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Participation in screening programs | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Healthy eating | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Physical activity and screen time | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Physical activity | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Substance use, including tobacco | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Gambling | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Sexual health | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Genitourinary and sexual health | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Genitourinary and sexual health | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Eye health | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Ear health and hearing | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Oral and dental health | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Skin | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Immunisation | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Examination | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Absolute cardiovascular risk calculation | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Investigations | 0..1 | text | Value Set: | |
![]() ![]() ![]() |
Finalising the health check | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() |
In progress | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Complete | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Attention required | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Patient priorities and goals: What does the parent/carer say are the important things that have come out of this health check? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Patient priorities and goals: What does the parent/carer and child say are the important things that have come out of this health check? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Patient priorities and goals: What does the patient say are the important things that have come out of this health check? | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Brief intervention: advice and information provided during health check | 0..* | open-choice | Value Set: Options: 9 options | |
![]() ![]() ![]() ![]() |
Brief intervention: advice and information provided during health check | 0..* | open-choice | Value Set: Options: 7 options | |
![]() ![]() ![]() ![]() |
Brief intervention: advice and information provided during health check | 0..* | open-choice | Value Set: Options: 9 options | |
![]() ![]() ![]() ![]() |
Brief intervention: advice and information provided during health check | 0..* | open-choice | Value Set: Options: 10 options | |
![]() ![]() ![]() ![]() |
Brief intervention: advice and information provided during health check | 0..* | open-choice | Value Set: Options: 8 options | |
![]() ![]() ![]() ![]() |
Care provided as part of the health check (eg immunisations, medication review, investigations requested) | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Identified needs and plan (including new diagnoses) | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Follow-up | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Consider what follow-up appointments can be made at the time of the health check. | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Reminder: MBS follow up items for clients at risk of or with chronic disease are available to support follow-up of health checks | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Referrals and appointments | 0..* | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() ![]() |
Who | 0..1 | open-choice | Value Set: Options: 12 options | |
![]() ![]() ![]() ![]() ![]() ![]() |
Who | 0..1 | open-choice | Value Set: Options: 10 options | |
![]() ![]() ![]() ![]() ![]() ![]() |
Who | 0..1 | open-choice | Value Set: Options: 11 options | |
![]() ![]() ![]() ![]() ![]() ![]() |
Who | 0..1 | open-choice | Value Set: Options: 13 options | |
![]() ![]() ![]() ![]() ![]() ![]() |
Who | 0..1 | open-choice | Value Set: Options: 16 options | |
![]() ![]() ![]() ![]() ![]() ![]() |
When | 0..1 | date | Enable When:
Value Set: | |
![]() ![]() ![]() ![]() |
Recalls | 0..1 | group | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
e.g. clinical review, investigations, influenza vaccination, asthma plan/cycle of care, diabetes cycle of care, care plan review, cervical screening, investigations | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() ![]() |
