CH ORF (R4)
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CH ORF (R4), published by HL7 Switzerland. This guide is not an authorized publication; it is the continuous build for version 3.0.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7ch/ch-orf/ and changes regularly. See the Directory of published versions

: Radiology Order - JSON Representation

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{
  "resourceType" : "Bundle",
  "id" : "radiology-order",
  "meta" : {
    "profile" : [
      🔗 "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-document"
    ]
  },
  "language" : "de-CH",
  "identifier" : {
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:uuid:ac5fcff4-6f4c-4281-bc7c-451ee1047f15"
  },
  "type" : "document",
  "timestamp" : "2023-06-13T11:57:36+00:00",
  "entry" : [
    {
      "fullUrl" : "urn:uuid:c868aef5-ec90-4f43-be40-e5230fa49815",
      "resource" : {
        "resourceType" : "Composition",
        "language" : "de-CH",
        "text" : {
          "status" : "extensions",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"de-CH\" lang=\"de-CH\"><p><b>Generated Narrative: Composition</b></p><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\">Resource Composition  (Language &quot;de-CH&quot;) </p></div><p><b>CH ORF Receiver</b>: <a href=\"#urnuuidb09d7c4d-a7b1-443c-8c3b-4d01675ad970\">See above (urn:uuid:b09d7c4d-a7b1-443c-8c3b-4d01675ad970)</a></p><blockquote><p><b>EPR Data Enterer</b></p><blockquote><p><b>url</b></p><code>enterer</code></blockquote><p><b>value</b>: <a href=\"#urnuuidb6d4abb9-8c83-4d76-89d0-547c0b269f6d\">See above (urn:uuid:b6d4abb9-8c83-4d76-89d0-547c0b269f6d)</a></p></blockquote><p><b>CH ORF Copy Receiver</b>: <a href=\"#urnuuid6e46d994-9eca-4c8f-a0e3-98c5911d45e2\">See above (urn:uuid:6e46d994-9eca-4c8f-a0e3-98c5911d45e2)</a></p><p><b>status</b>: final</p><p><b>type</b>: Record artifact (record artifact) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#419891008)</span></p><p><b>category</b>: Order (record artifact) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#721963009)</span></p><p><b>date</b>: 2023-06-13 11:57:36+0000</p><p><b>author</b>: <a href=\"#urnuuidde8d3b4f-1a57-48c0-9b03-a758ff8f2d2f\">See above (urn:uuid:de8d3b4f-1a57-48c0-9b03-a758ff8f2d2f)</a></p><p><b>title</b>: Order and Referral by Form</p></div>"
        },
        "extension" : [
          {
            "url" : "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-receiver",
            "valueReference" : {
              "reference" : "urn:uuid:b09d7c4d-a7b1-443c-8c3b-4d01675ad970"
            }
          },
          {
            "url" : "http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-epr-dataenterer",
            "extension" : [
              {
                "url" : "enterer",
                "valueReference" : {
                  "reference" : "urn:uuid:b6d4abb9-8c83-4d76-89d0-547c0b269f6d"
                }
              }
            ]
          },
          {
            "url" : "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-copyreceiver",
            "valueReference" : {
              "reference" : "urn:uuid:6e46d994-9eca-4c8f-a0e3-98c5911d45e2"
            }
          }
        ],
        "status" : "final",
        "type" : {
          "coding" : [
            {
              "system" : "http://snomed.info/sct",
              "code" : "419891008"
            }
          ]
        },
        "category" : [
          {
            "coding" : [
              {
                "system" : "http://snomed.info/sct",
                "code" : "721963009"
              }
            ]
          }
        ],
        "subject" : {
          "reference" : "urn:uuid:6e46d994-9eca-4c8f-a0e3-98c5911d45e2"
        },
        "date" : "2023-06-13T11:57:36+00:00",
        "author" : [
          {
            "reference" : "urn:uuid:de8d3b4f-1a57-48c0-9b03-a758ff8f2d2f"
          }
        ],
        "title" : "Order and Referral by Form",
        "section" : [
          {
            "title" : "Order-Referral",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "93037-0",
                  "display" : "Portable medical order form"
                }
              ]
            },
            "entry" : [
              {
                "reference" : "urn:uuid:1fa2627b-3cd4-4992-94e8-823610ed903e"
              },
              {
                "reference" : "urn:uuid:bc5ac105-cdfe-49c0-b92b-fb378bed4f29"
              },
              {
                🔗 "reference" : "http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form"
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:6e46d994-9eca-4c8f-a0e3-98c5911d45e2",
      "resource" : {
        "resourceType" : "Patient",
        "language" : "de-CH",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"de-CH\" lang=\"de-CH\"><p><b>Generated Narrative: Patient</b></p><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\">Resource Patient  (Language &quot;de-CH&quot;) </p></div><p><b>name</b>: Susanna Ufferer , Leidend (MAIDEN)</p><p><b>telecom</b>: ph: 079 979 79 79, <a href=\"mailto:susanna@ufferer.ch\">susanna@ufferer.ch</a></p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1970-03-14</p><p><b>address</b>: Musterweg 6a Zürich 8000 Schweiz </p></div>"
        },
        "name" : [
          {
            "family" : "Ufferer",
            "given" : [
              "Susanna"
            ]
          },
          {
            "use" : "maiden",
            "family" : "Leidend"
          }
        ],
        "telecom" : [
          {
            "system" : "phone",
            "value" : "079 979 79 79"
          },
          {
            "system" : "email",
            "value" : "susanna@ufferer.ch"
          }
        ],
        "gender" : "female",
        "birthDate" : "1970-03-14",
        "address" : [
          {
            "line" : [
              "Musterweg",
              "6a"
            ],
            "city" : "Zürich",
            "postalCode" : "8000",
            "country" : "Schweiz"
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:1fa2627b-3cd4-4992-94e8-823610ed903e",
      "resource" : {
        "resourceType" : "QuestionnaireResponse",
        "meta" : {
          "profile" : [
            🔗 "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-questionnaireresponse"
          ]
        },
        "language" : "de-CH",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"de-CH\" lang=\"de-CH\"><p><b>Generated Narrative: QuestionnaireResponse</b></p><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\">Resource QuestionnaireResponse  (Language &quot;de-CH&quot;) </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ch-orf-questionnaireresponse.html\">CH ORF QuestionnaireResponse</a></p></div><p><b>questionnaire</b>: <a href=\"Questionnaire-order-referral-form.html\">Order Referral Form</a></p><p><b>status</b>: completed</p><blockquote><p><b>item</b></p><p><b>linkId</b>: order</p><p><b>text</b>: Auftrag</p><blockquote><p><b>item</b></p><p><b>linkId</b>: order.placerOrderIdentifier</p><p><b>text</b>: Auftragsnummer des Auftraggebers</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: order.placerOrderIdentifierDomain</p><p><b>text</b>: Identifier Domain der Auftragsnummer des Auftraggebers</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: order.priority</p><p><b>text</b>: Auftragspriorität</p><blockquote><p><b>answer</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: receiver</p><p><b>text</b>: Empfänger</p><blockquote><p><b>item</b></p><p><b>linkId</b>: receiver.practitioner</p><p><b>text</b>: Empfangende Person</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: receiver.organization</p><p><b>text</b>: Empfangende Organisation</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient</p><p><b>text</b>: Patient</p><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.familyName</p><p><b>text</b>: Name</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.maidenName</p><p><b>text</b>: Ledigname</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.givenName</p><p><b>text</b>: Vorname</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.birthDate</p><p><b>text</b>: Geburtsdatum</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.gender</p><p><b>text</b>: Geschlecht</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.phone</p><p><b>text</b>: Telefon</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.email</p><p><b>text</b>: E-Mail</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.streetAddressLine</p><p><b>text</b>: Strasse, Hausnummer, Postfach etc.</p><blockquote><p><b>answer</b></p></blockquote><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.postalCode</p><p><b>text</b>: PLZ</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.city</p><p><b>text</b>: Ort</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.country</p><p><b>text</b>: Land</p><blockquote><p><b>answer</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: sender</p><p><b>text</b>: Absender</p><blockquote><p><b>item</b></p><p><b>linkId</b>: sender.author</p><p><b>text</b>: Verantwortlicher</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: sender.dataenterer</p><p><b>text</b>: Erfasser</p><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: receiverCopy</p><p><b>text</b>: Kopieempfänger (Kopie dieses Auftrags und aller daraus resultierenden Resultate)</p><blockquote><p><b>item</b></p><p><b>linkId</b>: receiverCopy.patient</p><p><b>text</b>: Patient selbst</p><blockquote><p><b>answer</b></p></blockquote></blockquote></blockquote></div>"
        },
        "questionnaire" : "http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form",
        "status" : "completed",
        "item" : [
          {
            "linkId" : "order",
            "text" : "Auftrag",
            "item" : [
              {
                "linkId" : "order.placerOrderIdentifier",
                "text" : "Auftragsnummer des Auftraggebers",
                "answer" : [
                  {
                    "valueString" : "2156286"
                  }
                ]
              },
              {
                "linkId" : "order.placerOrderIdentifierDomain",
                "text" : "Identifier Domain der Auftragsnummer des Auftraggebers",
                "answer" : [
                  {
                    "valueString" : "urn:oid:2.999.1.3.4.5.6.7"
                  }
                ]
              },
              {
                "linkId" : "order.priority",
                "text" : "Auftragspriorität",
                "answer" : [
                  {
                    "valueCoding" : {
                      "system" : "http://hl7.org/fhir/request-priority",
                      "code" : "routine"
                    }
                  }
                ]
              }
            ]
          },
          {
            "linkId" : "receiver",
            "text" : "Empfänger",
            "item" : [
              {
                "linkId" : "receiver.practitioner",
                "text" : "Empfangende Person",
                "item" : [
                  {
                    "linkId" : "receiver.practitioner.title",
                    "text" : "Titel",
                    "answer" : [
                      {
                        "valueString" : "Dr. med."
