Smart Health Checks
0.4.0 - CI Build Australia flag

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

Questionnaire: Aboriginal and Torres Strait Islander Health Check - Patient Details

Official URL: http://www.health.gov.au/assessments/mbs/715/PatientDetails Version: 0.4.0
Draft as of 2025-03-14 Computable Name: PatientDetails

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/.

Structure
LinkIDTextCardinalityTypeFlagsDescription & Constraintsdoco
.. PatientDetails Questionnaire http://www.health.gov.au/assessments/mbs/715/PatientDetails#0.4.0
... 5b224753-9365-44e3-823b-9c17e7394005 Patient details 0..1 group Value Set:
.... CD-in-progress-32 In progress 0..1 display Value Set:
.... CD-complete-32 Complete 0..1 display Value Set:
.... CD-attention-32 Attention required 0..1 display Value Set:
.... patientdetails-writebackinstruction 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:
.... 17596726-34cf-4133-9960-7081e1d63558 Name 0..1 string iconicon Value Set:
.... 57093a06-62f7-4b8b-8cb4-2c9f451ac851 Preferred name 0..1 string iconicon Value Set:
.... 540b1034-7c9a-4aba-a9ef-afb77d445a58 Preferred pronouns 0..1 choice iconicon Value Set: Australian Pronouns
.... f669a4fe-4818-429a-8847-d20da88d2bb3 Gender identity 0..1 choice iconicon Value Set: Gender Identity Response
.... 418e4a02-de77-48a0-a92a-fe8fcc52b1aa Administrative gender 0..1 choice iconicon Value Set: AdministrativeGender
.... 56ef44bb-3d1d-4972-aad1-834b69185d61 Sex assigned at birth 0..1 choice iconicon Value Set: Biological Sex
.... 90ad8f16-16e4-4438-a7aa-b3189f510da2 Date of birth 0..1 date iconicon Value Set:
.... e2a16e4d-2765-4b61-b286-82cfc6356b30 Age 0..1 integer iconicon Value Set:
.... 8acde9f8-7a91-4f0c-9216-38531ec984ef Aboriginal and/or Torres Strait Islander status 0..1 choice iconicon Value Set: Aboriginal and/or Torres Strait Islander
.... c8852db9-efe9-4102-96db-cef3a8be0a5f Parents/primary carer/s 0..* choice Value Set: Primary Carer Of Parent Or Grandparent
.... 7089c48e-4216-4089-a548-034cd585e4da Other family 0..* string Value Set:
.... 42b1f5e0-bf4a-47d9-86a4-f2fe946ac01f Other 0..* string Value Set:
.... 06737e46-e880-4037-9a2c-bcd278cd70ba Parents/primary carer/s details 0..* group Value Set:
..... cc20ce96-af06-4cd7-aa9b-c2601a6169ad Name of parent/primary carer 0..1 string Value Set:
..... 372d79bb-9d0b-42d2-a98c-cbe332bd3745 Relationship to child 0..1 string Value Set:
.... f1262ade-843c-4eba-a86d-51a9c97d134b Home address 0..1 group iconicon Value Set:
..... 311d83bb-f22e-4f60-9b50-b6e38dd2059b No fixed address 0..1 boolean Value Set:
..... 4e0dc185-f83e-4027-b7a8-ecb543d42c6d Home address 0..* group Value Set:
...... 2fee2d51-7828-4178-b8c1-35edd32ba338 Street address 0..1 string Value Set:
...... ddb65ed1-f4b2-4730-af2a-2f98bc73c76f City 0..1 string Value Set:
...... d9a1236c-8d6e-4f20-a12a-9d5de5a1d0f6 State 0..1 choice Value Set: Australian States and Territories
...... 3f61a1ea-1c74-4f52-8519-432ce861a74f Postcode 0..1 string Value Set:
.... edc081ea-b5ba-4234-9234-8ee598c2f95f Postal address 0..* group iconicon Value Set:
..... 622970f1-3cf1-4f0a-bf05-b00a08046eba Purpose of use 0..1 string Value Set:
..... 2e8437cd-5ea0-4d44-8ab2-d2aa9ef18ba7 Street address 0..1 string Value Set:
..... 2bde25e5-2c4c-4c0c-b6f3-c6859535a764 City 0..1 string Value Set:
..... b41a8b11-8dbf-4999-9d0a-71d39240fed1 State 0..1 choice Value Set: Australian States and Territories
..... 28b58e50-2a04-4192-9655-efc8d72f32fa Postcode 0..1 string Value Set:
.... 9541f0b0-f5ba-4fe7-a8e9-ad003cef897b Home phone 0..* string iconicon Value Set:
.... 4037a02b-4a85-40e0-9be6-5b17df1aac56 Mobile phone 0..* string iconicon Value Set:
.... c22390d3-1be6-4fd1-b775-6443b7239a6b Emergency contact 0..* group iconicon Value Set:
..... d7f2dd75-20c8-480f-8c22-71d604ebee8d Name 0..1 string Value Set:
..... aa35d559-f45b-4d35-9453-dd02e4a790f3 Relationship to child 0..1 string Value Set:
..... 27099697-d6d1-42c0-bb0a-5e9ff7372a96 Relationship to patient 0..1 string Value Set:
..... 626e3723-6310-4b99-81c1-525676b027c8 Phone 0..* string Value Set:
.... df1475ea-bf7e-4bf0-a69f-7f9608c3ed3c Medicare number 0..* group iconicon Value Set:
..... eb2a59ed-9632-4df1-b5b1-1e85c3b4b7cf Number 0..1 string Value Set:
..... d6253253-a124-494e-a1d8-7ce02c69ec11 Reference number 0..1 string Value Set:
..... c520e213-5313-42c3-860a-d30206620290 Expiry 0..1 string Value Set:
.... c1e4e967-c0aa-4280-b5d4-ab1f375ed9ac Pensioner Card Number 0..1 string iconicon Max Length: 10
Value Set:
.... a7e97574-3cea-4dfa-bef2-2665e7748364 Health Care Card Number 0..1 string iconicon Max Length: 10
Value Set:
.... 83814495-3a81-43f4-88df-42186cce516a Registered for Closing the Gap PBS Co-payment Measure (CTG) 0..1 boolean iconicon Value Set:
.... e63547c6-1623-412f-963f-5f1ebf23563f Child has a birth certificate 0..1 choice iconicon Value Set: Yes/No/NA
.... a8143230-b30d-4b85-9805-5f2f73f2dffa My Aged Care 0..1 group Value Set:
..... 7165c072-e3d8-4564-9d1d-d17f6807787c Registered for My Aged Care 0..1 choice iconicon Value Set: Yes/No/NA
..... 04e50521-dc85-4744-b7ab-6f8682aacb11 My Aged Care Number 0..1 string Enable When: 7165c072-e3d8-4564-9d1d-d17f6807787c = Yes (v2 Y/N Indicator#Y)
Value Set:
.... 2bfe50cb-7913-4f31-bce2-763c17ff8b1a National Disability Insurance Scheme 0..1 group Value Set:
..... 924b4500-53ac-4c4e-831b-7ab5569ff981 Registered for NDIS 0..1 choice iconicon Value Set: Yes/No/NA
..... 7379a0fd-d95b-4ecb-a781-9f43d1394f10 NDIS Number 0..1 string Enable When: 924b4500-53ac-4c4e-831b-7ab5569ff981 = Yes (v2 Y/N Indicator#Y)
Value Set:
.... 9bc882bc-e989-4600-9587-8089fb757641 Children 0..1 group Value Set:
..... e90b436b-2751-4e07-a40c-adfe951b6528 Do you have children? 0..1 choice iconicon Value Set: Yes/No/NA
..... 241f5fca-f61a-49bd-8972-52613c0e6d15 Number of children 0..1 integer Enable When: e90b436b-2751-4e07-a40c-adfe951b6528 = Yes (v2 Y/N Indicator#Y)
Value Set:
..... 74ce4c60-31d6-4e78-9056-579937379451 Number of children in your care 0..1 integer Enable When: e90b436b-2751-4e07-a40c-adfe951b6528 = Yes (v2 Y/N Indicator#Y)
Value Set:
.... 2b5ae784-4341-4172-875d-1698cc8069f0 Someone's carer 0..1 group Value Set:
..... a08271f1-194b-4fe9-91f9-4f3398858eb0 Are you responsible for caring for someone else? 0..1 choice iconicon Value Set: Yes/No/NA
..... 4c14b158-3ae4-4994-8446-76e02640702c Details 0..1 text Enable When: a08271f1-194b-4fe9-91f9-4f3398858eb0 = Yes (v2 Y/N Indicator#Y)
Value Set:
.... 6c80c675-1320-4ca3-ae3f-51ad173da741 Your carer 0..1 group Value Set:
..... d05558fb-a3cc-4bd6-b803-b672b36b9c51 Do you have a carer? 0..1 choice iconicon Value Set: Yes/No/NA
..... b9991e7e-ce03-465d-b4b0-5a1725b24e02 Details 0..1 text Enable When: d05558fb-a3cc-4bd6-b803-b672b36b9c51 = Yes (v2 Y/N Indicator#Y)
Value Set:
.... 3494631c-6b56-46dc-abf7-a17bfc1d025f Providers 0..1 group Value Set:
..... 41210be5-d441-4c44-b9c2-8dd94a44cbb4 Are name and contact details of other key providers (eg case workers, support services) up to date? 0..1 choice iconicon Value Set: Yes/No/NA
..... 6733d6ec-5b6b-4ee2-a21e-0e9474c2b22b Details 0..1 text Value Set:
.... 38f81a73-447f-4ecd-a8eb-6eccd9dee050 Advance care planning 0..1 group Value Set:
..... c023ef16-b554-4ed9-8993-1331e5f5a3b4 Enduring Power of Attorney 0..1 group Value Set:
...... 036eace9-ea83-46ec-9d01-f2093f710816 Enduring Power of Attorney 0..1 choice iconicon Value Set: Yes/No/NA
...... 83518215-7151-4365-b745-d7464bbb9528 Discussed today 0..1 text Value Set:
..... c4f68251-26af-462f-879a-a69b449066ff Advance Health Directive 0..1 group Value Set:
...... b0632039-c12b-4748-9e94-52073590c0ba Advance Health Directive 0..1 choice iconicon Value Set: Yes/No/NA
...... c4bc2d84-e411-488d-9c0d-761f0377a026 Discussed today 0..1 text Value Set:
.... patientdetails-section-end-divider null 0..1 display Value Set:
.... MarkComplete-32 Section completion status 0..1 choice Value Set:
Options: 3 options