Recall entered | 0..* | string | Value Set: | |
![]() ![]() ![]() ![]() |
Parent/carer actions | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Parent/patient actions | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
Patient actions | 0..1 | text | Value Set: | |
![]() ![]() ![]() ![]() |
A copy of this health check has been offered - including details of follow-up and future appointments | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() ![]() |
null | 0..1 | display | Value Set: | |
![]() ![]() ![]() ![]() |
Section completion status | 0..1 | choice | Value Set: Options: 3 options | |
Documentation for this format | |||||
Options Sets
Answer options for MarkComplete-1
Answer options for 5bbfb4a3-a667-4ef2-98c2-76e76da55c03
Answer options for 9a51c056-021d-445d-8eaa-2123a69aa9c2
Answer options for MarkComplete-30
Answer options for MarkComplete-32
Answer options for MarkComplete-5
Answer options for MarkComplete-17
Answer options for MarkComplete-23
Answer options for MarkComplete-3
Answer options for MarkComplete-9
Answer options for MarkComplete-27
Answer options for MarkComplete-28
Answer options for MarkComplete-12
Answer options for MarkComplete-15
Answer options for MarkComplete-16
Answer options for MarkComplete-33
Answer options for MarkComplete-19
Answer options for MarkComplete-18
Answer options for MarkComplete-4
Answer options for c1cf9c00-15ef-4b98-bab0-20a5f01b4932
Answer options for 29fada07-f981-44cf-8092-61c86365a965
Answer options for 521df1b1-ff36-458b-8f99-e41c2b1685c8
Answer options for MarkComplete-24
Answer options for MarkComplete-11
Answer options for MarkComplete-21
Answer options for MarkComplete-34
Answer options for 0b520b20-98df-4024-b25d-2986f6b96e77
Answer options for 9c717263-341e-416f-aad8-7aec7d2167c9
Answer options for c10acb25-fdc3-401e-b0aa-d85b2921e5bb
Answer options for b6bb38f6-8084-4c89-a0f2-9d77aacab61d
Answer options for c0ad8dc5-4672-4b21-b30d-6dcc7a00109a
Answer options for fc0977e1-fd83-4d0b-a57a-e94c7fd41fdb
Answer options for 70f7b96f-eaae-490b-8522-1214c1b1aede
Answer options for 03ff1391-f48d-4b99-894c-159f4d09eb33
Answer options for ee5f0a61-a8a1-473e-addf-ca5b1eaad7d3
Answer options for 2b23128e-1622-4880-abd6-c9cd429b48e3
Answer options for dfb86be5-b6ff-400e-b7d6-68701df086da
Answer options for 4d802a6d-c89e-4460-8091-874f855be4ad
Answer options for b8e1a699-ed65-491f-9865-8ab855bb2d33
Answer options for 6c3637ed-4afd-45be-a15c-9d5e7d8e78e8
Answer options for 25d67a2f-8bbe-4f79-9488-1682d2ce49fa
Answer options for f00b5ae1-cc33-44f9-bd9b-f9b6c93cc005
Answer options for 3e06438a-ee7d-4880-83aa-68d2ade997ce
Answer options for 49d172b4-bc2f-46cd-95a8-2f3ecba8e852
Answer options for 785ec313-7b25-4d0d-9421-382981286cbc
Answer options for 2c2b263e-41a5-4dae-94e1-814f5bfca20a
Answer options for d6d7d675-0fee-466d-85e8-5dae46adac40
Answer options for c48e4138-0952-49a7-9c77-14b3e6d1dad3
Answer options for 433e768c-8458-476a-8330-3f59a4aa94b4
Answer options for 06d96181-2b2d-48de-b80f-bd5ccb2fb3c1
Answer options for e08345d3-a919-4bf0-8775-5df84a173832
Answer options for 7f3861fd-b9f0-489d-8a39-5fdd18eeaf0e
Answer options for 68809920-fbf4-48e5-89f7-c0b49a8b8f78
Answer options for 5cf7c9bc-b3ec-43ac-8de8-65078f57a82b
Answer options for a1137862-767c-49fb-883b-92bee7588edc
Answer options for dd83d558-6a7f-4b94-b677-7c2b31ccc52f
Answer options for 5ea4460c-a4c5-4025-bf85-64884a66458f
Answer options for 75b597b4-3b38-4efd-aeb2-ab1551d83c3c
Answer options for f23ac52c-2064-4032-b283-6ce09fc306fa
Answer options for 758d4109-363a-48c9-95f3-8a8d8b1b32ec
Answer options for MarkComplete-22
Answer options for MarkComplete-29
Answer options for MarkComplete-10
Answer options for MarkComplete-25
Answer options for MarkComplete-35
Answer options for MarkComplete-36
Answer options for 202b5b91-541e-4a72-b1f6-1d474b59b7a3
Answer options for 6ae69487-345e-46a0-a8db-b1356671ee59
Answer options for MarkComplete-8
Answer options for dedfc83e-7451-404d-bd24-97b1254304eb
Answer options for 23daa784-4476-447f-8aa2-42933b4490d9
Answer options for 079df9c5-234c-4129-8769-800dab47a59a
Answer options for ce1fc869-a412-4aea-aa53-36e794a14519
Answer options for MarkComplete-6
Answer options for MarkComplete-20
Answer options for MarkComplete-26
Answer options for MarkComplete-13
Answer options for MarkComplete-7
Answer options for 3dbb0e63-3b28-4567-8ef3-bac242fd95f6
Answer options for MarkComplete-2