                      }
                    ]
                  },
                  {
                    "linkId" : "receiver.practitioner.familyName",
                    "text" : "Name",
                    "answer" : [
                      {
                        "valueString" : "Rderfiller"
                      }
                    ]
                  },
                  {
                    "linkId" : "receiver.practitioner.givenName",
                    "text" : "Vorname",
                    "answer" : [
                      {
                        "valueString" : "Otto"
                      }
                    ]
                  },
                  {
                    "linkId" : "receiver.practitioner.gln",
                    "text" : "GLN",
                    "answer" : [
                      {
                        "valueString" : "7601000201041"
                      }
                    ]
                  },
                  {
                    "linkId" : "receiver.practitioner.phone",
                    "text" : "Telefon",
                    "answer" : [
                      {
                        "valueString" : "044 412 00 99"
                      }
                    ]
                  },
                  {
                    "linkId" : "receiver.practitioner.email",
                    "text" : "E-Mail",
                    "answer" : [
                      {
                        "valueString" : "o.rderfiller@happyhospital.ch"
                      }
                    ]
                  }
                ]
              },
              {
                "linkId" : "receiver.organization",
                "text" : "Empfangende Organisation",
                "item" : [
                  {
                    "linkId" : "receiver.organization.name",
                    "text" : "Name der Organisation",
                    "answer" : [
                      {
                        "valueString" : "Klinik Happy Hospital"
                      }
                    ]
                  },
                  {
                    "linkId" : "receiver.organization.streetAddressLine",
                    "text" : "Strasse, Hausnummer, Postfach etc.",
                    "answer" : [
                      {
                        "valueString" : "Seestrasse 133"
                      },
                      {
                        "valueString" : "Haus C"
                      }
                    ]
                  },
                  {
                    "linkId" : "receiver.organization.postalCode",
                    "text" : "PLZ",
                    "answer" : [
                      {
                        "valueString" : "8000"
                      }
                    ]
                  },
                  {
                    "linkId" : "receiver.organization.city",
                    "text" : "Ort",
                    "answer" : [
                      {
                        "valueString" : "Zürich"
                      }
                    ]
                  },
                  {
                    "linkId" : "receiver.organization.country",
                    "text" : "Land",
                    "answer" : [
                      {
                        "valueString" : "Schweiz"
                      }
                    ]
                  }
                ]
              }
            ]
          },
          {
            "linkId" : "patient",
            "text" : "Patient",
            "item" : [
              {
                "linkId" : "patient.familyName",
                "text" : "Name",
                "answer" : [
                  {
                    "valueString" : "Ufferer"
                  }
                ]
              },
              {
                "linkId" : "patient.maidenName",
                "text" : "Ledigname",
                "answer" : [
                  {
                    "valueString" : "Leidend"
                  }
                ]
              },
              {
                "linkId" : "patient.givenName",
                "text" : "Vorname",
                "answer" : [
                  {
                    "valueString" : "Susanna"
                  }
                ]
              },
              {
                "linkId" : "patient.birthDate",
                "text" : "Geburtsdatum",
                "answer" : [
                  {
                    "valueDate" : "1970-03-14"
                  }
                ]
              },
              {
                "linkId" : "patient.gender",
                "text" : "Geschlecht",
                "answer" : [
                  {
                    "valueCoding" : {
                      "system" : "http://hl7.org/fhir/administrative-gender",
                      "code" : "female"
                    }
                  }
                ]
              },
              {
                "linkId" : "patient.phone",
                "text" : "Telefon",
                "answer" : [
                  {
                    "valueString" : "079 979 79 79"
                  }
                ]
              },
              {
                "linkId" : "patient.email",
                "text" : "E-Mail",
                "answer" : [
                  {
                    "valueString" : "susanna@ufferer.ch"
                  }
                ]
              },
              {
                "linkId" : "patient.streetAddressLine",
                "text" : "Strasse, Hausnummer, Postfach etc.",
                "answer" : [
                  {
                    "valueString" : "Musterweg"
                  },
                  {
                    "valueString" : "6a"
                  }
                ]
              },
              {
                "linkId" : "patient.postalCode",
                "text" : "PLZ",
                "answer" : [
                  {
                    "valueString" : "8000"
                  }
                ]
              },
              {
                "linkId" : "patient.city",
                "text" : "Ort",
                "answer" : [
                  {
                    "valueString" : "Zürich"
                  }
                ]
              },
              {
                "linkId" : "patient.country",
                "text" : "Land",
                "answer" : [
                  {
                    "valueString" : "Schweiz"
                  }
                ]
              }
            ]
          },
          {
            "linkId" : "sender",
            "text" : "Absender",
            "item" : [
              {
                "linkId" : "sender.author",
                "text" : "Verantwortlicher",
                "item" : [
                  {
                    "linkId" : "sender.author.practitioner",
                    "text" : "Verantwortliche Person",
                    "item" : [
                      {
                        "linkId" : "sender.author.practitioner.title",
                        "text" : "Titel",
                        "answer" : [
                          {
                            "valueString" : "Dr. med."
                          }
                        ]
                      },
                      {
                        "linkId" : "sender.author.practitioner.familyName",
                        "text" : "Name",
                        "answer" : [
                          {
                            "valueString" : "Rderplacer"
                          }
                        ]
                      },
                      {
                        "linkId" : "sender.author.practitioner.givenName",
                        "text" : "Vorname",
                        "answer" : [
                          {
                            "valueString" : "Ottilie"
                          }
                        ]
                      },
                      {
                        "linkId" : "sender.author.practitioner.gln",
                        "text" : "GLN",
                        "answer" : [
                          {
                            "valueString" : "7601000618627"
                          }
                        ]
                      },
                      {
                        "linkId" : "sender.author.practitioner.phone",
                        "text" : "Telefon",
                        "answer" : [
                          {
                            "valueString" : "044 333 22 11"
                          }
                        ]
                      },
                      {
                        "linkId" : "sender.author.practitioner.email",
                        "text" : "E-Mail",
                        "answer" : [
                          {
                            "valueString" : "o.rderplacer@happydoctors.ch"
                          }
                        ]
                      }
                    ]
                  },
                  {
                    "linkId" : "sender.author.organization",
                    "text" : "Verantwortliche Organisation",
                    "item" : [
                      {
                        "linkId" : "sender.author.organization.name",
                        "text" : "Name der Organisation",
                        "answer" : [
                          {
                            "valueString" : "Praxis Happy Doctors"
                          }
                        ]
                      },
                      {
                        "linkId" : "sender.author.organization.streetAddressLine",
                        "text" : "Strasse, Hausnummer, Postfach etc.",
                        "answer" : [
                          {
                            "valueString" : "Kantonsstrasse 14"
                          },
                          {
                            "valueString" : "Postfach 14"
                          }
                        ]
                      },
                      {
                        "linkId" : "sender.author.organization.postalCode",
                        "text" : "PLZ",
                        "answer" : [
                          {
                            "valueString" : "8000"
                          }
                        ]
                      },
                      {
                        "linkId" : "sender.author.organization.city",
                        "text" : "Ort",
                        "answer" : [
                          {
                            "valueString" : "Zürich"
                          }
                        ]
                      },
                      {
                        "linkId" : "sender.author.organization.country",
                        "text" : "Land",
                        "answer" : [
                          {
                            "valueString" : "Schweiz"
                          }
                        ]
                      }
                    ]
                  }
                ]
              },
              {
                "linkId" : "sender.dataenterer",
                "text" : "Erfasser",
                "item" : [
                  {
                    "linkId" : "sender.dataenterer.practitioner",
                    "text" : "Erfassende Person",
                    "item" : [
                      {
                        "linkId" : "sender.dataenterer.practitioner.familyName",
                        "text" : "Name",
                        "answer" : [
                          {
                            "valueString" : "Ataenterer"
                          }
                        ]
                      },
                      {
                        "linkId" : "sender.dataenterer.practitioner.givenName",
                        "text" : "Vorname",
                        "answer" : [
                          {
                            "valueString" : "Doris"
                          }
                        ]
                      },
                      {
                        "linkId" : "sender.dataenterer.practitioner.phone",
                        "text" : "Telefon",
                        "answer" : [
                          {
                            "valueString" : "044 333 22 11"
                          }
                        ]
                      },
                      {
                        "linkId" : "sender.dataenterer.practitioner.email",
                        "text" : "E-Mail",
                        "answer" : [
                          {
                            "valueString" : "d.ataenterer@happydoctors.ch"
                          }
                        ]
                      }
                    ]
                  }
                ]
              }
            ]
          },
          {
            "linkId" : "receiverCopy",
            "text" : "Kopieempfänger (Kopie dieses Auftrags und aller daraus resultierenden Resultate)",
            "item" : [
              {
                "linkId" : "receiverCopy.patient",
                "text" : "Patient selbst",
                "answer" : [
                  {
                    "valueBoolean" : true
                  }
                ]
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:bc5ac105-cdfe-49c0-b92b-fb378bed4f29",
      "resource" : {
        "resourceType" : "ServiceRequest",
        "language" : "de-CH",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"de-CH\" lang=\"de-CH\"><p><b>Generated Narrative: ServiceRequest</b></p><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\">Resource ServiceRequest  (Language &quot;de-CH&quot;) </p></div><p><b>identifier</b>: Placer Identifier:\u00a02156286</p><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>priority</b>: routine</p><p><b>subject</b>: <a href=\"#urnuuid6e46d994-9eca-4c8f-a0e3-98c5911d45e2\">See above (urn:uuid:6e46d994-9eca-4c8f-a0e3-98c5911d45e2)</a></p><p><b>requester</b>: <a href=\"#urnuuidde8d3b4f-1a57-48c0-9b03-a758ff8f2d2f\">See above (urn:uuid:de8d3b4f-1a57-48c0-9b03-a758ff8f2d2f)</a></p></div>"
        },
        "identifier" : [
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "PLAC"
                }
              ]
            },
            "system" : "urn:oid:2.999.1.3.4.5.6.7",
            "value" : "2156286"
          }
        ],
        "status" : "active",
        "intent" : "order",
        "priority" : "routine",
        "subject" : {
          "reference" : "urn:uuid:6e46d994-9eca-4c8f-a0e3-98c5911d45e2"
        },
        "requester" : {
          "reference" : "urn:uuid:de8d3b4f-1a57-48c0-9b03-a758ff8f2d2f"
        }
      }
    },
    {
      "fullUrl" : "http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form",
      "resource" : {
        "resourceType" : "Questionnaire",
        "id" : "order-referral-form",
        "meta" : {
          "versionId" : "42",
          "lastUpdated" : "2023-06-12T21:11:39.305+00:00",
          "source" : "#dQEVCLkxu8TKSXYI",
          "profile" : [
            🔗 "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-questionnaire"🔗 ,
            "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire"🔗 ,
            "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap"🔗 ,
            "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-pop-exp"
          ]
        },
        "language" : "de-CH",
        "text" : {