doco Documentation for this format

Options Sets

Answer options for MarkComplete-32

  • Complete
  • In progress
  • Attention required

Patient details

  • linkId: 5b224753-9365-44e3-823b-9c17e7394005
  • Answers:

In progress

  • linkId: CD-in-progress-32
  • Answers:

Complete

  • linkId: CD-complete-32
  • Answers:

Attention required

  • linkId: CD-attention-32
  • Answers:

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.

  • linkId: patientdetails-writebackinstruction
  • Answers:

Name

  • linkId: 17596726-34cf-4133-9960-7081e1d63558
  • Answers:

Preferred name

  • linkId: 57093a06-62f7-4b8b-8cb4-2c9f451ac851
  • Answers:

Preferred pronouns

Gender identity

Administrative gender

Sex assigned at birth

Date of birth

  • linkId: 90ad8f16-16e4-4438-a7aa-b3189f510da2
  • Answers:

Age

  • linkId: e2a16e4d-2765-4b61-b286-82cfc6356b30
  • Answers:

Aboriginal and/or Torres Strait Islander status

Parents/primary carer/s

Other family

  • linkId: 7089c48e-4216-4089-a548-034cd585e4da
  • Answers:

Other

  • linkId: 42b1f5e0-bf4a-47d9-86a4-f2fe946ac01f
  • Answers:

Parents/primary carer/s details

  • linkId: 06737e46-e880-4037-9a2c-bcd278cd70ba
  • Answers:

Name of parent/primary carer

  • linkId: cc20ce96-af06-4cd7-aa9b-c2601a6169ad
  • Answers:

Relationship to child

  • linkId: 372d79bb-9d0b-42d2-a98c-cbe332bd3745
  • Answers:

Home address

  • linkId: f1262ade-843c-4eba-a86d-51a9c97d134b
  • Answers:

No fixed address

  • linkId: 311d83bb-f22e-4f60-9b50-b6e38dd2059b
  • Answers:

Home address

  • linkId: 4e0dc185-f83e-4027-b7a8-ecb543d42c6d
  • Answers:

Street address

  • linkId: 2fee2d51-7828-4178-b8c1-35edd32ba338
  • Answers:

City

  • linkId: ddb65ed1-f4b2-4730-af2a-2f98bc73c76f
  • Answers:

State

Postcode

  • linkId: 3f61a1ea-1c74-4f52-8519-432ce861a74f
  • Answers:

Postal address

  • linkId: edc081ea-b5ba-4234-9234-8ee598c2f95f
  • Answers:

Purpose of use

  • linkId: 622970f1-3cf1-4f0a-bf05-b00a08046eba
  • Answers:

Street address

  • linkId: 2e8437cd-5ea0-4d44-8ab2-d2aa9ef18ba7
  • Answers:

City

  • linkId: 2bde25e5-2c4c-4c0c-b6f3-c6859535a764
  • Answers:

State

Postcode

  • linkId: 28b58e50-2a04-4192-9655-efc8d72f32fa
  • Answers:

Home phone

  • linkId: 9541f0b0-f5ba-4fe7-a8e9-ad003cef897b
  • Answers:

Mobile phone

  • linkId: 4037a02b-4a85-40e0-9be6-5b17df1aac56
  • Answers:

Emergency contact

  • linkId: c22390d3-1be6-4fd1-b775-6443b7239a6b
  • Answers:

Name

  • linkId: d7f2dd75-20c8-480f-8c22-71d604ebee8d
  • Answers:

Relationship to child

  • linkId: aa35d559-f45b-4d35-9453-dd02e4a790f3
  • Answers:

Relationship to patient

  • linkId: 27099697-d6d1-42c0-bb0a-5e9ff7372a96
  • Answers:

Phone

  • linkId: 626e3723-6310-4b99-81c1-525676b027c8
  • Answers:

Medicare number

  • linkId: df1475ea-bf7e-4bf0-a69f-7f9608c3ed3c
  • Answers:

Number

  • linkId: eb2a59ed-9632-4df1-b5b1-1e85c3b4b7cf
  • Answers:

Reference number

  • linkId: d6253253-a124-494e-a1d8-7ce02c69ec11
  • Answers:

Expiry

  • linkId: c520e213-5313-42c3-860a-d30206620290
  • Answers:

Pensioner Card Number

  • linkId: c1e4e967-c0aa-4280-b5d4-ab1f375ed9ac
  • Max Length:: 10
  • Answers:

Health Care Card Number

  • linkId: a7e97574-3cea-4dfa-bef2-2665e7748364
  • Max Length:: 10
  • Answers:

Registered for Closing the Gap PBS Co-payment Measure (CTG)

  • linkId: 83814495-3a81-43f4-88df-42186cce516a
  • Answers:

Child has a birth certificate

  • linkId: e63547c6-1623-412f-963f-5f1ebf23563f
  • Answers: Yes/No/NA

My Aged Care

  • linkId: a8143230-b30d-4b85-9805-5f2f73f2dffa
  • Answers:

Registered for My Aged Care

  • linkId: 7165c072-e3d8-4564-9d1d-d17f6807787c
  • Answers: Yes/No/NA

My Aged Care Number

  • linkId: 04e50521-dc85-4744-b7ab-6f8682aacb11
  • Enable When: todo
  • Answers:

National Disability Insurance Scheme

  • linkId: 2bfe50cb-7913-4f31-bce2-763c17ff8b1a
  • Answers:

Registered for NDIS

  • linkId: 924b4500-53ac-4c4e-831b-7ab5569ff981
  • Answers: Yes/No/NA

NDIS Number

  • linkId: 7379a0fd-d95b-4ecb-a781-9f43d1394f10
  • Enable When: todo
  • Answers:

Children

  • linkId: 9bc882bc-e989-4600-9587-8089fb757641
  • Answers:

Do you have children?

  • linkId: e90b436b-2751-4e07-a40c-adfe951b6528
  • Answers: Yes/No/NA

Number of children

  • linkId: 241f5fca-f61a-49bd-8972-52613c0e6d15
  • Enable When: todo
  • Answers:

Number of children in your care

  • linkId: 74ce4c60-31d6-4e78-9056-579937379451
  • Enable When: todo
  • Answers:

Someone's carer

  • linkId: 2b5ae784-4341-4172-875d-1698cc8069f0
  • Answers:

Are you responsible for caring for someone else?

  • linkId: a08271f1-194b-4fe9-91f9-4f3398858eb0
  • Answers: Yes/No/NA

Details

  • linkId: 4c14b158-3ae4-4994-8446-76e02640702c
  • Enable When: todo
  • Answers:

Your carer

  • linkId: 6c80c675-1320-4ca3-ae3f-51ad173da741
  • Answers:

Do you have a carer?