Answer options for MarkComplete-14
Answer options for d0e58402-a08a-49ca-b2ca-9f4bbdb89da0
Answer options for 0f70dec3-c1f2-4b36-b1f6-bd7f5743d5f8
Answer options for eaed9770-95f4-4c6a-b06c-d573427a2616
Answer options for 25f27e83-fcf0-49c8-86c1-e285e201a043
Answer options for 2657da9c-a27e-4939-af7a-08a19b9ab6f7
Answer options for 4044d0b4-94b2-4a89-b826-a14614298511
Answer options for f97f211a-ef2a-49a3-aef7-c4e9cd08aa2a
Answer options for 07cfe077-ba93-4f93-b2a5-027023faa33b
Answer options for a525c370-d8c3-4764-ab3a-bf62081725e0
Answer options for d68d9693-48d3-4663-9dbb-dd3a7aec5278
Answer options for 8176151f-6d86-45eb-91b1-12458d75a181
Answer options for MarkComplete-31
About the health check
In progress
Complete
Attention required
Eligible for health check
not claimed 715 or 228 in past nine months
Health check already in progress?
Date of last completed health check
Date this health check commenced
Section completion status
Consent
In progress
Complete
Attention required
Consent given after discussion of process and benefits of a health check
Consent given by parent/primary carer after discussion of process and benefits of a health check
Parent/primary caregiver present
Parent/primary caregiver is present for health check?
Relationship to child
Consent for sharing of information
Consent given for sharing of information with relevant healthcare providers?
Who/details
Date
Doctor
Nurse
Aboriginal and/or Torres Strait Islander Health Worker / Health Practitioner
Location of health check
Location of health check
Section completion status
Patient details
In progress
Complete
Attention required
This section contains several read only, non-editable items. Updates to these items will need to be done in the patient record. The form can be repopulated to include any updates.
Name
Preferred name
Preferred pronouns
Gender identity
Administrative gender
Sex assigned at birth
Date of birth
Age
Aboriginal and/or Torres Strait Islander status
Parents/primary carer/s
Other family
Other
Parents/primary carer/s details
Name of parent/primary carer
Relationship to child
Home address
No fixed address
Home address
Street address
City
State
Postcode
Postal address
Purpose of use
Street address
City
State
Postcode
Home phone
Mobile phone
Emergency contact
Name
Relationship to child
Relationship to patient
Phone
Medicare number
Number
Reference number
Expiry
Pensioner Card Number
Health Care Card Number
Registered for Closing the Gap PBS Co-payment Measure (CTG)
Child has a birth certificate
My Aged Care
Registered for My Aged Care
My Aged Care Number
National Disability Insurance Scheme
Registered for NDIS
NDIS Number
Children
Do you have children?
Number of children
Number of children in your care
Someone's carer
Are you responsible for caring for someone else?
Details
Your carer
Do you have a carer?
Details
Providers
Are name and contact details of other key providers (eg case workers, support services) up to date?
Details
Advance care planning
Enduring Power of Attorney
Enduring Power of Attorney
Discussed today
Advance Health Directive
Advance Health Directive
Discussed today
Section completion status
Current health/patient priorities
In progress
Complete
Attention required
What are the important things for you in this health check today?
Is there anything you are worried about?
Is there anything that you are worried about with your child's health or wellbeing?
Child Health Book
Does your child have a Child Health Book?
Is it up to date?
Do you have any specific health goals? Is there anything in particular about your health and wellbeing that you would like to improve?
Health priorities, actions and follow-up
Section completion status
Medical history and current problems
In progress
Complete
Attention required
Birth history
Gestation at birth
weeks
Birth weight
kg
Medical history summary
Recorded problems/diagnoses
Condition
Clinical status
Onset date
Abatement date
New problems/diagnoses
Condition*
Onset date
Comment
Health priorities, actions and follow-up
Section completion status
Regular medications
In progress
Complete
Attention required
Check medications are still required, appropriate dose, understanding of medication and adherence
Medication summary
Recorded medications
Medication
Status*
Dosage
Clinical indication
Comment
New medications
Medication*
Dosage
Clinical indication
Comment
Does your child take any regular medications (prescribed, over-the-counter, traditional, complementary and alternative)?