          "status" : "extensions",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"de-CH\" lang=\"de-CH\"><p><b>Generated Narrative: Questionnaire</b><a name=\"order-referral-form\"> </a></p><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\">Resource Questionnaire &quot;order-referral-form&quot; Version &quot;42&quot; Updated &quot;2023-06-12 21:11:39+0000&quot;  (Language &quot;de-CH&quot;) </p><p style=\"margin-bottom: 0px\">Information Source: #dQEVCLkxu8TKSXYI!</p><p style=\"margin-bottom: 0px\">Profiles: <a href=\"StructureDefinition-ch-orf-questionnaire.html\">CH ORF Questionnaire</a>, <a href=\"http://hl7.org/fhir/uv/sdc/STU3/StructureDefinition-sdc-questionnaire.html\">SDCBaseQuestionnaire</a>, <a href=\"http://hl7.org/fhir/uv/sdc/STU3/StructureDefinition-sdc-questionnaire-extr-smap.html\">Extractable Questionnaire - StructureMap</a>, <a href=\"http://hl7.org/fhir/uv/sdc/STU3/StructureDefinition-sdc-questionnaire-pop-exp.html\">Populatable Questionnaire - Expression</a></p></div><p><b>Target structure map</b>: <a href=\"StructureMap-OrfQrToBundle.html\">OrfQrToBundle</a></p><blockquote><p><b>Launch context resources</b></p><blockquote><p><b>url</b></p><code>name</code></blockquote><p><b>value</b>: Patient (Details: http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext code patient = 'Patient', stated as 'null')</p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Patient</p></blockquote><blockquote><p><b>Launch context resources</b></p><blockquote><p><b>url</b></p><code>name</code></blockquote><p><b>value</b>: User (Details: http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext code user = 'User', stated as 'User')</p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Practitioner</p><blockquote><p><b>url</b></p><code>description</code></blockquote><p><b>value</b>: The practitioner that is to be used to pre-populate the form</p></blockquote><p><b>Assembled From Questionnaire</b>: <a href=\"http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-order\">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-order|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href=\"http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-practitioner-nametel\">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-practitioner-nametel|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href=\"http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-receiver\">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-receiver|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href=\"http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-address\">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-address|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href=\"http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-initiator\">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-initiator|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href=\"http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-patient\">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-patient|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href=\"http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-familydoctor\">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-familydoctor|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href=\"http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-requestedencounter\">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-requestedencounter|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href=\"http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-coverage\">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-coverage|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href=\"http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-sender\">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-sender|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href=\"http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-receivercopy\">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-receivercopy|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href=\"http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-appointment\">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-appointment|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href=\"http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-consent\">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-consent|1.1.0</a></p><p><b>url</b>: <code>http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form</code></p><p><b>version</b>: 1.1.0-assembled</p><p><b>name</b>: OrderReferralForm</p><p><b>title</b>: Order Referral Form</p><p><b>status</b>: active</p><p><b>subjectType</b>: Patient</p><p><b>date</b>: 2022-07-07</p><p><b>publisher</b>: HL7 Switzerland</p><p><b>contact</b>: HL7 Switzerland: <a href=\"https://www.hl7.ch/\">https://www.hl7.ch/</a></p><p><b>jurisdiction</b>: Switzerland <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.4.0/CodeSystem-ISO3166Part1.html\">ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code</a>#CH)</span></p><p><b>copyright</b>: CC-BY-SA-4.0</p><blockquote><p><b>item</b></p><p><b>linkId</b>: order</p><p><b>text</b>: Auftrag</p><p><b>type</b>: group</p><p><b>required</b>: true</p><blockquote><p><b>item</b></p><p><b>linkId</b>: order.authoredOn</p><p><b>text</b>: Daum/Zeit der Auftragserteilung</p><p><b>type</b>: dateTime</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: order.placerOrderIdentifier</p><p><b>text</b>: Auftragsnummer des Auftraggebers</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>hidden</b>: true</p><p><b>linkId</b>: order.placerOrderIdentifierDomain</p><p><b>text</b>: Identifier Domain der Auftragsnummer des Auftraggebers</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: order.fillerOrderIdentifier</p><p><b>text</b>: Auftragsnummer des Auftragsempfängers</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>hidden</b>: true</p><p><b>linkId</b>: order.fillerOrderIdentifierDomain</p><p><b>text</b>: Identifier Domain der Auftragsnummer des Auftragsempfängers</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>hidden</b>: true</p><p><b>linkId</b>: order.precedentDocumentIdentifier</p><p><b>text</b>: Identifier des Vorgängerdokuments</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: order.notificationContactDocument</p><p><b>text</b>: Dringender Benachrichtigungskontakt für dieses Dokument</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: order.notificationContactDocumentResponse</p><p><b>text</b>: Dringender Benachrichtigungskontakt für die Antwort auf dieses Dokument</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: order.priority</p><p><b>text</b>: Auftragspriorität</p><p><b>type</b>: choice</p><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: receiver</p><p><b>text</b>: Empfänger</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p><p><b>linkId</b>: receiver.practitioner</p><p><b>text</b>: Empfangende Person</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>Variable</b>: <span title=\"text/fhirpath\"><code>'receiver.organization.'</code></span>(<b>linkIdPrefix</b>)</p><p><b>linkId</b>: receiver.organization</p><p><b>text</b>: Empfangende Organisation</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: initiator</p><p><b>text</b>: Initiant dieser Anmeldung</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p><p><b>linkId</b>: initiator.legalrelation</p><p><b>text</b>: Juristische Beziehung zum Patienten</p><p><b>type</b>: choice</p><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: initiator.personalrelation</p><p><b>text</b>: Persönliche Beziehung zum Patienten?</p><p><b>type</b>: choice</p><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: initiator.practitionerRole</p><p><b>text</b>: Gesundheitsfachperson oder -organisation</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: initiator.relatedPerson</p><p><b>text</b>: Andere Person</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>Variable</b>: <span title=\"text/fhirpath\"><code>'patient.'</code></span>(<b>linkIdPrefix</b>)</p><p><b>Variable</b>: <span title=\"text/fhirpath\"><code>%patient.address</code></span>(<b>address</b>)</p><p><b>linkId</b>: patient</p><p><b>text</b>: Patient</p><p><b>type</b>: group</p><p><b>required</b>: true</p><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title=\"text/fhirpath\"><code>%patient.name.where(use='official').family</code></span></p><p><b>linkId</b>: patient.familyName</p><p><b>text</b>: Name</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title=\"text/fhirpath\"><code>%patient.name.where(use='maiden').family</code></span></p><p><b>linkId</b>: patient.maidenName</p><p><b>text</b>: Ledigname</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title=\"text/fhirpath\"><code>%patient.name.where(use='official').given</code></span></p><p><b>linkId</b>: patient.givenName</p><p><b>text</b>: Vorname</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title=\"text/fhirpath\"><code>%patient.identifier.where(type.coding.where(system='http://terminology.hl7.org/CodeSystem/v2-0203' and code='MR').exists()).value</code></span></p><p><b>linkId</b>: patient.localPid</p><p><b>text</b>: Lokale Patienten-ID</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>hidden</b>: true</p><p><b>linkId</b>: patient.localPidDomain</p><p><b>text</b>: Lokale Patienten-ID Domain</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title=\"text/fhirpath\"><code>%patient.birthDate</code></span></p><p><b>linkId</b>: patient.birthDate</p><p><b>text</b>: Geburtsdatum</p><p><b>type</b>: date</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title=\"text/fhirpath\"><code>%questionnaire.repeat(item).where(linkId='patient.gender').answerOption.valueCoding.where(code=%patient.gender)</code></span></p><p><b>linkId</b>: patient.gender</p><p><b>text</b>: Geschlecht</p><p><b>type</b>: choice</p><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title=\"text/fhirpath\"><code>%patient.maritalStatus</code></span></p><p><b>linkId</b>: patient.maritalStatus</p><p><b>text</b>: Zivilstand</p><p><b>type</b>: choice</p><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title=\"text/fhirpath\"><code>%patient.telecom.where(system='phone').value</code></span></p><p><b>linkId</b>: patient.phone</p><p><b>text</b>: Telefon</p><p><b>type</b>: string</p><p><b>repeats</b>: true</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title=\"text/fhirpath\"><code>%patient.telecom.where(system='email').value</code></span></p><p><b>linkId</b>: patient.email</p><p><b>text</b>: E-Mail</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title=\"text/fhirpath\"><code>%address.line</code></span></p><p><b>linkId</b>: patient.streetAddressLine</p><p><b>text</b>: Strasse, Hausnummer, Postfach etc.</p><p><b>type</b>: string</p><p><b>repeats</b>: true</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title=\"text/fhirpath\"><code>%address.postalCode</code></span></p><p><b>linkId</b>: patient.postalCode</p><p><b>text</b>: PLZ</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title=\"text/fhirpath\"><code>%address.city</code></span></p><p><b>linkId</b>: patient.city</p><p><b>text</b>: Ort</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title=\"text/fhirpath\"><code>%address.country</code></span></p><p><b>linkId</b>: patient.country</p><p><b>text</b>: Land</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title=\"text/fhirpath\"><code>%patient.communication.where(preferred=true).language.coding</code></span></p><p><b>linkId</b>: patient.languageOfCorrespondence</p><p><b>text</b>: Korrespondenzsprache</p><p><b>type</b>: choice</p><p><b>answerValueSet</b>: <a href=\"http://fhir.ch/ig/ch-epr-term/2.0.10/ValueSet-DocumentEntry.languageCode.html\">DocumentEntry.languageCode</a></p></blockquote><blockquote><p><b>item</b></p><p><b>Variable</b>: <span title=\"text/fhirpath\"><code>%patient.contact</code></span>(<b>contact</b>)</p><p><b>linkId</b>: patient.contactperson</p><p><b>text</b>: Kontaktperson</p><p><b>type</b>: group</p><p><b>repeats</b>: true</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: familydoctor</p><p><b>text</b>: Hausarzt</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: requestedEncounter</p><p><b>text</b>: Patientenaufnahme</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p><p><b>linkId</b>: requestedEncounter.class</p><p><b>text</b>: Voraussichtlich: Ambulant / Stationär / Notfall</p><p><b>type</b>: choice</p><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: requestedEncounter.desiredAccommodation</p><p><b>text</b>: Zimmerkategorie</p><p><b>type</b>: choice</p><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: coverage</p><p><b>text</b>: Kostenträger</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p><p><b>linkId</b>: coverage.beneficiary</p><p><b>text</b>: Begünstigter (Patient)</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: coverage.kvg</p><p><b>text</b>: Krankenkasse (nach KVG)</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: coverage.uvg</p><p><b>text</b>: Unfallversicherung (nach UVG)</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: coverage.vvg</p><p><b>text</b>: Zusatzversicherung (nach VVG)</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: coverage.iv</p><p><b>text</b>: Invalidenversicherung (IV)</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: coverage.mv</p><p><b>text</b>: Militärversicherung (MV)</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: coverage.self</p><p><b>text</b>: Selbstzahler</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: coverage.other</p><p><b>text</b>: Anderer Kostenträger</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: sender</p><p><b>text</b>: Absender</p><p><b>type</b>: group</p><p><b>required</b>: true</p><blockquote><p><b>item</b></p><p><b>Variable</b>: <span title=\"application/x-fhir-query\"><code>PractitionerRole?practitioner={{%user.id}}</code></span>(<b>senderPractitionerRoles</b>)</p><p><b>Variable</b>: <span title=\"text/fhirpath\"><code>%senderPractitionerRoles.entry[0].resource</code></span>(<b>senderPractitionerRole</b>)</p><p><b>Variable</b>: <span title=\"application/x-fhir-query\"><code>Organization?_id={{%senderPractitionerRole.organization.reference}}</code></span>(<b>senderOrganizations</b>)</p><p><b>Variable</b>: <span title=\"text/fhirpath\"><code>%senderOrganizations.entry[0].resource</code></span>(<b>senderOrganization</b>)</p><p><b>Variable</b>: <span title=\"text/fhirpath\"><code>%senderOrganization.address</code></span>(<b>address</b>)</p><p><b>linkId</b>: sender.author</p><p><b>text</b>: Verantwortlicher</p><p><b>type</b>: group</p><p><b>required</b>: true</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: sender.dataenterer</p><p><b>text</b>: Erfasser</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: receiverCopy</p><p><b>text</b>: Kopieempfänger (Kopie dieses Auftrags und aller daraus resultierenden Resultate)</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p><p><b>linkId</b>: receiverCopy.practitionerRole</p><p><b>text</b>: Gesundheitsfachperson oder -organisation</p><p><b>type</b>: group</p><p><b>repeats</b>: true</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: receiverCopy.patient</p><p><b>text</b>: Patient selbst</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: receiverCopy.relatedPerson</p><p><b>text</b>: Andere Person</p><p><b>type</b>: group</p><p><b>repeats</b>: true</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: antecedentEpisodeOfCare</p><p><b>text</b>: Vorgängiger Aufenthalt in Spital / Heim</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p><p><b>linkId</b>: antecedentEpisodeOfCare.start</p><p><b>text</b>: Von</p><p><b>type</b>: dateTime</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: antecedentEpisodeOfCare.end</p><p><b>text</b>: Bis</p><p><b>type</b>: dateTime</p></blockquote><blockquote><p><b>item</b></p><p><b>Variable</b>: <span title=\"text/fhirpath\"><code>'antecedentEpisodeOfCare.managingOrganization.'</code></span>(<b>linkIdPrefix</b>)</p><p><b>linkId</b>: antecedentEpisodeOfCare.managingOrganization</p><p><b>text</b>: Spital /Heim</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: appointment</p><p><b>text</b>: Ort und Zeit der Durchführung der angeforderten Leistung</p><p><b>type</b>: group</p><p><b>repeats</b>: true</p><blockquote><p><b>item</b></p><p><b>Variable</b>: <span title=\"text/fhirpath\"><code>'appointment.location.'</code></span>(<b>linkIdPrefix</b>)</p><p><b>linkId</b>: appointment.location</p><p><b>text</b>: Ort der Durchführung</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: appointment.requestedPeriod</p><p><b>text</b>: Datum und Zeit, wann der Termin bevorzugt geplant werden soll</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: appointment.status</p><p><b>text</b>: Status</p><p><b>type</b>: choice</p><p><b>required</b>: true</p><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: appointment.patientInstruction</p><p><b>text</b>: Patienteninformation für diesen Termin</p><p><b>type</b>: string</p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: consent</p><p><b>text</b>: Einverständniserklärung</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.consent.statement</p><p><b>text</b>: Ist der Patient über die Anmeldung informiert und explizit einverstanden?</p><p><b>type</b>: choice</p><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: note</p><p><b>text</b>: Bemerkungen</p><p><b>type</b>: group</p><p><b>repeats</b>: true</p><h3>Items</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>LinkId</b></td><td><b>Text</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>note.text</td><td>Kommentar</td><td>string</td></tr></table></blockquote></div>"
