external-diagnostics-order
type: Bundle
node role: treeRoot
resource.id:
  value: external-diagnostics-order
resource.meta:
  meta.profile:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-document
    index: 0
    link: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-document
bundle.identifier:
  identifier.system:
    value: urn:ietf:rfc:3986
bundle.type:
  value: document
bundle.timestamp:
  value: 2021-03-30T13:26:15+00:00
bundle.entry:
  index: 0
bundle.entry:
  index: 1
bundle.entry:
  index: 2
bundle.entry:
  index: 3
bundle.entry:
  index: 4
bundle.entry:
  index: 5
bundle.entry:
  index: 6
bundle.entry:
  index: 7
bundle.entry:
  index: 8
bundle.entry:
  index: 9
bundle.entry:
  index: 10
bundle.entry:
  index: 11
bundle.entry:
  index: 12
bundle.entry:
  index: 13
bundle.entry:
  index: 14
  bundle.entry.full url:
    value: http://example.com/fhir/Questionnaire/order-referral-form
  bundle.entry.resource: order-referral-form

urn:…
type: Composition
domain resource.text:
  narrative.status:
    value: extensions
  narrative.div: Generated Narrative CH ORF Urgent Notification Contact For This Documet: See above (urn:uuid:0cc17698-6d88-4d48-9c6a-1b0886350ef6) CH ORF Urgent Notification Contact For The Response To This Document: See above (urn:uuid:b924d326-3f5a-48c0-be83-5bb02521cb25) CH ORF Receiver: See above (urn:uuid:354ddeae-95c5-4970-83e5-71b78aeb1c6d) status: final type: Imaging order (record artifact) (SNOMED CT Swiss Extension#2161000195103) category: Order (record artifact) (SNOMED CT#721963009) date: 2021-03-30T13:26:15Z author: See above (urn:uuid:e11eeb26-31a1-491f-afbc-d885f6157172) title: Order-Referral-Form
domain resource.extension:
  index: 0
  extension.url:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-urgentnoficationcontactforthisdocument
domain resource.extension:
  index: 1
  extension.url:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-urgentnoficationcontactfortheresponsetothisdocument
domain resource.extension:
  index: 2
  extension.url:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-receiver
  extension.value reference:
    reference.type:
      value: PractitionerRole
composition.status:
  value: final
composition.type:
  codeable concept.coding:
    index: 0
    coding.system:
      value: urn:oid:2.16.756.5.30.1.127.3.4
    coding.code:
      value: 2161000195103
    coding.display:
      value: Imaging order (record artifact)
composition.category:
  index: 0
  codeable concept.coding: http://snomed.info/id/721963009
    index: 0
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 721963009
    coding.display:
      value: Order (record artifact)
composition.subject:
  reference.type:
    value: Patient
composition.date:
  value: 2021-03-30T13:26:15+00:00
composition.author:
  index: 0
  reference.type:
    value: PractitionerRole
composition.title:
  value: Order-Referral-Form
composition.section:
  index: 0
  composition.section.title:
    value: Order-Referral
  composition.section.code:
    codeable concept.coding: http://loinc.org/rdf#93037-0
      index: 0
      coding.system:
        value: http://loinc.org
      coding.code:
        value: 93037-0
      coding.display:
        value: Portable medical order form
  composition.section.entry:
    index: 0
    link: http://example.com/fhir/Questionnaire/order-referral-form
    reference.reference:
      value: http://example.com/fhir/Questionnaire/order-referral-form
    reference.type:
      value: Questionnaire
  composition.section.entry:
    index: 1
    reference.type:
      value: QuestionnaireResponse
  composition.section.entry:
    index: 2
    reference.type:
      value: ServiceRequest