Do you take any regular medications (prescribed, over-the-counter, traditional, complementary and alternative)?
Check the health record is up to date
Check medication understanding and adherence with patient
Health priorities, actions and follow-up
Section completion status
Allergies/adverse reactions
In progress
Complete
Attention required
Adverse reaction risk summary
Recorded adverse reaction risks
Substance
Status
Manifestation
Comment
New adverse reaction risks
Substance*
Manifestation
Comment
Health priorities, actions and follow-up
Section completion status
Family history
In progress
Complete
Attention required
Provide relevant family history information
Provide relevant family history information (including diabetes, heart disease, cancer, mental health)
Health priorities, actions and follow-up
Section completion status
Social and emotional wellbeing
In progress
Complete
Attention required
Stressful life events
Have there been any particular stressful life events that are impacting on you/your health lately?
Details
Social and emotional wellbeing assessment: consider tools such as Aboriginal and Torres Strait Islander Youth Social Emotional Wellbeing assessment question guide or HEEADSSS
Consider conversation about social connection, which could include questions about sports/hobbies/clubs/other activities
Health priorities, actions and follow-up
Section completion status
Social history: Information about family and child's living arrangements
In progress
Complete
Attention required
Who lives in your household? / Who does the child live with?
Stressful life events
Have there been any stressful life events that would cause you or your child to be upset?
Details
If indicated, ask about depression and other mental health concerns
Health priorities, actions and follow-up
Section completion status
Home and family
In progress
Complete
Attention required
Who do you live with?
Housing stability
Do you have stable housing?
Details
Home safety
Do you feel safe at home?
Details
Health priorities, actions and follow-up
Section completion status
Learning and development
In progress
Complete
Attention required
Is there anything that you are worried about with your child's development?
Is there anything that you are worried about with your child's learning?
Is there anything that you are worried about with your child's behaviour?
Is there anything that you are worried about with your child's sleep?
What childcare/early learning centre/kindergarten does your child go to? How often?
How often does your child miss childcare/early learning centre/kindergarten?
Is there anything you are worried about at school?
How often does your child miss school?
Is your child having any difficulties making friends?
Are there any other concerns about your child's learning and development?
Health priorities, actions and follow-up
Section completion status
Learning and work
In progress
Complete
Attention required
Learning
Are you studying at school/uni?
Details
Learning
Are you studying?
Details
Work
Are you working?
Details (occupation including occupational hazards, study, training, disability, etc)
Health priorities, actions and follow-up
Section completion status
Work
In progress
Complete
Attention required
Work
Are you working?
Details (occupation including occupational hazards, study, training, disability, etc)
Health priorities, actions and follow-up
Section completion status
Mood
In progress
Complete
Attention required
How have you been feeling lately?
If indicated, ask about depression (consider screening tools, eg aPHQ-9, K5 or K10) and complete risk assessment
Explore other mental health concerns as indicated
Health priorities, actions and follow-up
Section completion status
Memory and thinking
In progress
Complete
Attention required
Personal concerns about your memory or thinking
Do you have any worries about your memory or thinking?
Details
Family concerns about your memory or thinking
Does anyone in your family have any worries about your memory or thinking?
Details
If any concerns are raised and/or high risk for cognitive impairment identified, follow up with cognitive screening (eg clock test, GPCOG, KICA-Cog, MMSE)
Health priorities, actions and follow-up
Section completion status
Chronic disease associated with ageing
In progress
Complete
Attention required
For older people with chronic disease and/or conditions associated with ageing, consider assessing: Osteoporosis risk; Falls risk; Balance, coordination and mobility; Pain; Nutrition; Regularity of chronic disease management and review
Health priorities, actions and follow-up
Section completion status
Participation in screening programs
In progress
Complete
Attention required
Cervical screening (age <=74 years)
Cervical screening status
Cervical screening next due
Cervical screening details
Breast screening (age <=74 years)
Breast screening status
Breast screening next due
Breast screening details
Bowel cancer screening (age <=74 years)
Bowel cancer screening status
Bowel cancer screening next due
Bowel cancer screening details
Health priorities, actions and follow-up
Section completion status
Healthy eating
In progress
Complete
Attention required
Child eating concerns
Is there anything that you are worried about with your child's feeding/eating?