        },
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-targetStructureMap",
            "valueCanonical" : "http://fhir.ch/ig/ch-orf/StructureMap/OrfQrToBundle"
          },
          {
            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext",
            "extension" : [
              {
                "url" : "name",
                "valueCoding" : {
                  "system" : "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext",
                  "code" : "patient"
                }
              },
              {
                "url" : "type",
                "valueCode" : "Patient"
              }
            ]
          },
          {
            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext",
            "extension" : [
              {
                "url" : "name",
                "valueCoding" : {
                  "system" : "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext",
                  "code" : "user",
                  "display" : "User"
                }
              },
              {
                "url" : "type",
                "valueCode" : "Practitioner"
              },
              {
                "url" : "description",
                "valueString" : "The practitioner that is to be used to pre-populate the form"
              }
            ]
          },
          {
            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
            "valueCanonical" : "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-order|1.1.0"
          },
          {
            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
            "valueCanonical" : "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-practitioner-nametel|1.1.0"
          },
          {
            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
            "valueCanonical" : "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-receiver|1.1.0"
          },
          {
            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
            "valueCanonical" : "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-address|1.1.0"
          },
          {
            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
            "valueCanonical" : "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-initiator|1.1.0"
          },
          {
            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
            "valueCanonical" : "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-patient|1.1.0"
          },
          {
            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
            "valueCanonical" : "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-familydoctor|1.1.0"
          },
          {
            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
            "valueCanonical" : "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-requestedencounter|1.1.0"
          },
          {
            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
            "valueCanonical" : "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-coverage|1.1.0"
          },
          {
            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
            "valueCanonical" : "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-sender|1.1.0"
          },
          {
            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
            "valueCanonical" : "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-receivercopy|1.1.0"
          },
          {
            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
            "valueCanonical" : "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-appointment|1.1.0"
          },
          {
            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom",
            "valueCanonical" : "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-consent|1.1.0"
          }
        ],
        "url" : "http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form",
        "version" : "1.1.0-assembled",
        "name" : "OrderReferralForm",
        "title" : "Order Referral Form",
        "status" : "active",
        "subjectType" : [
          "Patient"
        ],
        "date" : "2022-07-07",
        "publisher" : "HL7 Switzerland",
        "contact" : [
          {
            "name" : "HL7 Switzerland",
            "telecom" : [
              {
                "system" : "url",
                "value" : "https://www.hl7.ch/"
              }
            ]
          }
        ],
        "jurisdiction" : [
          {
            "coding" : [
              {
                "system" : "urn:iso:std:iso:3166",
                "code" : "CH"
              }
            ]
          }
        ],
        "copyright" : "CC-BY-SA-4.0",
        "item" : [
          {
            "linkId" : "order",
            "text" : "Auftrag",
            "type" : "group",
            "required" : true,
            "item" : [
              {
                "linkId" : "order.authoredOn",
                "text" : "Daum/Zeit der Auftragserteilung",
                "type" : "dateTime"
              },
              {
                "linkId" : "order.placerOrderIdentifier",
                "text" : "Auftragsnummer des Auftraggebers",
                "type" : "string"
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                    "valueBoolean" : true
                  }
                ],
                "linkId" : "order.placerOrderIdentifierDomain",
                "text" : "Identifier Domain der Auftragsnummer des Auftraggebers",
                "type" : "string"
              },
              {
                "linkId" : "order.fillerOrderIdentifier",
                "text" : "Auftragsnummer des Auftragsempfängers",
                "type" : "string"
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                    "valueBoolean" : true
                  }
                ],
                "linkId" : "order.fillerOrderIdentifierDomain",
                "text" : "Identifier Domain der Auftragsnummer des Auftragsempfängers",
                "type" : "string"
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                    "valueBoolean" : true
                  }
                ],
                "linkId" : "order.precedentDocumentIdentifier",
                "text" : "Identifier des Vorgängerdokuments",
                "type" : "string"
              },
              {
                "linkId" : "order.notificationContactDocument",
                "text" : "Dringender Benachrichtigungskontakt für dieses Dokument",
                "type" : "group",
                "item" : [
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                        "valueExpression" : {
                          "name" : "linkIdPrefix",
                          "language" : "text/fhirpath",
                          "expression" : "'order.notificationContactDocument.practitioner.'"
                        }
                      }
                    ],
                    "linkId" : "order.notificationContactDocument.practitioner",
                    "text" : "Zu benachrichtigende Person",
                    "type" : "group",
                    "item" : [
                      {
                        "linkId" : "order.notificationContactDocument.practitioner.title",
                        "text" : "Titel",
                        "type" : "string"
                      },
                      {
                        "linkId" : "order.notificationContactDocument.practitioner.familyName",
                        "text" : "Name",
                        "type" : "string"
                      },
                      {
                        "linkId" : "order.notificationContactDocument.practitioner.givenName",
                        "text" : "Vorname",
                        "type" : "string"
                      },
                      {
                        "linkId" : "order.notificationContactDocument.practitioner.phone",
                        "text" : "Telefon",
                        "type" : "string"
                      },
                      {
                        "linkId" : "order.notificationContactDocument.practitioner.email",
                        "text" : "E-Mail",
                        "type" : "string"
                      }
                    ]
                  }
                ]
              },
              {
                "linkId" : "order.notificationContactDocumentResponse",
                "text" : "Dringender Benachrichtigungskontakt für die Antwort auf dieses Dokument",
                "type" : "group",
                "item" : [
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                        "valueExpression" : {
                          "name" : "linkIdPrefix",
                          "language" : "text/fhirpath",
                          "expression" : "'order.notificationContactDocumentResponse.practitioner.'"
                        }
                      }
                    ],
                    "linkId" : "order.notificationContactDocumentResponse.practitioner",
                    "text" : "Zu benachrichtigende Person",
                    "type" : "group",
                    "item" : [
                      {
                        "linkId" : "order.notificationContactDocumentResponse.practitioner.title",
                        "text" : "Titel",
                        "type" : "string"
                      },
                      {
                        "linkId" : "order.notificationContactDocumentResponse.practitioner.familyName",
                        "text" : "Name",
                        "type" : "string"
                      },
                      {
                        "linkId" : "order.notificationContactDocumentResponse.practitioner.givenName",
                        "text" : "Vorname",
                        "type" : "string"
                      },
                      {
                        "linkId" : "order.notificationContactDocumentResponse.practitioner.phone",
                        "text" : "Telefon",
                        "type" : "string"
                      },
                      {
                        "linkId" : "order.notificationContactDocumentResponse.practitioner.email",
                        "text" : "E-Mail",
                        "type" : "string"
                      }
                    ]
                  }
                ]
              },
              {
                "linkId" : "order.priority",
                "text" : "Auftragspriorität",
                "type" : "choice",
                "answerOption" : [
                  {
                    "valueCoding" : {
                      "system" : "http://hl7.org/fhir/request-priority",
                      "code" : "routine",
                      "display" : "Die Anfrage hat normale Priorität."
                    },
                    "initialSelected" : true
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://hl7.org/fhir/request-priority",
                      "code" : "urgent",
                      "display" : "Die Anfrage sollte dringend bearbeitet werden - höhere Priorität als normal."
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://hl7.org/fhir/request-priority",
                      "code" : "asap",
                      "display" : "Die Anfrage sollte so schnell wie möglich bearbeitet werden - höhere Priorität als dringend."
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://hl7.org/fhir/request-priority",
                      "code" : "stat",
                      "display" : "Die Anfrage sollte sofort bearbeitet werden - höchstmögliche Priorität. Z.B. bei einem Notfall."
                    }
                  }
                ]
              }
            ]
          },
          {
            "linkId" : "receiver",
            "text" : "Empfänger",
            "type" : "group",
            "item" : [
              {
                "linkId" : "receiver.practitioner",
                "text" : "Empfangende Person",
                "type" : "group",
                "item" : [
                  {
                    "linkId" : "receiver.practitioner.title",
                    "text" : "Titel",
                    "type" : "string"
                  },
                  {
                    "linkId" : "receiver.practitioner.familyName",
                    "text" : "Name",
                    "type" : "string"
                  },
                  {
                    "linkId" : "receiver.practitioner.givenName",
                    "text" : "Vorname",
                    "type" : "string"
                  },
                  {
                    "linkId" : "receiver.practitioner.gln",
                    "text" : "GLN",
                    "type" : "string"
                  },
                  {
                    "linkId" : "receiver.practitioner.zsr",
                    "text" : "ZSR",
                    "type" : "string"
                  },
                  {
                    "linkId" : "receiver.practitioner.phone",
                    "text" : "Telefon",
                    "type" : "string"
                  },
                  {
                    "linkId" : "receiver.practitioner.email",
                    "text" : "E-Mail",
                    "type" : "string"
                  }
                ]
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                    "valueExpression" : {
                      "name" : "linkIdPrefix",
                      "language" : "text/fhirpath",
                      "expression" : "'receiver.organization.'"