urn:…
type: Patient
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative identifier: Medical record number: 44.34.9472.1 name: Susanna Ufferer (OFFICIAL), Leidend (MAIDEN) telecom: ph: 079 979 79 79, susanna@ufferer.ch gender: female birthDate: 1970-03-14 address: Musterweg 6a Zürich 8000 Schweiz
patient.identifier:
  index: 0
  identifier.type:
    codeable concept.coding:
      index: 0
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/v2-0203
      coding.code:
        value: MR
  identifier.system:
    value: urn:oid:2.999.1.2
  identifier.value:
    value: 44.34.9472.1
patient.name:
  index: 0
  human name.use:
    value: official
  human name.family:
    value: Ufferer
    element.extension:
      index: 0
      extension.url:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-ech-11-name
      extension.value code:
        value: officialName
  human name.given:
    value: Susanna
    index: 0
    element.extension:
      index: 0
      extension.url:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-ech-11-firstname
      extension.value code:
        value: officialFirstName
patient.name:
  index: 1
  human name.use:
    value: maiden
  human name.family:
    value: Leidend
    element.extension:
      index: 0
      extension.url:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-ech-11-name
      extension.value code:
        value: originalName
patient.telecom:
  index: 0
  contact point.system:
    value: phone
  contact point.value:
    value: 079 979 79 79
patient.telecom:
  index: 1
  contact point.system:
    value: email
patient.gender:
  value: female
patient.birth date:
  value: 1970-03-14
patient.address:
  index: 0
  address.line:
    value: Musterweg
    index: 0
  address.line:
    value: 6a
    index: 1
  address.city:
    value: Zürich
  address.postal code:
    value: 8000
  address.country:
    value: Schweiz