Is there anything that you are worried about with your child's eating?
Details
Breastfeeding history
Bottle feeding history
Diet or weight concerns
Do you have any worries about your diet or weight?
Details
Unintended weight loss
Have you lost weight without trying to in the last three months?
Details
Document conversation about age-appropriate healthy eating, which could include: current diet; transition to solids; dietary recommendations re fruit and vegetable intake, iron-rich foods, avoiding sugary drinks
Document conversation about healthy eating which could include: current diet including food and drinks; recommendations about fruit and vegetable intake, water as the main drink, avoiding sugary drinks, avoiding highly processed foods (including supermarket-bought and take-away like KFC, Maccas, etc)
Food availability issues
Are there any issues about availability of food?
Details
Health priorities, actions and follow-up
Section completion status
Physical activity and screen time
In progress
Complete
Attention required
Physical activity concerns
Is there anything that you are worried about with your child's level of physical activity?
Details
Screen time concerns
Is there anything that you are worried about with your child's level of screen time?
Details
Physical activity or screen time concerns
Do you have any worries about physical activity or screen time?
Details
Document conversation about age-appropriate recommendations re physical activity and screen time
Document conversation about social connection, which could include questions about sports/hobbies/clubs/other activities
Health priorities, actions and follow-up
Section completion status
Physical activity
In progress
Complete
Attention required
Physical activity concerns
Do you have any worries about physical activity?
Details
Document conversation about recommendations re physical activity
Health priorities, actions and follow-up
Section completion status
Red flags early identification guide for children
In progress
Complete
Attention required
This is based on material from the The State of Queensland, Red flags early identification guide (for children aged birth to five years). 2nd edn. South Brisbane, Qld: Child Development Program, Queensland Health, 2016. Available at www.childrens.health.qld.gov.au/wp-content/uploads/PDF/red-flags-a3.pdf [Accessed 2 December 2019]. © Developed by the Child Development Program in conjunction with Brisbane North Primary Health Network. Updated: July 2016.
What age group is the child closest to?
Red flags
Social Emotional
Social Emotional
Social Emotional
Social Emotional
Social Emotional
Social Emotional
Social Emotional
Social Emotional
Communication
Communication
Communication
Communication
Communication
Communication
Communication
Communication
Cognition, fine motor and self care
Cognition, fine motor and self care
Cognition, fine motor and self care
Cognition, fine motor and self care
Cognition, fine motor and self care
Cognition, fine motor and self care
Cognition, fine motor and self care
Cognition, fine motor and self care
Gross motor
Gross motor
Gross motor
Gross motor
Gross motor
Gross motor
Gross motor
Gross motor
Red flags at any age
Section completion status
Substance use, including tobacco
In progress
Complete
Attention required
Smoking
Smoking status
Smoking status
Last status
Last status value
New status
New date
Quit status
How many?
How long as a smoker?
Alcohol and other substance use
Quantity and frequency of: alcohol; caffeine (coffee, soft drinks, iced coffee); cannabis/yarndi/gunja; other substance use: IVDU, methamphetamine, opiates, solvents, other
Health priorities, actions and follow-up
Section completion status
Gambling
In progress
Complete
Attention required
Gambling issues
Have you or someone close to you ever had issues with gambling?
Details
Health priorities, actions and follow-up
Section completion status
Sexual health (sexual activity, contraception, safe sex/protection, sexual orientation, gender identity, pressure to have sex, STIs)
In progress
Complete
Attention required
Puberty and sexual health concerns
Is there anything that you are worried about in relation to puberty/your sexual health?
Details
Consider discussing as relevant to age/sex/gender: menstruation (including risk of anaemia); current sexual activity; contraception; safe sex practice (eg use of condoms); sexually transmitted infection symptoms and screening; blood-borne virus screening
Health priorities, actions and follow-up
Section completion status
Genitourinary and sexual health
In progress
Complete
Attention required
Sexual health concerns
Is there anything that you are worried about in relation to your sexual health?