                    }
                  }
                ],
                "linkId" : "receiver.organization",
                "text" : "Empfangende Organisation",
                "type" : "group",
                "item" : [
                  {
                    "linkId" : "receiver.organization.name",
                    "text" : "Name der Organisation",
                    "type" : "string"
                  },
                  {
                    "linkId" : "receiver.organization.gln",
                    "text" : "GLN",
                    "type" : "string"
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.line"
                        }
                      }
                    ],
                    "linkId" : "receiver.organization.streetAddressLine",
                    "text" : "Strasse, Hausnummer, Postfach etc.",
                    "type" : "string",
                    "repeats" : true
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.postalCode"
                        }
                      }
                    ],
                    "linkId" : "receiver.organization.postalCode",
                    "text" : "PLZ",
                    "type" : "string"
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.city"
                        }
                      }
                    ],
                    "linkId" : "receiver.organization.city",
                    "text" : "Ort",
                    "type" : "string"
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.country"
                        }
                      }
                    ],
                    "linkId" : "receiver.organization.country",
                    "text" : "Land",
                    "type" : "string"
                  }
                ]
              }
            ]
          },
          {
            "linkId" : "initiator",
            "text" : "Initiant dieser Anmeldung",
            "type" : "group",
            "item" : [
              {
                "linkId" : "initiator.legalrelation",
                "text" : "Juristische Beziehung zum Patienten",
                "type" : "choice",
                "answerOption" : [
                  {
                    "valueCoding" : {
                      "system" : "http://snomed.info/sct",
                      "code" : "373068000",
                      "display" : "Nicht definiert"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://snomed.info/sct",
                      "code" : "58626002",
                      "display" : "Gesetzlicher Vertreter"
                    }
                  }
                ]
              },
              {
                "linkId" : "initiator.personalrelation",
                "text" : "Persönliche Beziehung zum Patienten?",
                "type" : "choice",
                "answerOption" : [
                  {
                    "valueCoding" : {
                      "system" : "http://snomed.info/sct",
                      "code" : "66089001",
                      "display" : "Tochter"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://snomed.info/sct",
                      "code" : "65616008",
                      "display" : "Sohn"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://snomed.info/sct",
                      "code" : "127849001",
                      "display" : "Ehemann"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://snomed.info/sct",
                      "code" : "127850001",
                      "display" : "Ehefrau"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://snomed.info/sct",
                      "code" : "394921008",
                      "display" : "Partner (eingetragene  Partnerschaft)"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://snomed.info/sct",
                      "code" : "70924004",
                      "display" : "Bruder"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://snomed.info/sct",
                      "code" : "27733009",
                      "display" : "Schwester"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://snomed.info/sct",
                      "code" : "72705000",
                      "display" : "Mutter"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://snomed.info/sct",
                      "code" : "66839005",
                      "display" : "Vater"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://snomed.info/sct",
                      "code" : "48385004",
                      "display" : "Bekannt"
                    }
                  }
                ]
              },
              {
                "linkId" : "initiator.practitionerRole",
                "text" : "Gesundheitsfachperson oder -organisation",
                "type" : "group",
                "item" : [
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                        "valueExpression" : {
                          "name" : "linkIdPrefix",
                          "language" : "text/fhirpath",
                          "expression" : "'initiator.practitionerRole.practitioner.'"
                        }
                      }
                    ],
                    "linkId" : "initiator.practitionerRole.practitioner",
                    "text" : "Gesundheitsfachperson",
                    "type" : "group",
                    "item" : [
                      {
                        "linkId" : "initiator.practitionerRole.practitioner.title",
                        "text" : "Titel",
                        "type" : "string"
                      },
                      {
                        "linkId" : "initiator.practitionerRole.practitioner.familyName",
                        "text" : "Name",
                        "type" : "string"
                      },
                      {
                        "linkId" : "initiator.practitionerRole.practitioner.givenName",
                        "text" : "Vorname",
                        "type" : "string"
                      },
                      {
                        "linkId" : "initiator.practitionerRole.practitioner.phone",
                        "text" : "Telefon",
                        "type" : "string"
                      },
                      {
                        "linkId" : "initiator.practitionerRole.practitioner.email",
                        "text" : "E-Mail",
                        "type" : "string"
                      }
                    ]
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                        "valueExpression" : {
                          "name" : "linkIdPrefix",
                          "language" : "text/fhirpath",
                          "expression" : "'initiator.practitionerRole.organization.'"
                        }
                      }
                    ],
                    "linkId" : "initiator.practitionerRole.organization",
                    "text" : "Gesundheitsorganisatiton",
                    "type" : "group",
                    "item" : [
                      {
                        "linkId" : "initiator.practitionerRole.organization.name",
                        "text" : "Name der Organisation",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.line"
                            }
                          }
                        ],
                        "linkId" : "initiator.practitionerRole.organization.streetAddressLine",
                        "text" : "Strasse, Hausnummer, Postfach etc.",
                        "type" : "string",
                        "repeats" : true
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.postalCode"
                            }
                          }
                        ],
                        "linkId" : "initiator.practitionerRole.organization.postalCode",
                        "text" : "PLZ",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.city"
                            }
                          }
                        ],
                        "linkId" : "initiator.practitionerRole.organization.city",
                        "text" : "Ort",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.country"
                            }
                          }
                        ],
                        "linkId" : "initiator.practitionerRole.organization.country",
                        "text" : "Land",
                        "type" : "string"
                      }
                    ]
                  }
                ]
              },
              {
                "linkId" : "initiator.relatedPerson",
                "text" : "Andere Person",
                "type" : "group",
                "item" : [
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                        "valueExpression" : {
                          "name" : "linkIdPrefix",
                          "language" : "text/fhirpath",
                          "expression" : "'initiator.relatedPerson.'"
                        }
                      }
                    ],
                    "linkId" : "initiator.relatedPerson.familyName",
                    "text" : "Name",
                    "type" : "string"
                  },
                  {
                    "linkId" : "initiator.relatedPerson.givenName",
                    "text" : "Vorname",
                    "type" : "string"
                  },
                  {
                    "linkId" : "initiator.relatedPerson.phone",
                    "text" : "Telefon",
                    "type" : "string",
                    "repeats" : true
                  },
                  {
                    "linkId" : "initiator.relatedPerson.email",
                    "text" : "E-Mail",
                    "type" : "string"
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.line"
                        }
                      }
                    ],
                    "linkId" : "initiator.relatedPerson.streetAddressLine",
                    "text" : "Strasse, Hausnummer, Postfach etc.",
                    "type" : "string",
                    "repeats" : true
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.postalCode"
                        }
                      }
                    ],
                    "linkId" : "initiator.relatedPerson.postalCode",
                    "text" : "PLZ",
                    "type" : "string"
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.city"
                        }
                      }
                    ],
                    "linkId" : "initiator.relatedPerson.city",
                    "text" : "Ort",
                    "type" : "string"
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.country"
                        }
                      }
                    ],
                    "linkId" : "initiator.relatedPerson.country",
                    "text" : "Land",
                    "type" : "string"
                  }
                ]
              }
            ]
          },
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                "valueExpression" : {
                  "name" : "linkIdPrefix",
                  "language" : "text/fhirpath",
                  "expression" : "'patient.'"
                }
              },
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                "valueExpression" : {
                  "name" : "address",
                  "language" : "text/fhirpath",
                  "expression" : "%patient.address"
                }
              }
            ],
            "linkId" : "patient",
            "text" : "Patient",
            "type" : "group",
            "required" : true,
            "item" : [
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                    "valueExpression" : {
                      "language" : "text/fhirpath",
                      "expression" : "%patient.name.where(use='official').family"
                    }
                  }
                ],
                "linkId" : "patient.familyName",
                "text" : "Name",
                "type" : "string"
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                    "valueExpression" : {
                      "language" : "text/fhirpath",
                      "expression" : "%patient.name.where(use='maiden').family"
                    }
                  }
                ],
                "linkId" : "patient.maidenName",
                "text" : "Ledigname",
                "type" : "string"
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                    "valueExpression" : {
                      "language" : "text/fhirpath",
                      "expression" : "%patient.name.where(use='official').given"
                    }
                  }
                ],
                "linkId" : "patient.givenName",
                "text" : "Vorname",
                "type" : "string"
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                    "valueExpression" : {
                      "language" : "text/fhirpath",
                      "expression" : "%patient.identifier.where(type.coding.where(system='http://terminology.hl7.org/CodeSystem/v2-0203' and code='MR').exists()).value"
                    }
                  }
                ],
                "linkId" : "patient.localPid",
                "text" : "Lokale Patienten-ID",
                "type" : "string"
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                    "valueBoolean" : true
                  }
                ],
                "linkId" : "patient.localPidDomain",
                "text" : "Lokale Patienten-ID Domain",
                "type" : "string"
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                    "valueExpression" : {
                      "language" : "text/fhirpath",
                      "expression" : "%patient.birthDate"
                    }
                  }
                ],
                "linkId" : "patient.birthDate",
                "text" : "Geburtsdatum",
                "type" : "date"
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                    "valueExpression" : {
                      "language" : "text/fhirpath",
                      "expression" : "%questionnaire.repeat(item).where(linkId='patient.gender').answerOption.valueCoding.where(code=%patient.gender)"
                    }
                  }
                ],
                "linkId" : "patient.gender",
                "text" : "Geschlecht",
                "type" : "choice",
                "answerOption" : [
                  {
                    "valueCoding" : {
                      "system" : "http://hl7.org/fhir/administrative-gender",
                      "code" : "male",
                      "display" : "Männlich"
                    },
                    "initialSelected" : true
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://hl7.org/fhir/administrative-gender",
                      "code" : "female",
                      "display" : "Weiblich"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://hl7.org/fhir/administrative-gender",
                      "code" : "other",
                      "display" : "Anderes"
                    }
                  }
                ]
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                    "valueExpression" : {
                      "language" : "text/fhirpath",
                      "expression" : "%patient.maritalStatus"
                    }
                  }
                ],
                "linkId" : "patient.maritalStatus",
                "text" : "Zivilstand",
                "type" : "choice",
                "answerOption" : [
                  {
                    "valueCoding" : {
                      "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
                      "code" : "1",
                      "display" : "ledig"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
                      "code" : "2",
                      "display" : "verheiratet"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
                      "code" : "3",
                      "display" : "verwitwet"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
                      "code" : "4",
                      "display" : "geschieden"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
                      "code" : "5",
                      "display" : "unverheiratet"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
                      "code" : "6",
                      "display" : "in eingetragener Partnerschaft"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
                      "code" : "7",
                      "display" : "aufgelöste Partnerschaft"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
                      "code" : "9",
                      "display" : "unbekannt"
                    }
                  }
                ]
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                    "valueExpression" : {
                      "language" : "text/fhirpath",
                      "expression" : "%patient.telecom.where(system='phone').value"
                    }
                  }
                ],
                "linkId" : "patient.phone",
                "text" : "Telefon",
                "type" : "string",
                "repeats" : true
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                    "valueExpression" : {
                      "language" : "text/fhirpath",
                      "expression" : "%patient.telecom.where(system='email').value"
                    }
                  }
                ],
                "linkId" : "patient.email",
                "text" : "E-Mail",
                "type" : "string"
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                    "valueExpression" : {
                      "language" : "text/fhirpath",
                      "expression" : "%address.line"
                    }
                  }
                ],
                "linkId" : "patient.streetAddressLine",
                "text" : "Strasse, Hausnummer, Postfach etc.",
                "type" : "string",
                "repeats" : true
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                    "valueExpression" : {
                      "language" : "text/fhirpath",
                      "expression" : "%address.postalCode"
                    }
                  }
                ],
                "linkId" : "patient.postalCode",
                "text" : "PLZ",
                "type" : "string"
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                    "valueExpression" : {
                      "language" : "text/fhirpath",
                      "expression" : "%address.city"
                    }
                  }
                ],
                "linkId" : "patient.city",
                "text" : "Ort",
                "type" : "string"
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                    "valueExpression" : {
                      "language" : "text/fhirpath",
                      "expression" : "%address.country"
                    }
                  }
                ],
                "linkId" : "patient.country",
                "text" : "Land",
                "type" : "string"
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                    "valueExpression" : {
                      "language" : "text/fhirpath",
                      "expression" : "%patient.communication.where(preferred=true).language.coding"
                    }
                  }
                ],
                "linkId" : "patient.languageOfCorrespondence",
                "text" : "Korrespondenzsprache",
                "type" : "choice",
                "answerValueSet" : "http://fhir.ch/ig/ch-epr-term/ValueSet/DocumentEntry.languageCode"
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                    "valueExpression" : {
                      "name" : "contact",
                      "language" : "text/fhirpath",
                      "expression" : "%patient.contact"
                    }
                  }
                ],
                "linkId" : "patient.contactperson",
                "text" : "Kontaktperson",
                "type" : "group",
                "repeats" : true,
                "item" : [
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%contact.relationship.text"
                        }
                      }
                    ],
                    "linkId" : "patient.contactperson.relationship",
                    "text" : "Beziehung",
                    "type" : "string"
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%contact.name.family"
                        }
                      }
                    ],
                    "linkId" : "patient.contactperson.familyName",
                    "text" : "Name",
                    "type" : "string"
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%contact.name.given"
                        }
                      }
                    ],
                    "linkId" : "patient.contactperson.givenName",
                    "text" : "Vorname",
                    "type" : "string"
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%contact.telecom.where(system='phone').value"
                        }
                      }
                    ],
                    "linkId" : "patient.contactperson.phone",
                    "text" : "Telefon",
                    "type" : "string",
                    "repeats" : true
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%contact.telecom.where(system='email').value"
                        }
                      }
                    ],
                    "linkId" : "patient.contactperson.email",
                    "text" : "E-Mail",
                    "type" : "string"
                  }
                ]
              },
              {
                "linkId" : "familydoctor",
                "text" : "Hausarzt",
                "type" : "group",
                "item" : [
                  {
                    "linkId" : "familydoctor.practitioner",
                    "text" : "Hausarzt Person",
                    "type" : "group",
                    "item" : [
                      {
                        "linkId" : "familydoctor.practitioner.title",
                        "text" : "Titel",
                        "type" : "string"
                      },
                      {
                        "linkId" : "familydoctor.practitioner.familyName",
                        "text" : "Name",
                        "type" : "string"
                      },
                      {
                        "linkId" : "familydoctor.practitioner.givenName",
                        "text" : "Vorname",
                        "type" : "string"
                      },
                      {
                        "linkId" : "familydoctor.practitioner.gln",
                        "text" : "GLN",
                        "type" : "string"
                      },
                      {
                        "linkId" : "familydoctor.practitioner.zsr",
                        "text" : "ZSR",
                        "type" : "string"
                      },
                      {
                        "linkId" : "familydoctor.practitioner.phone",
                        "text" : "Telefon",
                        "type" : "string"
                      },
                      {
                        "linkId" : "familydoctor.practitioner.email",
                        "text" : "E-Mail",
                        "type" : "string"
                      }
                    ]
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                        "valueExpression" : {
                          "name" : "linkIdPrefix",
                          "language" : "text/fhirpath",
                          "expression" : "'familydoctor.organization.'"