urn:…
type: QuestionnaireResponse
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative questionnaire: Order-Referral-Form status: completed item linkId: order text: Auftrag item linkId: order.placerOrderIdentifier text: Auftragsnummer des Auftraggebers item linkId: order.placerOrderIdentifierDomain text: Identifier Domain der Auftragsnummer des Auftraggebers item linkId: order.notificationContactDocument text: Dringender Benachrichtigungskontakt für dieses Dokument item linkId: order.notificationContactDocumentResponse text: Dringender Benachrichtigungskontakt für die Antwort auf dieses Dokument item linkId: order.priority text: Auftragspriorität item linkId: receiver text: Empfänger item linkId: receiver.practitioner text: Empfangende Person item linkId: receiver.organization text: Empfangende Organisation item linkId: patient text: Patient item linkId: patient.familyName text: Name item linkId: patient.maidenName text: Ledigname item linkId: patient.givenName text: Vorname item linkId: patient.localPid text: Lokale Patienten-ID item linkId: patient.birthDate text: Geburtsdatum item linkId: patient.gender text: Geschlecht item linkId: patient.phone text: Telefon item linkId: patient.email text: E-Mail item linkId: patient.streetAddressLine text: Strasse, Hausnummer, Postfach etc. item linkId: patient.postalCode text: PLZ item linkId: patient.city text: Ort item linkId: patient.country text: Land item linkId: sender text: Absender item linkId: sender.author text: Verantwortlicher
questionnaire response.questionnaire:
  value: http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form
  link: http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form
questionnaire response.status:
  value: completed
questionnaire response.item:
  index: 0
  questionnaire response.item.link id:
    value: order
  questionnaire response.item.text:
    value: Auftrag
  questionnaire response.item.item:
    index: 0
    questionnaire response.item.link id:
      value: order.placerOrderIdentifier
    questionnaire response.item.text:
      value: Auftragsnummer des Auftraggebers
    questionnaire response.item.answer:
      index: 0
      questionnaire response.item.answer.value string:
        value: 60823
  questionnaire response.item.item:
    index: 1
    questionnaire response.item.link id:
      value: order.placerOrderIdentifierDomain
    questionnaire response.item.text:
      value: Identifier Domain der Auftragsnummer des Auftraggebers
    questionnaire response.item.answer:
      index: 0
      questionnaire response.item.answer.value string:
        value: urn:oid:2.16.756.5.30.1
  questionnaire response.item.item:
    index: 2
    questionnaire response.item.link id:
      value: order.notificationContactDocument
    questionnaire response.item.text:
      value: Dringender Benachrichtigungskontakt für dieses Dokument
    questionnaire response.item.item:
      index: 0
      questionnaire response.item.link id:
        value: order.notificationContactDocument.practitioner
      questionnaire response.item.text:
        value: Zu benachrichtigende Person
      questionnaire response.item.item:
        index: 0
      questionnaire response.item.item:
        index: 1
      questionnaire response.item.item:
        index: 2
      questionnaire response.item.item:
        index: 3
      questionnaire response.item.item:
        index: 4
  questionnaire response.item.item:
    index: 3
    questionnaire response.item.link id:
      value: order.notificationContactDocumentResponse
    questionnaire response.item.text:
      value: Dringender Benachrichtigungskontakt für die Antwort auf dieses Dokument
    questionnaire response.item.item:
      index: 0
      questionnaire response.item.link id:
        value: order.notificationContactDocumentResponse.practitioner
      questionnaire response.item.text:
        value: Zu benachrichtigende Person
      questionnaire response.item.item:
        index: 0
      questionnaire response.item.item:
        index: 1
      questionnaire response.item.item:
        index: 2
      questionnaire response.item.item:
        index: 3
      questionnaire response.item.item:
        index: 4
  questionnaire response.item.item:
    index: 4
    questionnaire response.item.link id:
      value: order.priority
    questionnaire response.item.text:
      value: Auftragspriorität
    questionnaire response.item.answer:
      index: 0
questionnaire response.item:
  index: 1
  questionnaire response.item.link id:
    value: receiver
  questionnaire response.item.text:
    value: Empfänger
  questionnaire response.item.item:
    index: 0
    questionnaire response.item.link id:
      value: receiver.practitioner
    questionnaire response.item.text:
      value: Empfangende Person
    questionnaire response.item.item:
      index: 0
      questionnaire response.item.link id:
        value: receiver.practitioner.title
      questionnaire response.item.text:
        value: Titel
      questionnaire response.item.answer:
        index: 0
    questionnaire response.item.item:
      index: 1
      questionnaire response.item.link id:
        value: receiver.practitioner.familyName
      questionnaire response.item.text:
        value: Name
      questionnaire response.item.answer:
        index: 0
    questionnaire response.item.item:
      index: 2
      questionnaire response.item.link id:
        value: receiver.practitioner.givenName
      questionnaire response.item.text:
        value: Vorname
      questionnaire response.item.answer:
        index: 0
    questionnaire response.item.item:
      index: 3
      questionnaire response.item.link id:
        value: receiver.practitioner.gln
      questionnaire response.item.text:
        value: GLN
      questionnaire response.item.answer:
        index: 0
    questionnaire response.item.item:
      index: 4
      questionnaire response.item.link id:
        value: receiver.practitioner.phone
      questionnaire response.item.text:
        value: Telefon
      questionnaire response.item.answer:
        index: 0
    questionnaire response.item.item:
      index: 5
      questionnaire response.item.link id:
        value: receiver.practitioner.email
      questionnaire response.item.text:
        value: E-Mail
      questionnaire response.item.answer:
        index: 0
  questionnaire response.item.item:
    index: 1
    questionnaire response.item.link id:
      value: receiver.organization
    questionnaire response.item.text:
      value: Empfangende Organisation
    questionnaire response.item.item:
      index: 0
      questionnaire response.item.link id:
        value: receiver.organization.name
      questionnaire response.item.text:
        value: Name der Organisation
      questionnaire response.item.answer:
        index: 0
    questionnaire response.item.item:
      index: 1
      questionnaire response.item.link id:
        value: receiver.organization.streetAddressLine
      questionnaire response.item.text:
        value: Strasse, Hausnummer, Postfach etc.
      questionnaire response.item.answer:
        index: 0
      questionnaire response.item.answer:
        index: 1
    questionnaire response.item.item:
      index: 2
      questionnaire response.item.link id:
        value: receiver.organization.postalCode
      questionnaire response.item.text:
        value: PLZ
      questionnaire response.item.answer:
        index: 0
    questionnaire response.item.item:
      index: 3
      questionnaire response.item.link id:
        value: receiver.organization.city
      questionnaire response.item.text:
        value: Ort
      questionnaire response.item.answer:
        index: 0
    questionnaire response.item.item:
      index: 4
      questionnaire response.item.link id:
        value: receiver.organization.country
      questionnaire response.item.text:
        value: Land
      questionnaire response.item.answer:
        index: 0
questionnaire response.item:
  index: 2
  questionnaire response.item.link id:
    value: patient
  questionnaire response.item.text:
    value: Patient

urn:…
type: ServiceRequest
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative identifier: Placer Identifier: 60823 status: active intent: order priority: stat subject: See above (urn:uuid:60580cae-b784-43fb-a0b0-e87702c15285) requester: See above (urn:uuid:e11eeb26-31a1-491f-afbc-d885f6157172)
service request.identifier:
  index: 0
  identifier.type:
    codeable concept.coding:
      index: 0
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/v2-0203
      coding.code:
        value: PLAC
  identifier.system:
    value: urn:oid:2.999.1.2.3
  identifier.value:
    value: 60823
service request.status:
  value: active
service request.intent:
  value: order
service request.priority:
  value: stat
service request.subject:
  reference.type:
    value: Patient
service request.requester:
  reference.type:
    value: PractitionerRole