Details
Cervical screening
Cervical screening status
Next due
Details
Consider discussing as relevant to age/sex/gender: contraception; menstruation; sexually transmitted infection symptoms and screening; blood-borne virus screening; continence; menopause; erectile dysfunction
Health priorities, actions and follow-up
Section completion status
Genitourinary and sexual health
In progress
Complete
Attention required
Sexual health concerns
Consider asking when appropriate: Is there anything that you are worried about in relation to your sexual health?
Details
Continence issues
Do you have problems with urine leaking?
Details
Consider discussing as relevant to age/sex/gender: menopause; erectile dysfunction; prostatic symptoms
Health priorities, actions and follow-up
Section completion status
Eye health
In progress
Complete
Attention required
Vision concerns
Is there anything that you are worried about with your child's vision?
Is there anything that you are worried about with your vision?
Details
Eye examination
Red reflex (up to six months)
Left eye
Right eye
Evidence of squint or other abnormality
Left eye
Right eye
Visual acuity
Left eye
Right eye
Trachoma Check (endemic areas)
Left eye
Right eye
Health priorities, actions and follow-up
Section completion status
Ear health and hearing
In progress
Complete
Attention required
Child listening concerns
Is there anything that you are worried about with your child's listening?
Details
Child language concerns
Is there anything you are worried about with your child's language/talking?
Details
Child snoring
Do you notice snoring/noisy breathing at night/while your child is sleeping?
Details
Hearing concerns
Is there anything that you are worried about with your hearing?
Details
Last hearing test (audiology)
Ear examination
Otoscopy
Video otoscopy procedure recommended where possible as it allows for parental education and for images to be saved for tracking over time.
Otoscopy findings
Left ear
Right ear
Otoscopy findings
Left ear
Right ear
Tympanometry
Left ear
Right ear
Health priorities, actions and follow-up
Section completion status
Oral and dental health
In progress
Complete
Attention required
Dental concerns
Is there anything that you are worried about with your child's teeth or mouth?
Is there anything that you are worried about with your teeth?
Details
Last dental checkup
Dentures?
Teeth and mouth check
Examination findings
Document conversation about oral health and care of teeth
Health priorities, actions and follow-up
Section completion status
Skin
In progress
Complete
Attention required
Skin problems
Does your child have any skin problems?
Is there anything that you are worried about with your skin?
Details
Do you use sun protection?
Document conversation about sun protection as appropriate (ie sunscreen, hats, shade).
General skin examination findings
Health priorities, actions and follow-up
Section completion status
Immunisation
In progress
Complete
Attention required
Check Child Health Record/Book and Australian Immunisation Register
Eligibility for funded vaccines may vary across jurisdictions
Check Australian Immunisation Register
Check recommended primary vaccinations completed and provide catch-up if required
Vaccines previously given
Vaccine
Batch number
Administration date
Comment
Immunisations are up to date?
Immunisations due
Vaccines given today
Vaccine*
Batch number
Administration date*
Comment
Have all vaccines been recorded on the Australian Immunisation Register?
Health priorities, actions and follow-up
Section completion status
Examination
In progress
Complete
Attention required
Growth measures recorded on Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) growth charts for centile and tracking overtime
The tabled observations will display the most recent results available from the patient record. New observations may be added.
Length/Height
Last result
New result
cm
New result date
Height
Last result
New result
cm
New result date
Weight
Last result
New result
kg
New result date
BMI (calculated)
Last result
New result
kg/m2
Head circumference
Last result
New result
cm
New result date
Waist circumference
Last result
New result
cm
New result date
Heart rate
Last result
New result
/min
New result date
Heart rhythm
Last result
Last result value
New result
New result date
Blood pressure
Blood pressure
Last result
Systolic
mm Hg
Diastolic
mm Hg
Date performed
Cardiac auscultation
Abdominal examination
Gait examination (musculoskeletal structure, balance, coordination)
Newborn examination (if indicated, infant aged <=6 weeks)
Haemoglobin (children at risk of iron deficiency anaemia)
Health priorities, actions and follow-up
Section completion status
Absolute cardiovascular disease risk calculation
In progress
Complete
Attention required
The Australian guideline for assessing and managing cardiovascular disease risk recommends the use of the Aus CVD Risk calculator.