                        }
                      }
                    ],
                    "linkId" : "familydoctor.organization",
                    "text" : "Hausarzt Organisation",
                    "type" : "group",
                    "item" : [
                      {
                        "linkId" : "familydoctor.organization.name",
                        "text" : "Name der Organisation",
                        "type" : "string"
                      },
                      {
                        "linkId" : "familydoctor.organization.gln",
                        "text" : "GLN",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.line"
                            }
                          }
                        ],
                        "linkId" : "familydoctor.organization.streetAddressLine",
                        "text" : "Strasse, Hausnummer, Postfach etc.",
                        "type" : "string",
                        "repeats" : true
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.postalCode"
                            }
                          }
                        ],
                        "linkId" : "familydoctor.organization.postalCode",
                        "text" : "PLZ",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.city"
                            }
                          }
                        ],
                        "linkId" : "familydoctor.organization.city",
                        "text" : "Ort",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.country"
                            }
                          }
                        ],
                        "linkId" : "familydoctor.organization.country",
                        "text" : "Land",
                        "type" : "string"
                      }
                    ]
                  }
                ]
              }
            ]
          },
          {
            "linkId" : "requestedEncounter",
            "text" : "Patientenaufnahme",
            "type" : "group",
            "item" : [
              {
                "linkId" : "requestedEncounter.class",
                "text" : "Voraussichtlich: Ambulant / Stationär / Notfall",
                "type" : "choice",
                "answerOption" : [
                  {
                    "valueCoding" : {
                      "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                      "code" : "AMB",
                      "display" : "Ambulant"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                      "code" : "IMP",
                      "display" : "Stationär"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                      "code" : "EMER",
                      "display" : "Notfall"
                    }
                  }
                ]
              },
              {
                "linkId" : "requestedEncounter.desiredAccommodation",
                "text" : "Zimmerkategorie",
                "type" : "choice",
                "answerOption" : [
                  {
                    "valueCoding" : {
                      "system" : "http://fhir.ch/ig/ch-core/CodeSystem/bfs-medstats-21-encountertype",
                      "code" : "1",
                      "display" : "allgemein"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://fhir.ch/ig/ch-core/CodeSystem/bfs-medstats-21-encountertype",
                      "code" : "2",
                      "display" : "halbprivat"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://fhir.ch/ig/ch-core/CodeSystem/bfs-medstats-21-encountertype",
                      "code" : "3",
                      "display" : "privat"
                    }
                  }
                ]
              }
            ]
          },
          {
            "linkId" : "coverage",
            "text" : "Kostenträger",
            "type" : "group",
            "item" : [
              {
                "linkId" : "coverage.beneficiary",
                "text" : "Begünstigter (Patient)",
                "type" : "group",
                "item" : [
                  {
                    "linkId" : "coverage.beneficiary.ahvn13",
                    "text" : "AHV-Nr. des Patienten",
                    "type" : "string"
                  }
                ]
              },
              {
                "linkId" : "coverage.kvg",
                "text" : "Krankenkasse (nach KVG)",
                "type" : "group",
                "item" : [
                  {
                    "linkId" : "coverage.kvg.name",
                    "text" : "Name der Versicherung",
                    "type" : "string"
                  },
                  {
                    "linkId" : "coverage.kvg.insuranceCardNumber",
                    "text" : "Kennnummer der Versichertenkarte",
                    "type" : "string"
                  }
                ]
              },
              {
                "linkId" : "coverage.uvg",
                "text" : "Unfallversicherung (nach UVG)",
                "type" : "group",
                "item" : [
                  {
                    "linkId" : "coverage.uvg.name",
                    "text" : "Name der Versicherung",
                    "type" : "string"
                  },
                  {
                    "linkId" : "coverage.uvg.claimNumber",
                    "text" : "Schadennummer",
                    "type" : "string"
                  }
                ]
              },
              {
                "linkId" : "coverage.vvg",
                "text" : "Zusatzversicherung (nach VVG)",
                "type" : "group",
                "item" : [
                  {
                    "linkId" : "coverage.vvg.name",
                    "text" : "Name der Versicherung",
                    "type" : "string"
                  },
                  {
                    "linkId" : "coverage.vvg.insuranceCardNumber",
                    "text" : "Kennnummer der Versichertenkarte",
                    "type" : "string"
                  }
                ]
              },
              {
                "linkId" : "coverage.iv",
                "text" : "Invalidenversicherung (IV)",
                "type" : "group",
                "item" : [
                  {
                    "linkId" : "coverage.iv.verfuegungsnummer",
                    "text" : "IV-Verfügungsnummer",
                    "type" : "string"
                  }
                ]
              },
              {
                "linkId" : "coverage.mv",
                "text" : "Militärversicherung (MV)",
                "type" : "group",
                "item" : [
                  {
                    "linkId" : "coverage.mv.versichertennummer",
                    "text" : "MV-Versichertennummer",
                    "type" : "string"
                  }
                ]
              },
              {
                "linkId" : "coverage.self",
                "text" : "Selbstzahler",
                "type" : "group",
                "item" : [
                  {
                    "linkId" : "coverage.self.patient",
                    "text" : "Patient selbst",
                    "type" : "boolean"
                  },
                  {
                    "linkId" : "coverage.self.patientRelatedPerson",
                    "text" : "Andere Person",
                    "type" : "boolean",
                    "enableWhen" : [
                      {
                        "question" : "coverage.self.patient",
                        "operator" : "=",
                        "answerBoolean" : false
                      }
                    ]
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                        "valueExpression" : {
                          "name" : "linkIdPrefix",
                          "language" : "text/fhirpath",
                          "expression" : "'coverage.self.relatedPerson.'"
                        }
                      }
                    ],
                    "linkId" : "coverage.self.relatedPerson",
                    "text" : "Andere Person",
                    "type" : "group",
                    "enableWhen" : [
                      {
                        "question" : "coverage.self.patientRelatedPerson",
                        "operator" : "=",
                        "answerBoolean" : true
                      }
                    ],
                    "item" : [
                      {
                        "linkId" : "coverage.self.relatedPerson.familyName",
                        "text" : "Name",
                        "type" : "string"
                      },
                      {
                        "linkId" : "coverage.self.relatedPerson.givenName",
                        "text" : "Vorname",
                        "type" : "string"
                      },
                      {
                        "linkId" : "coverage.self.relatedPerson.phone",
                        "text" : "Telefon",
                        "type" : "string",
                        "repeats" : true
                      },
                      {
                        "linkId" : "coverage.self.relatedPerson.email",
                        "text" : "E-Mail",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.line"
                            }
                          }
                        ],
                        "linkId" : "coverage.self.relatedPerson.streetAddressLine",
                        "text" : "Strasse, Hausnummer, Postfach etc.",
                        "type" : "string",
                        "repeats" : true
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.postalCode"
                            }
                          }
                        ],
                        "linkId" : "coverage.self.relatedPerson.postalCode",
                        "text" : "PLZ",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.city"
                            }
                          }
                        ],
                        "linkId" : "coverage.self.relatedPerson.city",
                        "text" : "Ort",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.country"
                            }
                          }
                        ],
                        "linkId" : "coverage.self.relatedPerson.country",
                        "text" : "Land",
                        "type" : "string"
                      }
                    ]
                  }
                ]
              },
              {
                "linkId" : "coverage.other",
                "text" : "Anderer Kostenträger",
                "type" : "group",
                "item" : [
                  {
                    "linkId" : "coverage.other.name",
                    "text" : "Name des Kostenträgers",
                    "type" : "string"
                  },
                  {
                    "linkId" : "coverage.other.id",
                    "text" : "Beliebige ID",
                    "type" : "string"
                  },
                  {
                    "linkId" : "coverage.other.id.note",
                    "text" : "Bemerkung zur ID",
                    "type" : "string"
                  }
                ]
              }
            ]
          },
          {
            "linkId" : "sender",
            "text" : "Absender",
            "type" : "group",
            "required" : true,
            "item" : [
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                    "valueExpression" : {
                      "name" : "senderPractitionerRoles",
                      "language" : "application/x-fhir-query",
                      "expression" : "PractitionerRole?practitioner={{%user.id}}"
                    }
                  },
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                    "valueExpression" : {
                      "name" : "senderPractitionerRole",
                      "language" : "text/fhirpath",
                      "expression" : "%senderPractitionerRoles.entry[0].resource"
                    }
                  },
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                    "valueExpression" : {
                      "name" : "senderOrganizations",
                      "language" : "application/x-fhir-query",
                      "expression" : "Organization?_id={{%senderPractitionerRole.organization.reference}}"
                    }
                  },
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                    "valueExpression" : {
                      "name" : "senderOrganization",
                      "language" : "text/fhirpath",
                      "expression" : "%senderOrganizations.entry[0].resource"
                    }
                  },
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                    "valueExpression" : {
                      "name" : "address",
                      "language" : "text/fhirpath",
                      "expression" : "%senderOrganization.address"
                    }
                  }
                ],
                "linkId" : "sender.author",
                "text" : "Verantwortlicher",
                "type" : "group",
                "required" : true,
                "item" : [
                  {
                    "linkId" : "sender.author.practitioner",
                    "text" : "Verantwortliche Person",
                    "type" : "group",
                    "item" : [
                      {
                        "linkId" : "sender.author.practitioner.title",
                        "text" : "Titel",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%user.name.family"
                            }
                          }
                        ],
                        "linkId" : "sender.author.practitioner.familyName",
                        "text" : "Name",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%user.name.given"
                            }
                          }
                        ],
                        "linkId" : "sender.author.practitioner.givenName",
                        "text" : "Vorname",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%user.identifier.where(system='urn:oid:2.51.1.3').value"
                            }
                          }
                        ],
                        "linkId" : "sender.author.practitioner.gln",
                        "text" : "GLN",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%user.identifier.where(system='urn:oid:2.16.756.5.30.1.123.100.2.1.1').value"
                            }
                          }
                        ],
                        "linkId" : "sender.author.practitioner.zsr",
                        "text" : "ZSR",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%user.telecom.where(system='phone').value"
                            }
                          }
                        ],
                        "linkId" : "sender.author.practitioner.phone",
                        "text" : "Telefon",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%user.telecom.where(system='email').value"
                            }
                          }
                        ],
                        "linkId" : "sender.author.practitioner.email",
                        "text" : "E-Mail",
                        "type" : "string"
                      }
                    ]
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                        "valueExpression" : {
                          "name" : "linkIdPrefix",
                          "language" : "text/fhirpath",
                          "expression" : "'sender.author.organization.'"
