Prescription Search Support
1.0.0 - STU1

Prescription Search Support, published by eHealth Platform Belgium. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-be/pss/ and changes regularly. See the Directory of published versions

## : Terms and Conditions Consent Form - XML Representation

Draft as of 2026-01-14

Raw xml | Download

    <Questionnaire xmlns="http://hl7.org/fhir">
      <id value="26491cef-c5c7-4c5f-b10b-839e938f6b3e"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-computablequestionnaire"/>
      </meta>
      <language value="en"/>
      <text>
        <status value="extensions"/>
        <div xml:lang="en" xmlns="http://www.w3.org/1999/xhtml" lang="en"><p class="res-header-id"><b>Generated Narrative: Questionnaire 26491cef-c5c7-4c5f-b10b-839e938f6b3e</b></p><a name="26491cef-c5c7-4c5f-b10b-839e938f6b3e"> </a><a name="hc26491cef-c5c7-4c5f-b10b-839e938f6b3e"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Language: en</p><p style="margin-bottom: 0px">Profile: <a href="http://hl7.org/fhir/uv/cpg/STU2/StructureDefinition-cpg-computablequestionnaire.html">CPG Computable Questionnaire</a></p></div><b>Structure</b><table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Cardinality</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description &amp; Constraints</a><span style="float: right"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="." style="background-color: white; background-color: inherit" title="QuestionnaireRoot" class="hierarchy"/> TCConsentForm</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">http://openhie.org/fhir/Questionnaire/hiv-case-report-questionnaire#1.0.0</td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item.tc" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="group" class="hierarchy"/> tc</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Terms and Conditions</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.tcpolicy" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="." style="background-color: white; background-color: inherit" title="display" class="hierarchy"/> tcpolicy</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Door een account aan te maken gaat u akkoord met de [Gebruiksvoorwaarden en privacyverklaring](https://www.riziv.fgov.be/nl/thema-s/egezondheid/beslissingsondersteunend-platform-voor-voorschrijvers-meer-gepaste-zorg-en-minder-veiligheidsrisico-s/gebruiksvoorwaarden-en-privacyverklaring-voor-de-applicatie-pss).</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.tcversion" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="display" class="hierarchy"/> tcversion</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">version</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" id="item.consent" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: white; background-color: inherit" title="boolean" class="hierarchy"/> consent</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Consent</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" id="item.anonymizationPreference" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> anonymizationPreference</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Statistical anonymization preference</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.anonymizationPreference">2 options</a></td></tr>
    <tr><td colspan="5" class="hierarchy"><br/><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name="opt-item.anonymizationPreference"> </a><p><b>Answer options for anonymizationPreference </b></p><ul><li style="font-size: 11px">null#cluster-anon (&quot;Ik geef toestemming om gegevens over mijn gebruik van deze app anoniem te verzamelen op het niveau van mijn onderwijsinstelling (cluster) voor statistische doeleinden.&quot;)</li><li style="font-size: 11px">null#full-anon (&quot;Ik geef de voorkeur aan volledige anonimiteit wanneer voor statistische doeleinden gegevens worden verzameld over mijn gebruik van deze app.&quot;)</li></ul></div>
      </text>
      <url
           value="http://openhie.org/fhir/Questionnaire/hiv-case-report-questionnaire"/>
      <identifier>
        <system value="urn:ietf:rfc:3986"/>
        <value value="urn:oid:2.16.840.1.113883.2.51.22.2.35.3"/>
      </identifier>
      <version value="1.0.0"/>
      <name value="TCConsentForm"/>
      <status value="draft"/>
      <date value="2026-01-14T15:46:28+00:00"/>
      <publisher value="eHealth Platform Belgium"/>
      <contact>
        <name value="eHealth Platform Belgium"/>
        <telecom>
          <system value="url"/>
          <value value="https://www.ehealth.fgov.be/standards/fhir/"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="support@be-ehealth-standards.atlassian.net"/>
        </telecom>
      </contact>
      <contact>
        <name value="Message Structure eHealth"/>
        <telecom>
          <system value="email"/>
          <value value="support@be-ehealth-standards.atlassian.net"/>
          <use value="work"/>