CVD risk result
Latest available result
A previous CVD risk result has been found. Do you want to perform a new assessment?
Do you have access to the Aus CVD Risk-i application from your clinical system?
Using the Aus CVD Risk-i application, calculate the CVD risk result and save it to the patient record. This form can then be repopulated to retrieve and include the result above.
Do you need to manually enter a new CVD risk result instead of repopulating?
New CVD risk result
Use the online Australian CVD risk calculator - https://www.cvdcheck.org.au/calculator
Risk result score
%
Assessed risk category
CVD risk calculator variables
Age
years
Sex at birth
Smoking status
Systolic blood pressure
mm Hg
Cholesterol
Ratio of total cholesterol to HDL cholesterol
Total Cholesterol
mmol/L
HDL Cholesterol
mmol/L
Use of CVD medicines within last 6 months
Blood pressure-lowering medicines
Lipid-modifying medicines
Antithrombotic medicines
History of atrial fibrillation
Postcode
Diabetes
Additional diabetes details
Years since diabetes diagnosis
years
Glycated haemoglobin (HbA1c)
mmol/mol
uACR
mg/mmol
eGFR
mL/min/1.73 m²
Body mass index (BMI)
Weight
kg
Height
m
Use of insulin within last 6 months
Health priorities, actions and follow-up
Section completion status
Investigations
In progress
Complete
Attention required
Full blood count, HbA1c or blood glucose level, serum lipids, Kidney function including eGFR, Liver function tests, ACR
Chlamydia, gonorrhoea: <=30, first void urine (male and female) and/or endocervical swab or self-administered vaginal swab (female) or throat and anal swab (men who have sex with men [MSM])
Syphilis (endemic areas, MSM, others at high risk)
Trichomoniasis (<=30, male and female, remote areas and other endemic areas, first void urine and/or endocervical swab or self-administered vaginal swab)
Blood-borne virus screening: HBV if status not known/not recorded on file, HCV if risk factors, HIV if risk factors
Health priorities, actions and follow-up
Section completion status
Health Priorities, Actions And Follow-Up Summary
The following information is a read-only collection of the 'Health priorities, actions and follow-up' sections entered in the previous tabs. Only sections where previous information entered will be displayed here.
Current health/patient priorities
Medical history and current problems
Regular medications
Allergies/adverse reactions
Family history
Social and emotional wellbeing
Social history
Home and family
Learning and development
Learning and work
Work
Mood
Memory and thinking
Chronic disease associated with ageing
Participation in screening programs
Healthy eating
Physical activity and screen time
Physical activity
Substance use, including tobacco
Gambling
Sexual health
Genitourinary and sexual health
Genitourinary and sexual health
Eye health
Ear health and hearing
Oral and dental health
Skin
Immunisation
Examination
Absolute cardiovascular risk calculation
Investigations
Finalising the health check
In progress
Complete
Attention required
Patient priorities and goals: What does the parent/carer say are the important things that have come out of this health check?
Patient priorities and goals: What does the parent/carer and child say are the important things that have come out of this health check?
Patient priorities and goals: What does the patient say are the important things that have come out of this health check?
Brief intervention: advice and information provided during health check
Brief intervention: advice and information provided during health check
Brief intervention: advice and information provided during health check
Brief intervention: advice and information provided during health check
Brief intervention: advice and information provided during health check
Care provided as part of the health check (eg immunisations, medication review, investigations requested)
Identified needs and plan (including new diagnoses)
Follow-up
Consider what follow-up appointments can be made at the time of the health check.