                        }
                      }
                    ],
                    "linkId" : "sender.author.organization",
                    "text" : "Verantwortliche Organisation",
                    "type" : "group",
                    "item" : [
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%senderOrganization.name"
                            }
                          }
                        ],
                        "linkId" : "sender.author.organization.name",
                        "text" : "Name der Organisation",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%senderOrganization.identifier.where(system='urn:oid:2.51.1.3').value"
                            }
                          }
                        ],
                        "linkId" : "sender.author.organization.gln",
                        "text" : "GLN",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.line"
                            }
                          }
                        ],
                        "linkId" : "sender.author.organization.streetAddressLine",
                        "text" : "Strasse, Hausnummer, Postfach etc.",
                        "type" : "string",
                        "repeats" : true
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.postalCode"
                            }
                          }
                        ],
                        "linkId" : "sender.author.organization.postalCode",
                        "text" : "PLZ",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.city"
                            }
                          }
                        ],
                        "linkId" : "sender.author.organization.city",
                        "text" : "Ort",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.country"
                            }
                          }
                        ],
                        "linkId" : "sender.author.organization.country",
                        "text" : "Land",
                        "type" : "string"
                      }
                    ]
                  }
                ]
              },
              {
                "linkId" : "sender.dataenterer",
                "text" : "Erfasser",
                "type" : "group",
                "item" : [
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                        "valueExpression" : {
                          "name" : "linkIdPrefix",
                          "language" : "text/fhirpath",
                          "expression" : "'sender.dataenterer.practitioner.'"
                        }
                      }
                    ],
                    "linkId" : "sender.dataenterer.practitioner",
                    "text" : "Erfassende Person",
                    "type" : "group",
                    "item" : [
                      {
                        "linkId" : "sender.dataenterer.practitioner.title",
                        "text" : "Titel",
                        "type" : "string"
                      },
                      {
                        "linkId" : "sender.dataenterer.practitioner.familyName",
                        "text" : "Name",
                        "type" : "string"
                      },
                      {
                        "linkId" : "sender.dataenterer.practitioner.givenName",
                        "text" : "Vorname",
                        "type" : "string"
                      },
                      {
                        "linkId" : "sender.dataenterer.practitioner.phone",
                        "text" : "Telefon",
                        "type" : "string"
                      },
                      {
                        "linkId" : "sender.dataenterer.practitioner.email",
                        "text" : "E-Mail",
                        "type" : "string"
                      }
                    ]
                  }
                ]
              }
            ]
          },
          {
            "linkId" : "receiverCopy",
            "text" : "Kopieempfänger (Kopie dieses Auftrags und aller daraus resultierenden Resultate)",
            "type" : "group",
            "item" : [
              {
                "linkId" : "receiverCopy.practitionerRole",
                "text" : "Gesundheitsfachperson oder -organisation",
                "type" : "group",
                "repeats" : true,
                "item" : [
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                        "valueExpression" : {
                          "name" : "linkIdPrefix",
                          "language" : "text/fhirpath",
                          "expression" : "'receiverCopy.practitionerRole.practitioner.'"
                        }
                      }
                    ],
                    "linkId" : "receiverCopy.practitionerRole.practitioner",
                    "text" : "Gesundheitsfachperson",
                    "type" : "group",
                    "item" : [
                      {
                        "linkId" : "receiverCopy.practitionerRole.practitioner.title",
                        "text" : "Titel",
                        "type" : "string"
                      },
                      {
                        "linkId" : "receiverCopy.practitionerRole.practitioner.familyName",
                        "text" : "Name",
                        "type" : "string"
                      },
                      {
                        "linkId" : "receiverCopy.practitionerRole.practitioner.givenName",
                        "text" : "Vorname",
                        "type" : "string"
                      },
                      {
                        "linkId" : "receiverCopy.practitionerRole.practitioner.phone",
                        "text" : "Telefon",
                        "type" : "string"
                      },
                      {
                        "linkId" : "receiverCopy.practitionerRole.practitioner.email",
                        "text" : "E-Mail",
                        "type" : "string"
                      }
                    ]
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                        "valueExpression" : {
                          "name" : "linkIdPrefix",
                          "language" : "text/fhirpath",
                          "expression" : "'receiverCopy.practitionerRole.organization.'"
                        }
                      }
                    ],
                    "linkId" : "receiverCopy.practitionerRole.organization",
                    "text" : "Gesundheitsorganisatiton",
                    "type" : "group",
                    "item" : [
                      {
                        "linkId" : "receiverCopy.practitionerRole.organization.name",
                        "text" : "Name der Organisation",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.line"
                            }
                          }
                        ],
                        "linkId" : "receiverCopy.practitionerRole.organization.streetAddressLine",
                        "text" : "Strasse, Hausnummer, Postfach etc.",
                        "type" : "string",
                        "repeats" : true
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.postalCode"
                            }
                          }
                        ],
                        "linkId" : "receiverCopy.practitionerRole.organization.postalCode",
                        "text" : "PLZ",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.city"
                            }
                          }
                        ],
                        "linkId" : "receiverCopy.practitionerRole.organization.city",
                        "text" : "Ort",
                        "type" : "string"
                      },
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                            "valueExpression" : {
                              "language" : "text/fhirpath",
                              "expression" : "%address.country"
                            }
                          }
                        ],
                        "linkId" : "receiverCopy.practitionerRole.organization.country",
                        "text" : "Land",
                        "type" : "string"
                      }
                    ]
                  }
                ]
              },
              {
                "linkId" : "receiverCopy.patient",
                "text" : "Patient selbst",
                "type" : "boolean"
              },
              {
                "linkId" : "receiverCopy.relatedPerson",
                "text" : "Andere Person",
                "type" : "group",
                "repeats" : true,
                "item" : [
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                        "valueExpression" : {
                          "name" : "linkIdPrefix",
                          "language" : "text/fhirpath",
                          "expression" : "'receiverCopy.relatedPerson.'"
                        }
                      }
                    ],
                    "linkId" : "receiverCopy.relatedPerson.familyName",
                    "text" : "Name",
                    "type" : "string"
                  },
                  {
                    "linkId" : "receiverCopy.relatedPerson.givenName",
                    "text" : "Vorname",
                    "type" : "string"
                  },
                  {
                    "linkId" : "receiverCopy.relatedPerson.phone",
                    "text" : "Telefon",
                    "type" : "string",
                    "repeats" : true
                  },
                  {
                    "linkId" : "receiverCopy.relatedPerson.email",
                    "text" : "E-Mail",
                    "type" : "string"
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.line"
                        }
                      }
                    ],
                    "linkId" : "receiverCopy.relatedPerson.streetAddressLine",
                    "text" : "Strasse, Hausnummer, Postfach etc.",
                    "type" : "string",
                    "repeats" : true
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.postalCode"
                        }
                      }
                    ],
                    "linkId" : "receiverCopy.relatedPerson.postalCode",
                    "text" : "PLZ",
                    "type" : "string"
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.city"
                        }
                      }
                    ],
                    "linkId" : "receiverCopy.relatedPerson.city",
                    "text" : "Ort",
                    "type" : "string"
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.country"
                        }
                      }
                    ],
                    "linkId" : "receiverCopy.relatedPerson.country",
                    "text" : "Land",
                    "type" : "string"
                  }
                ]
              }
            ]
          },
          {
            "linkId" : "antecedentEpisodeOfCare",
            "text" : "Vorgängiger Aufenthalt in Spital / Heim",
            "type" : "group",
            "item" : [
              {
                "linkId" : "antecedentEpisodeOfCare.start",
                "text" : "Von",
                "type" : "dateTime"
              },
              {
                "linkId" : "antecedentEpisodeOfCare.end",
                "text" : "Bis",
                "type" : "dateTime"
              },
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                    "valueExpression" : {
                      "name" : "linkIdPrefix",
                      "language" : "text/fhirpath",
                      "expression" : "'antecedentEpisodeOfCare.managingOrganization.'"
                    }
                  }
                ],
                "linkId" : "antecedentEpisodeOfCare.managingOrganization",
                "text" : "Spital /Heim",
                "type" : "group",
                "item" : [
                  {
                    "linkId" : "antecedentEpisodeOfCare.managingOrganization.name",
                    "text" : "Name der Organisation",
                    "type" : "string"
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.line"
                        }
                      }
                    ],
                    "linkId" : "antecedentEpisodeOfCare.managingOrganization.streetAddressLine",
                    "text" : "Strasse, Hausnummer, Postfach etc.",
                    "type" : "string",
                    "repeats" : true
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.postalCode"
                        }
                      }
                    ],
                    "linkId" : "antecedentEpisodeOfCare.managingOrganization.postalCode",
                    "text" : "PLZ",
                    "type" : "string"
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.city"
                        }
                      }
                    ],
                    "linkId" : "antecedentEpisodeOfCare.managingOrganization.city",
                    "text" : "Ort",
                    "type" : "string"
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.country"
                        }
                      }
                    ],
                    "linkId" : "antecedentEpisodeOfCare.managingOrganization.country",
                    "text" : "Land",
                    "type" : "string"
                  }
                ]
              }
            ]
          },
          {
            "linkId" : "appointment",
            "text" : "Ort und Zeit der Durchführung der angeforderten Leistung",
            "type" : "group",
            "repeats" : true,
            "item" : [
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/variable",
                    "valueExpression" : {
                      "name" : "linkIdPrefix",
                      "language" : "text/fhirpath",
                      "expression" : "'appointment.location.'"