urn:…
type: PractitionerRole
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative practitioner: See above (urn:uuid:23064476-d499-419e-908e-63fd804a57e6)
practitioner role.practitioner:
  reference.type:
    value: Practitioner

urn:…
type: Practitioner
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative name: Frederica Iller telecom: ph: 044 503 44 44, f.iller@univerityhospital.ch
practitioner.name:
  index: 0
  human name.family:
    value: Iller
  human name.given:
    value: Frederica
    index: 0
  human name.prefix:
    value: Dr. med.
    index: 0
    element.extension:
      index: 0
      extension.url:
        value: http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier
      extension.value code:
        value: AC
practitioner.telecom:
  index: 0
  contact point.system:
    value: phone
  contact point.value:
    value: 044 503 44 44
practitioner.telecom:
  index: 1
  contact point.system:
    value: email

urn:…
type: PractitionerRole
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative practitioner: See above (urn:uuid:f4ae3476-1fbd-42ae-b2e3-ae1b445a2460)
practitioner role.practitioner:
  reference.type:
    value: Practitioner

urn:…
type: Practitioner
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative name: Paul Lacer telecom: ph: 044 987 65 43, p.lacer@regionalhospital.ch
practitioner.name:
  index: 0
  human name.family:
    value: Lacer
  human name.given:
    value: Paul
    index: 0
  human name.prefix:
    value: Dr. med.
    index: 0
    element.extension:
      index: 0
      extension.url:
        value: http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier
      extension.value code:
        value: AC
practitioner.telecom:
  index: 0
  contact point.system:
    value: phone
  contact point.value:
    value: 044 987 65 43
practitioner.telecom:
  index: 1
  contact point.system:
    value: email

urn:…
type: PractitionerRole
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative practitioner: See above (urn:uuid:b60e96e4-0665-4759-95f2-e962e05da7d5) organization: See above (urn:uuid:04a1b8b0-04af-4ef1-ae1e-84f2da419fe3)
practitioner role.practitioner:
  reference.type:
    value: Practitioner
practitioner role.organization:
  reference.type:
    value: Organization

urn:…
type: Practitioner
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative identifier: id: 7601000099521 name: Frederica Iller telecom: ph: 044 503 44 44, f.iller@universityhospital.ch
practitioner.identifier:
  index: 0
  identifier.system:
    value: urn:oid:2.51.1.3
  identifier.value:
    value: 7601000099521
practitioner.name:
  index: 0
  human name.family:
    value: Iller
  human name.given:
    value: Frederica
    index: 0
  human name.prefix:
    value: Dr. med.
    index: 0
    element.extension:
      index: 0
      extension.url:
        value: http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier
      extension.value code:
        value: AC
practitioner.telecom:
  index: 0
  contact point.system:
    value: phone
  contact point.value:
    value: 044 503 44 44
practitioner.telecom:
  index: 1
  contact point.system:
    value: email

urn:…
type: Organization
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative name: University Hospital address: Uniweg 33 Radiology Zürich 8000 Schweiz
organization.name:
  value: University Hospital
organization.address:
  index: 0
  address.line:
    value: Uniweg 33
    index: 0
  address.line:
    value: Radiology
    index: 1
  address.city:
    value: Zürich
  address.postal code:
    value: 8000
  address.country:
    value: Schweiz

urn:…
type: PractitionerRole
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative practitioner: See above (urn:uuid:61dd236b-3a00-43e0-81fb-864f519bbac3) organization: See above (urn:uuid:987098fd-cb54-4b85-a814-fed59a78591e)
practitioner role.practitioner:
  reference.type:
    value: Practitioner
practitioner role.organization:
  reference.type:
    value: Organization

urn:…
type: Practitioner
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative identifier: id: 7601003334499 name: Paul Lacer telecom: ph: 044 987 65 43, p.lacer@regionalhospital.ch
practitioner.identifier:
  index: 0
  identifier.system:
    value: urn:oid:2.51.1.3
  identifier.value:
    value: 7601003334499
practitioner.name:
  index: 0
  human name.family:
    value: Lacer
  human name.given:
    value: Paul
    index: 0
  human name.prefix:
    value: Dr. med.
    index: 0
    element.extension:
      index: 0
      extension.url:
        value: http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier
      extension.value code:
        value: AC
practitioner.telecom:
  index: 0
  contact point.system:
    value: phone
  contact point.value:
    value: 044 987 65 43
practitioner.telecom:
  index: 1
  contact point.system:
    value: email