Reminder: MBS follow up items for clients at risk of or with chronic disease are available to support follow-up of health checks
Referrals and appointments
Who
Who
Who
Who
Who
When
Recalls
e.g. clinical review, investigations, influenza vaccination, asthma plan/cycle of care, diabetes cycle of care, care plan review, cervical screening, investigations
Recall entered
Parent/carer actions
Parent/patient actions
Patient actions
A copy of this health check has been offered - including details of follow-up and future appointments
Section completion status
| LinkID | Description & Constraints![]() |
|---|---|
![]() |
Value Set: |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Yes/No/NA |
![]() ![]() ![]() |
Value Set: Yes/No/NA |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Australian Pronouns |
![]() ![]() ![]() |
Value Set: Gender Identity Response |
![]() ![]() ![]() |
Value Set: AdministrativeGender |
![]() ![]() ![]() |
Value Set: Biological Sex |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Aboriginal and/or Torres Strait Islander |
![]() ![]() ![]() |
Value Set: Primary Carer Of Parent Or Grandparent |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: Australian States and Territories |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Australian States and Territories |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Max Length: 10 Value Set: |
![]() ![]() ![]() |
Max Length: 10 Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Yes/No/NA |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Yes/No |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: Clinical Condition |
![]() ![]() ![]() ![]() ![]() |
Value Set: Condition Clinical Status Minimal |
![]() ![]() ![]() ![]() ![]() |
Value Set: Condition Clinical Status Minimal |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: Clinical Condition |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: Smart Health Checks Medicine Products |
![]() ![]() ![]() ![]() ![]() |
Value Set: Medication Statement Status Limited |
![]() ![]() ![]() ![]() ![]() |
Value Set: Medication Statement Status Limited |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: Medication Reason Taken |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: Smart Health Checks Medicine Products |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: Medication Reason Taken |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: Adverse Reaction Agent |
![]() ![]() ![]() ![]() ![]() |
Value Set: Allergy Intolerance Clinical Status Minimal |
![]() ![]() ![]() ![]() ![]() |
Value Set: Allergy Intolerance Clinical Status Minimal |
![]() ![]() ![]() ![]() ![]() |
Value Set: Clinical Finding |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: Adverse Reaction Agent |
![]() ![]() ![]() ![]() ![]() |
Value Set: Clinical Finding |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Options: 5 options |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Options: 5 options |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Options: 5 options |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 8 options |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 1 option |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 1 option |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 1 option |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 1 option |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 1 option |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 1 option |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 1 option |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 4 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 3 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 1 option |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 3 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 4 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Value Set: Options: 7 options |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: Tobacco Use Status |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: Tobacco Use Status |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Smoking Quit Status |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No/Not Asked/Asked But Declined |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No/Not Asked/Asked But Declined |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Cervical Screening Status |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No/Not Asked/Asked But Declined |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: Options: 2 options |
![]() ![]() ![]() ![]() ![]() |
Value Set: Options: 2 options |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: Options: 10 options |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: Options: 10 options |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: Options: 6 options |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: Options: 6 options |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Australian Medicines Terminology Vaccine |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() |
Value Set: Australian Medicines Terminology Vaccine |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Australian Medicines Terminology Vaccine |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Yes/No |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: Heart Rhythm |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: Heart Rhythm |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: CVD Risk Category |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: Options: 2 options |
![]() ![]() ![]() ![]() |
Value Set: CVD Risk Smoking Status |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 9 options |
![]() ![]() ![]() |
Value Set: Options: 7 options |
![]() ![]() ![]() |
Value Set: Options: 9 options |
![]() ![]() ![]() |
Value Set: Options: 10 options |
![]() ![]() ![]() |
Value Set: Options: 8 options |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() ![]() |
Value Set: Options: 12 options |
![]() ![]() ![]() ![]() ![]() |
Value Set: Options: 10 options |
![]() ![]() ![]() ![]() ![]() |
Value Set: Options: 11 options |
![]() ![]() ![]() ![]() ![]() |
Value Set: Options: 13 options |
![]() ![]() ![]() ![]() ![]() |
Value Set: Options: 16 options |
![]() ![]() ![]() ![]() ![]() |
Enable When: Not done yet Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
![]() ![]() ![]() |
Value Set: |
![]() ![]() ![]() |
Value Set: Options: 3 options |
Documentation for this format | |
Try this questionnaire out:
There are currently no QuestionnaireResponse instances for this Questionnaire defined in this IG.