                    }
                  }
                ],
                "linkId" : "appointment.location",
                "text" : "Ort der Durchführung",
                "type" : "group",
                "item" : [
                  {
                    "linkId" : "appointment.location.name",
                    "text" : "Name",
                    "type" : "string",
                    "required" : true
                  },
                  {
                    "linkId" : "appointment.location.phone",
                    "text" : "Telefon",
                    "type" : "string"
                  },
                  {
                    "linkId" : "appointment.location.email",
                    "text" : "E-Mail",
                    "type" : "string"
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.line"
                        }
                      }
                    ],
                    "linkId" : "appointment.location.streetAddressLine",
                    "text" : "Strasse, Hausnummer, Postfach etc.",
                    "type" : "string",
                    "repeats" : true
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.postalCode"
                        }
                      }
                    ],
                    "linkId" : "appointment.location.postalCode",
                    "text" : "PLZ",
                    "type" : "string"
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.city"
                        }
                      }
                    ],
                    "linkId" : "appointment.location.city",
                    "text" : "Ort",
                    "type" : "string"
                  },
                  {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                        "valueExpression" : {
                          "language" : "text/fhirpath",
                          "expression" : "%address.country"
                        }
                      }
                    ],
                    "linkId" : "appointment.location.country",
                    "text" : "Land",
                    "type" : "string"
                  }
                ]
              },
              {
                "linkId" : "appointment.requestedPeriod",
                "text" : "Datum und Zeit, wann der Termin bevorzugt geplant werden soll",
                "type" : "group",
                "item" : [
                  {
                    "linkId" : "appointment.requestedPeriod.start",
                    "text" : "Von",
                    "type" : "dateTime"
                  },
                  {
                    "linkId" : "appointment.requestedPeriod.end",
                    "text" : "Bis",
                    "type" : "dateTime"
                  }
                ]
              },
              {
                "linkId" : "appointment.status",
                "text" : "Status",
                "type" : "choice",
                "required" : true,
                "answerOption" : [
                  {
                    "valueCoding" : {
                      "system" : "http://hl7.org/fhir/appointmentstatus",
                      "code" : "proposed",
                      "display" : "Wunsch des Patienten (vorgeschlagen)"
                    },
                    "initialSelected" : true
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://hl7.org/fhir/appointmentstatus",
                      "code" : "pending",
                      "display" : "Vom Patienten bestätigt, aber vom Leistungserbringer noch nicht (ausstehend)"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://hl7.org/fhir/appointmentstatus",
                      "code" : "booked",
                      "display" : "Vom Patienten und Leistungserbringer bestätigt (gebucht)"
                    }
                  }
                ]
              },
              {
                "linkId" : "appointment.patientInstruction",
                "text" : "Patienteninformation für diesen Termin",
                "type" : "string"
              }
            ]
          },
          {
            "linkId" : "consent",
            "text" : "Einverständniserklärung",
            "type" : "group",
            "item" : [
              {
                "linkId" : "patient.consent.statement",
                "text" : "Ist der Patient über die Anmeldung informiert und explizit einverstanden?",
                "type" : "choice",
                "answerOption" : [
                  {
                    "valueCoding" : {
                      "system" : "http://fhir.ch/ig/ch-orf/CodeSystem/ch-orf-cs-consentstatus",
                      "code" : "ExplicitAgreement",
                      "display" : "Patient is informed and has explicitly agreed"
                    }
                  },
                  {
                    "valueCoding" : {
                      "system" : "http://fhir.ch/ig/ch-orf/CodeSystem/ch-orf-cs-consentstatus",
                      "code" : "Other",
                      "display" : "Other situation such as 'implicit agreement', 'agreed by legal guardian'  etc."
                    }
                  }
                ],
                "item" : [
                  {
                    "linkId" : "patient.consent.statement.note",
                    "text" : "Anmerkung",
                    "type" : "string"
                  }
                ]
              }
            ]
          },
          {
            "linkId" : "note",
            "text" : "Bemerkungen",
            "type" : "group",
            "repeats" : true,
            "item" : [
              {
                "linkId" : "note.text",
                "text" : "Kommentar",
                "type" : "string"
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:b09d7c4d-a7b1-443c-8c3b-4d01675ad970",
      "resource" : {
        "resourceType" : "PractitionerRole",
        "language" : "de-CH",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"de-CH\" lang=\"de-CH\"><p><b>Generated Narrative: PractitionerRole</b></p><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\">Resource PractitionerRole  (Language &quot;de-CH&quot;) </p></div><p><b>practitioner</b>: <a href=\"#urnuuida4e7a174-e3d1-4096-b93b-eb11ba1f22e8\">See above (urn:uuid:a4e7a174-e3d1-4096-b93b-eb11ba1f22e8)</a></p><p><b>organization</b>: <a href=\"#urnuuid1ab1aa55-3096-4a6f-affc-a06a0d1d5786\">See above (urn:uuid:1ab1aa55-3096-4a6f-affc-a06a0d1d5786)</a></p></div>"
        },
        "practitioner" : {
          "reference" : "urn:uuid:a4e7a174-e3d1-4096-b93b-eb11ba1f22e8"
        },
        "organization" : {
          "reference" : "urn:uuid:1ab1aa55-3096-4a6f-affc-a06a0d1d5786"
        }
      }
    },
    {
      "fullUrl" : "urn:uuid:a4e7a174-e3d1-4096-b93b-eb11ba1f22e8",
      "resource" : {
        "resourceType" : "Practitioner",
        "language" : "de-CH",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"de-CH\" lang=\"de-CH\"><p><b>Generated Narrative: Practitioner</b></p><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\">Resource Practitioner  (Language &quot;de-CH&quot;) </p></div><p><b>identifier</b>: id:\u00a07601000201041</p><p><b>name</b>: Otto Rderfiller </p><p><b>telecom</b>: ph: 044 412 00 99, <a href=\"mailto:o.rderfiller@happyhospital.ch\">o.rderfiller@happyhospital.ch</a></p></div>"
        },
        "identifier" : [
          {
            "system" : "urn:oid:2.51.1.3",
            "value" : "7601000201041"
          }
        ],
        "name" : [
          {
            "family" : "Rderfiller",
            "given" : [
              "Otto"
            ],
            "prefix" : [
              "Dr. med."
            ],
            "_prefix" : [
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier",
                    "valueCode" : "AC"
                  }
                ]
              }
            ]
          }
        ],
        "telecom" : [
          {
            "system" : "phone",
            "value" : "044 412 00 99"
          },
          {
            "system" : "email",
            "value" : "o.rderfiller@happyhospital.ch"
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:1ab1aa55-3096-4a6f-affc-a06a0d1d5786",
      "resource" : {
        "resourceType" : "Organization",
        "language" : "de-CH",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"de-CH\" lang=\"de-CH\"><p><b>Generated Narrative: Organization</b></p><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\">Resource Organization  (Language &quot;de-CH&quot;) </p></div><p><b>name</b>: Klinik Happy Hospital</p><p><b>address</b>: Seestrasse 133 Haus C Zürich 8000 Schweiz </p></div>"
        },
        "name" : "Klinik Happy Hospital",
        "address" : [
          {
            "line" : [
              "Seestrasse 133",
              "Haus C"
            ],
            "city" : "Zürich",
            "postalCode" : "8000",
            "country" : "Schweiz"
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:de8d3b4f-1a57-48c0-9b03-a758ff8f2d2f",
      "resource" : {
        "resourceType" : "PractitionerRole",
        "language" : "de-CH",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"de-CH\" lang=\"de-CH\"><p><b>Generated Narrative: PractitionerRole</b></p><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\">Resource PractitionerRole  (Language &quot;de-CH&quot;) </p></div><p><b>practitioner</b>: <a href=\"#urnuuid0bba65f4-88a0-442d-91fa-1e95b54c954c\">See above (urn:uuid:0bba65f4-88a0-442d-91fa-1e95b54c954c)</a></p><p><b>organization</b>: <a href=\"#urnuuidf19b34ca-5f0d-449d-b6a1-0ca9c1257df0\">See above (urn:uuid:f19b34ca-5f0d-449d-b6a1-0ca9c1257df0)</a></p></div>"
        },
        "practitioner" : {
          "reference" : "urn:uuid:0bba65f4-88a0-442d-91fa-1e95b54c954c"
        },
        "organization" : {
          "reference" : "urn:uuid:f19b34ca-5f0d-449d-b6a1-0ca9c1257df0"
        }
      }
    },
    {
      "fullUrl" : "urn:uuid:0bba65f4-88a0-442d-91fa-1e95b54c954c",
      "resource" : {
        "resourceType" : "Practitioner",
        "language" : "de-CH",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"de-CH\" lang=\"de-CH\"><p><b>Generated Narrative: Practitioner</b></p><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\">Resource Practitioner  (Language &quot;de-CH&quot;) </p></div><p><b>identifier</b>: id:\u00a07601000618627</p><p><b>name</b>: Ottilie Rderplacer </p><p><b>telecom</b>: ph: 044 333 22 11, <a href=\"mailto:o.rderplacer@happydoctors.ch\">o.rderplacer@happydoctors.ch</a></p></div>"
        },
        "identifier" : [
          {
            "system" : "urn:oid:2.51.1.3",
            "value" : "7601000618627"
          }
        ],
        "name" : [
          {
            "family" : "Rderplacer",
            "given" : [
              "Ottilie"
            ],
            "prefix" : [
              "Dr. med."
            ],
            "_prefix" : [
              {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier",
                    "valueCode" : "AC"
                  }
                ]
              }
            ]
          }
        ],
        "telecom" : [
          {
            "system" : "phone",
            "value" : "044 333 22 11"
          },
          {
            "system" : "email",
            "value" : "o.rderplacer@happydoctors.ch"
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:f19b34ca-5f0d-449d-b6a1-0ca9c1257df0",
      "resource" : {
        "resourceType" : "Organization",
        "language" : "de-CH",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"de-CH\" lang=\"de-CH\"><p><b>Generated Narrative: Organization</b></p><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\">Resource Organization  (Language &quot;de-CH&quot;) </p></div><p><b>name</b>: Praxis Happy Doctors</p><p><b>address</b>: Kantonsstrasse 14 Postfach 14 Zürich 8000 Schweiz </p></div>"
        },
        "name" : "Praxis Happy Doctors",
        "address" : [
          {
            "line" : [
              "Kantonsstrasse 14",
              "Postfach 14"
            ],
            "city" : "Zürich",
            "postalCode" : "8000",
            "country" : "Schweiz"
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:b6d4abb9-8c83-4d76-89d0-547c0b269f6d",
      "resource" : {
        "resourceType" : "PractitionerRole",
        "language" : "de-CH",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"de-CH\" lang=\"de-CH\"><p><b>Generated Narrative: PractitionerRole</b></p><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\">Resource PractitionerRole  (Language &quot;de-CH&quot;) </p></div><p><b>practitioner</b>: <a href=\"#urnuuidcb7715e3-dbd4-4dc4-8f75-013074c88aba\">See above (urn:uuid:cb7715e3-dbd4-4dc4-8f75-013074c88aba)</a></p><p><b>organization</b>: <a href=\"#urnuuidf19b34ca-5f0d-449d-b6a1-0ca9c1257df0\">See above (urn:uuid:f19b34ca-5f0d-449d-b6a1-0ca9c1257df0)</a></p></div>"
        },
        "practitioner" : {
          "reference" : "urn:uuid:cb7715e3-dbd4-4dc4-8f75-013074c88aba"
        },
        "organization" : {
          "reference" : "urn:uuid:f19b34ca-5f0d-449d-b6a1-0ca9c1257df0"
        }
      }
    },
    {
      "fullUrl" : "urn:uuid:cb7715e3-dbd4-4dc4-8f75-013074c88aba",
      "resource" : {
        "resourceType" : "Practitioner",
        "language" : "de-CH",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"de-CH\" lang=\"de-CH\"><p><b>Generated Narrative: Practitioner</b></p><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\">Resource Practitioner  (Language &quot;de-CH&quot;) </p></div><p><b>name</b>: Doris Ataenterer </p><p><b>telecom</b>: ph: 044 333 22 11, <a href=\"mailto:d.ataenterer@happydoctors.ch\">d.ataenterer@happydoctors.ch</a></p></div>"
        },
        "name" : [
          {
            "family" : "Ataenterer",
            "given" : [
              "Doris"
            ]
          }
        ],
        "telecom" : [
          {
            "system" : "phone",
            "value" : "044 333 22 11"
          },
          {
            "system" : "email",
            "value" : "d.ataenterer@happydoctors.ch"
          }
        ]
      }
    }
  ]
}