urn:…
type: Organization
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative name: Regional Hospital address: Musterstrasse 129 Zürich 8000 Schweiz
organization.name:
  value: Regional Hospital
organization.address:
  index: 0
  address.line:
    value: Musterstrasse 129
    index: 0
  address.city:
    value: Zürich
  address.postal code:
    value: 8000
  address.country:
    value: Schweiz

order-referral-form
type: Questionnaire
resource.id:
  value: order-referral-form
resource.meta:
  meta.profile:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-questionnaire
    index: 0
    link: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-questionnaire
  meta.profile:
    value: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire
    index: 1
    link: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire
  meta.profile:
    value: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extract
    index: 2
    link: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extract
  meta.profile:
    value: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-populate
    index: 3
    link: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-populate
domain resource.text:
  narrative.status:
    value: extensions
  narrative.div: Generated Narrative Resource "order-referral-form" Profiles: CH ORF Questionnaire, Questionnaire, Extractable Questionnaire, Populatable Questionnaire Target structure map: OrfQrToBundle Source structure map: http://fhir.ch/ig/ch-orf/StructureMap/OrfPrepopBundleToQr Launch context resources value: Bundle value: Bundle value: The Bundle that is to be used to pre-populate the form url: http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form version: 0.11.0 name: OrderReferralForm title: Order-Referral-Form status: active subjectType: Patient date: 2022-01-06 publisher: HL7 Switzerland contact: HL7 Switzerland: https://www.hl7.ch/ jurisdiction: Switzerland (unknown#CH) copyright: CC-BY-SA-4.0 item linkId: order definition: CH ORF Document text: Auftrag type: group required: true item linkId: order.placerOrderIdentifier definition: CH ORF ServiceRequest text: Auftragsnummer des Auftraggebers type: string item hidden: true linkId: order.placerOrderIdentifierDomain definition: CH ORF ServiceRequest text: Identifier Domain der Auftragsnummer des Auftraggebers type: string item linkId: order.fillerOrderIdentifier definition: CH ORF ServiceRequest text: Auftragsnummer des Auftragsempfängers type: string item hidden: true linkId: order.fillerOrderIdentifierDomain definition: CH ORF ServiceRequest text: Identifier Domain der Auftragsnummer des Auftragsempfängers type: string item hidden: true linkId: order.precedentDocumentIdentifier definition: CH ORF Composition text: Identifier des Vorgängerdokuments type: string item linkId: order.notificationContactDocument definition: CH ORF Composition text: Dringender Benachrichtigungskontakt für dieses Dokument type: group item linkId: order.notificationContactDocumentResponse definition: CH ORF Composition text: Dringender Benachrichtigungskontakt für die Antwort auf dieses Dokument type: group item linkId: order.priority definition: CH ORF ServiceRequest text: Auftragspriorität type: choice item linkId: receiver definition: CH OR…
domain resource.extension:
  index: 0
  extension.url:
    value: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-targetStructureMap
  extension.value canonical:
    value: http://fhir.ch/ig/ch-orf/StructureMap/OrfQrToBundle
    link: http://fhir.ch/ig/ch-orf/StructureMap/OrfQrToBundle
domain resource.extension:
  index: 1
  extension.url:
    value: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-sourceStructureMap
  extension.value canonical:
    value: http://fhir.ch/ig/ch-orf/StructureMap/OrfPrepopBundleToQr
    link: http://fhir.ch/ig/ch-orf/StructureMap/OrfPrepopBundleToQr
domain resource.extension:
  index: 2
  extension.url:
    value: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext
  element.extension:
    index: 0
    extension.url:
      value: name
    extension.value id:
      value: Bundle
  element.extension:
    index: 1
    extension.url:
      value: type
    extension.value code:
      value: Bundle
  element.extension:
    index: 2
    extension.url:
      value: description
    extension.value string:
      value: The Bundle that is to be used to pre-populate the form
questionnaire.url:
  value: http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form
questionnaire.version:
  value: 0.11.0
questionnaire.name:
  value: OrderReferralForm
questionnaire.title:
  value: Order-Referral-Form
questionnaire.status:
  value: active
questionnaire.subject type:
  value: Patient
  index: 0
questionnaire.date:
  value: 2022-01-06
questionnaire.publisher:
  value: HL7 Switzerland
questionnaire.contact:
  index: 0
  contact detail.name:
    value: HL7 Switzerland
  contact detail.telecom:
    index: 0
    contact point.system:
      value: url
    contact point.value:
      value: https://www.hl7.ch/
questionnaire.jurisdiction:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: urn:iso:std:iso:3166
    coding.code:
      value: CH
questionnaire.copyright:
  value: CC-BY-SA-4.0
questionnaire.item:
  index: 0
  questionnaire.item.link id:
    value: order
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-document#Bundle
  questionnaire.item.text:
    value: Auftrag
  questionnaire.item.type:
    value: group
  questionnaire.item.required:
    value: true
  questionnaire.item.item:
    index: 0
    questionnaire.item.link id:
      value: order.placerOrderIdentifier
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.identifier:placerOrderIdentifier.value
    questionnaire.item.text:
      value: Auftragsnummer des Auftraggebers
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 1
    element.extension:
      index: 0
      extension.url:
        value: http://hl7.org/fhir/StructureDefinition/questionnaire-hidden
      extension.value boolean:
        value: true
    questionnaire.item.link id:
      value: order.placerOrderIdentifierDomain
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.identifier:placerOrderIdentifier.system
    questionnaire.item.text:
      value: Identifier Domain der Auftragsnummer des Auftraggebers
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 2
    questionnaire.item.link id:
      value: order.fillerOrderIdentifier
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.identifier:fillerOrderIdentifier.value
    questionnaire.item.text:
      value: Auftragsnummer des Auftragsempfängers
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 3
    element.extension:
      index: 0
      extension.url:
        value: http://hl7.org/fhir/StructureDefinition/questionnaire-hidden
      extension.value boolean:
        value: true
    questionnaire.item.link id:
      value: order.fillerOrderIdentifierDomain
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.identifier:fillerOrderIdentifier.system
    questionnaire.item.text:
      value: Identifier Domain der Auftragsnummer des Auftragsempfängers
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 4
    element.extension:
      index: 0
      extension.url:
        value: http://hl7.org/fhir/StructureDefinition/questionnaire-hidden
      extension.value boolean:
        value: true
    questionnaire.item.link id:
      value: order.precedentDocumentIdentifier
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension:precedentDocument
    questionnaire.item.text:
      value: Identifier des Vorgängerdokuments
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 5
    questionnaire.item.link id:
      value: order.notificationContactDocument
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension:urgentNoficationContactForThisDocument
    questionnaire.item.text:
      value: Dringender Benachrichtigungskontakt für dieses Dokument
    questionnaire.item.type:
      value: group
    questionnaire.item.item:
      index: 0
      questionnaire.item.link id:
        value: order.notificationContactDocument.practitioner
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner
      questionnaire.item.text:
        value: Zu benachrichtigende Person
      questionnaire.item.type:
        value: group
      questionnaire.item.item:
        index: 0
      questionnaire.item.item:
        index: 1
      questionnaire.item.item:
        index: 2