  • linkId: d05558fb-a3cc-4bd6-b803-b672b36b9c51
  • Answers: Yes/No/NA

Details

  • linkId: b9991e7e-ce03-465d-b4b0-5a1725b24e02
  • Enable When: todo
  • Answers:

Providers

  • linkId: 3494631c-6b56-46dc-abf7-a17bfc1d025f
  • Answers:

Are name and contact details of other key providers (eg case workers, support services) up to date?

  • linkId: 41210be5-d441-4c44-b9c2-8dd94a44cbb4
  • Answers: Yes/No/NA

Details

  • linkId: 6733d6ec-5b6b-4ee2-a21e-0e9474c2b22b
  • Answers:

Advance care planning

  • linkId: 38f81a73-447f-4ecd-a8eb-6eccd9dee050
  • Answers:

Enduring Power of Attorney

  • linkId: c023ef16-b554-4ed9-8993-1331e5f5a3b4
  • Answers:

Enduring Power of Attorney

  • linkId: 036eace9-ea83-46ec-9d01-f2093f710816
  • Answers: Yes/No/NA

Discussed today

  • linkId: 83518215-7151-4365-b745-d7464bbb9528
  • Answers:

Advance Health Directive

  • linkId: c4f68251-26af-462f-879a-a69b449066ff
  • Answers:

Advance Health Directive

  • linkId: b0632039-c12b-4748-9e94-52073590c0ba
  • Answers: Yes/No/NA

Discussed today

  • linkId: c4bc2d84-e411-488d-9c0d-761f0377a026
  • Answers:

  • linkId: patientdetails-section-end-divider
  • Answers:

Section completion status

LinkIDDescription & Constraintsdoco
.. 5b224753-9365-44e3-823b-9c17e7394005 Value Set:
... CD-in-progress-32 Value Set:
... CD-complete-32 Value Set:
... CD-attention-32 Value Set:
... patientdetails-writebackinstruction Value Set:
... 17596726-34cf-4133-9960-7081e1d63558 Value Set:
... 57093a06-62f7-4b8b-8cb4-2c9f451ac851 Value Set:
... 540b1034-7c9a-4aba-a9ef-afb77d445a58 Value Set: Australian Pronouns
... f669a4fe-4818-429a-8847-d20da88d2bb3 Value Set: Gender Identity Response
... 418e4a02-de77-48a0-a92a-fe8fcc52b1aa Value Set: AdministrativeGender
... 56ef44bb-3d1d-4972-aad1-834b69185d61 Value Set: Biological Sex
... 90ad8f16-16e4-4438-a7aa-b3189f510da2 Value Set:
... e2a16e4d-2765-4b61-b286-82cfc6356b30 Value Set:
... 8acde9f8-7a91-4f0c-9216-38531ec984ef Value Set: Aboriginal and/or Torres Strait Islander
... c8852db9-efe9-4102-96db-cef3a8be0a5f Value Set: Primary Carer Of Parent Or Grandparent
... 7089c48e-4216-4089-a548-034cd585e4da Value Set:
... 42b1f5e0-bf4a-47d9-86a4-f2fe946ac01f Value Set:
... 06737e46-e880-4037-9a2c-bcd278cd70ba Value Set:
.... cc20ce96-af06-4cd7-aa9b-c2601a6169ad Value Set:
.... 372d79bb-9d0b-42d2-a98c-cbe332bd3745 Value Set:
... f1262ade-843c-4eba-a86d-51a9c97d134b Value Set:
.... 311d83bb-f22e-4f60-9b50-b6e38dd2059b Value Set:
.... 4e0dc185-f83e-4027-b7a8-ecb543d42c6d Value Set:
..... 2fee2d51-7828-4178-b8c1-35edd32ba338 Value Set:
..... ddb65ed1-f4b2-4730-af2a-2f98bc73c76f Value Set:
..... d9a1236c-8d6e-4f20-a12a-9d5de5a1d0f6 Value Set: Australian States and Territories
..... 3f61a1ea-1c74-4f52-8519-432ce861a74f Value Set:
... edc081ea-b5ba-4234-9234-8ee598c2f95f Value Set:
.... 622970f1-3cf1-4f0a-bf05-b00a08046eba Value Set:
.... 2e8437cd-5ea0-4d44-8ab2-d2aa9ef18ba7 Value Set:
.... 2bde25e5-2c4c-4c0c-b6f3-c6859535a764 Value Set:
.... b41a8b11-8dbf-4999-9d0a-71d39240fed1 Value Set: Australian States and Territories
.... 28b58e50-2a04-4192-9655-efc8d72f32fa Value Set:
... 9541f0b0-f5ba-4fe7-a8e9-ad003cef897b Value Set:
... 4037a02b-4a85-40e0-9be6-5b17df1aac56 Value Set:
... c22390d3-1be6-4fd1-b775-6443b7239a6b Value Set:
.... d7f2dd75-20c8-480f-8c22-71d604ebee8d Value Set:
.... aa35d559-f45b-4d35-9453-dd02e4a790f3 Value Set:
.... 27099697-d6d1-42c0-bb0a-5e9ff7372a96 Value Set:
.... 626e3723-6310-4b99-81c1-525676b027c8 Value Set:
... df1475ea-bf7e-4bf0-a69f-7f9608c3ed3c Value Set:
.... eb2a59ed-9632-4df1-b5b1-1e85c3b4b7cf Value Set:
.... d6253253-a124-494e-a1d8-7ce02c69ec11 Value Set:
.... c520e213-5313-42c3-860a-d30206620290 Value Set:
... c1e4e967-c0aa-4280-b5d4-ab1f375ed9ac Max Length: 10
Value Set:
... a7e97574-3cea-4dfa-bef2-2665e7748364 Max Length: 10
Value Set:
... 83814495-3a81-43f4-88df-42186cce516a Value Set:
... e63547c6-1623-412f-963f-5f1ebf23563f Value Set: Yes/No/NA
... a8143230-b30d-4b85-9805-5f2f73f2dffa Value Set:
.... 7165c072-e3d8-4564-9d1d-d17f6807787c Value Set: Yes/No/NA
.... 04e50521-dc85-4744-b7ab-6f8682aacb11 Enable When: Not done yet
Value Set:
... 2bfe50cb-7913-4f31-bce2-763c17ff8b1a Value Set:
.... 924b4500-53ac-4c4e-831b-7ab5569ff981 Value Set: Yes/No/NA
.... 7379a0fd-d95b-4ecb-a781-9f43d1394f10 Enable When: Not done yet
Value Set:
... 9bc882bc-e989-4600-9587-8089fb757641 Value Set:
.... e90b436b-2751-4e07-a40c-adfe951b6528 Value Set: Yes/No/NA
.... 241f5fca-f61a-49bd-8972-52613c0e6d15 Enable When: Not done yet
Value Set:
.... 74ce4c60-31d6-4e78-9056-579937379451 Enable When: Not done yet
Value Set:
... 2b5ae784-4341-4172-875d-1698cc8069f0 Value Set:
.... a08271f1-194b-4fe9-91f9-4f3398858eb0 Value Set: Yes/No/NA
.... 4c14b158-3ae4-4994-8446-76e02640702c Enable When: Not done yet
Value Set:
... 6c80c675-1320-4ca3-ae3f-51ad173da741 Value Set:
.... d05558fb-a3cc-4bd6-b803-b672b36b9c51 Value Set: Yes/No/NA
.... b9991e7e-ce03-465d-b4b0-5a1725b24e02 Enable When: Not done yet
Value Set:
... 3494631c-6b56-46dc-abf7-a17bfc1d025f Value Set:
.... 41210be5-d441-4c44-b9c2-8dd94a44cbb4 Value Set: Yes/No/NA
.... 6733d6ec-5b6b-4ee2-a21e-0e9474c2b22b Value Set:
... 38f81a73-447f-4ecd-a8eb-6eccd9dee050 Value Set:
.... c023ef16-b554-4ed9-8993-1331e5f5a3b4 Value Set:
..... 036eace9-ea83-46ec-9d01-f2093f710816 Value Set: Yes/No/NA
..... 83518215-7151-4365-b745-d7464bbb9528 Value Set:
.... c4f68251-26af-462f-879a-a69b449066ff Value Set:
..... b0632039-c12b-4748-9e94-52073590c0ba Value Set: Yes/No/NA
..... c4bc2d84-e411-488d-9c0d-761f0377a026 Value Set:
... patientdetails-section-end-divider Value Set:
... MarkComplete-32 Value Set:
Options: 3 options

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