        </telecom>
      </contact>
      <jurisdiction>
        <coding>
          <system value="urn:iso:std:iso:3166"/>
          <code value="BE"/>
          <display value="Belgium"/>
        </coding>
      </jurisdiction>
      <item>
        <linkId value="tc"/>
        <text value="Terms and Conditions"/>
        <type value="group"/>
        <required value="true"/>
        <repeats value="false"/>
        <item>
          <linkId value="tcpolicy"/>
          <text
                value="Door een account aan te maken gaat u akkoord met de [Gebruiksvoorwaarden en privacyverklaring](https://www.riziv.fgov.be/nl/thema-s/egezondheid/beslissingsondersteunend-platform-voor-voorschrijvers-meer-gepaste-zorg-en-minder-veiligheidsrisico-s/gebruiksvoorwaarden-en-privacyverklaring-voor-de-applicatie-pss).">
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/rendering-markdown">
              <valueMarkdown
                             value="Door een account aan te maken gaat u akkoord met de [Gebruiksvoorwaarden en privacyverklaring](https://www.riziv.fgov.be/nl/thema-s/egezondheid/beslissingsondersteunend-platform-voor-voorschrijvers-meer-gepaste-zorg-en-minder-veiligheidsrisico-s/gebruiksvoorwaarden-en-privacyverklaring-voor-de-applicatie-pss)."/>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/translation">
              <extension url="lang">
                <valueCode value="fr-BE"/>
              </extension>
              <extension url="content">
                <valueString
                             value="En créant un compte, vous acceptez les [Conditions d'utilisation et politique de confidentialité](https://www.inami.fgov.be/fr/themes/esante/plateforme-d-aide-a-la-decision-pour-les-prescripteurs-des-soins-plus-adaptes-et-moins-de-risques-de-securite/conditions-d-utilisation-et-politique-de-confidentialite-pour-l-application-pss).">
                  <extension
                             url="http://hl7.org/fhir/StructureDefinition/rendering-markdown">
                    <valueMarkdown
                                   value="En créant un compte, vous acceptez les [Conditions d'utilisation et politique de confidentialité](https://www.inami.fgov.be/fr/themes/esante/plateforme-d-aide-a-la-decision-pour-les-prescripteurs-des-soins-plus-adaptes-et-moins-de-risques-de-securite/conditions-d-utilisation-et-politique-de-confidentialite-pour-l-application-pss"/>
                  </extension>
                </valueString>
              </extension>
            </extension>
          </text>
          <type value="display"/>
        </item>
        <item>
          <linkId value="tcversion"/>
          <text value="version"/>
          <type value="display"/>
        </item>
        <item>
          <linkId value="consent"/>
          <text value="Consent"/>
          <type value="boolean"/>
          <required value="true"/>
          <repeats value="false"/>
        </item>
      </item>
      <item>
        <linkId value="anonymizationPreference"/>
        <text value="Statistical anonymization preference"/>
        <type value="choice"/>
        <required value="true"/>
        <repeats value="false"/>
        <answerOption>
          <valueCoding>
            <code value="cluster-anon"/>
            <display
                     value="Ik geef toestemming om gegevens over mijn gebruik van deze app anoniem te verzamelen op het niveau van mijn onderwijsinstelling (cluster) voor statistische doeleinden.">
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/translation">
                <extension url="lang">
                  <valueCode value="fr-BE"/>
                </extension>
                <extension url="content">
                  <valueString
                               value="Je donne mon consentement pour que les données concernant mon utilisation de cette application soient collectées anonymement au niveau de mon établissement d'enseignement (cluster) à des fins statistiques."/>
                </extension>
              </extension>
            </display>
          </valueCoding>
        </answerOption>
        <answerOption>
          <valueCoding>
            <code value="full-anon"/>
            <display
                     value="Ik geef de voorkeur aan volledige anonimiteit wanneer voor statistische doeleinden gegevens worden verzameld over mijn gebruik van deze app.">
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/translation">
                <extension url="lang">
                  <valueCode value="fr-BE"/>
                </extension>
                <extension url="content">
                  <valueString
                               value="Je préfère une anonymité totale lors de la collecte de données sur mon utilisation de cette application à des fins statistiques."/>
                </extension>
              </extension>
            </display>
          </valueCoding>
        </answerOption>
      </item>
    </Questionnaire>