value: order.notificationContactDocument.practitioner.title

value: Titel

index: 0
questionnaire response.item.answer.value string:
  value: Dr. med.

value: order.notificationContactDocument.practitioner.familyName

value: Name

index: 0
questionnaire response.item.answer.value string:
  value: Iller

value: order.notificationContactDocument.practitioner.givenName

value: Vorname

index: 0
questionnaire response.item.answer.value string:
  value: Frederica

value: order.notificationContactDocument.practitioner.phone

value: Telefon

index: 0
questionnaire response.item.answer.value string:
  value: 044 503 44 44

value: order.notificationContactDocument.practitioner.email

value: E-Mail

index: 0

value: order.notificationContactDocumentResponse.practitioner.title

value: Titel

index: 0
questionnaire response.item.answer.value string:
  value: Dr. med.

value: order.notificationContactDocumentResponse.practitioner.familyName

value: Name

index: 0
questionnaire response.item.answer.value string:
  value: Lacer

value: order.notificationContactDocumentResponse.practitioner.givenName

value: Vorname

index: 0
questionnaire response.item.answer.value string:
  value: Paul

value: order.notificationContactDocumentResponse.practitioner.phone

value: Telefon

index: 0
questionnaire response.item.answer.value string:
  value: 044 987 65 43

value: order.notificationContactDocumentResponse.practitioner.email

value: E-Mail

index: 0

value: stat

value: Dr. med.

value: Iller

value: Frederica

value: 7601000099521

value: 044 503 44 44

value: University Hospital

value: Uniweg 33

value: Radiology

value: 8000

value: Zürich

value: Schweiz

index: 0
questionnaire response.item.link id:
  value: patient.familyName
questionnaire response.item.text:
  value: Name
questionnaire response.item.answer:
  index: 0
  questionnaire response.item.answer.value string:
    value: Ufferer

index: 1
questionnaire response.item.link id:
  value: patient.maidenName
questionnaire response.item.text:
  value: Ledigname
questionnaire response.item.answer:
  index: 0
  questionnaire response.item.answer.value string:
    value: Leidend

index: 2
questionnaire response.item.link id:
  value: patient.givenName
questionnaire response.item.text:
  value: Vorname
questionnaire response.item.answer:
  index: 0
  questionnaire response.item.answer.value string:
    value: Susanna

index: 3
questionnaire response.item.link id:
  value: patient.localPid
questionnaire response.item.text:
  value: Lokale Patienten-ID
questionnaire response.item.answer:
  index: 0
  questionnaire response.item.answer.value string:
    value: 44.34.9472.1

index: 4
questionnaire response.item.link id:
  value: patient.birthDate
questionnaire response.item.text:
  value: Geburtsdatum
questionnaire response.item.answer:
  index: 0
  questionnaire response.item.answer.value date:
    value: 1970-03-14

index: 5
questionnaire response.item.link id:
  value: patient.gender
questionnaire response.item.text:
  value: Geschlecht
questionnaire response.item.answer:
  index: 0
  questionnaire response.item.answer.value coding:
    coding.system:
      value: http://hl7.org/fhir/administrative-gender
    coding.code:
      value: female

index: 6
questionnaire response.item.link id:
  value: patient.phone
questionnaire response.item.text:
  value: Telefon
questionnaire response.item.answer:
  index: 0
  questionnaire response.item.answer.value string:
    value: 079 979 79 79

index: 7
questionnaire response.item.link id:
  value: patient.email
questionnaire response.item.text:
  value: E-Mail
questionnaire response.item.answer:
  index: 0

index: 8
questionnaire response.item.link id:
  value: patient.streetAddressLine
questionnaire response.item.text:
  value: Strasse, Hausnummer, Postfach etc.
questionnaire response.item.answer:
  index: 0
  questionnaire response.item.answer.value string:
    value: Musterweg
questionnaire response.item.answer:
  index: 1
  questionnaire response.item.answer.value string:
    value: 6a

index: 9
questionnaire response.item.link id:
  value: patient.postalCode
questionnaire response.item.text:
  value: PLZ
questionnaire response.item.answer:
  index: 0
  questionnaire response.item.answer.value string:
    value: 8000

index: 10
questionnaire response.item.link id:
  value: patient.city
questionnaire response.item.text:
  value: Ort
questionnaire response.item.answer:
  index: 0
  questionnaire response.item.answer.value string:
    value: Zürich

index: 11
questionnaire response.item.link id:
  value: patient.country
questionnaire response.item.text:
  value: Land
questionnaire response.item.answer:
  index: 0
  questionnaire response.item.answer.value string:
    value: Schweiz

index: 3
questionnaire response.item.link id:
  value: sender
questionnaire response.item.text:
  value: Absender
questionnaire response.item.item:
  index: 0
  questionnaire response.item.link id:
    value: sender.author
  questionnaire response.item.text:
    value: Verantwortlicher
  questionnaire response.item.item:
    index: 0
    questionnaire response.item.link id:
      value: sender.author.practitioner
    questionnaire response.item.text:
      value: Verantwortliche Person
    questionnaire response.item.item:
      index: 0
      questionnaire response.item.link id:
        value: sender.author.practitioner.title
      questionnaire response.item.text:
        value: Titel
      questionnaire response.item.answer:
        index: 0
    questionnaire response.item.item:
      index: 1
      questionnaire response.item.link id:
        value: sender.author.practitioner.familyName
      questionnaire response.item.text:
        value: Name
      questionnaire response.item.answer:
        index: 0
    questionnaire response.item.item:
      index: 2
      questionnaire response.item.link id:
        value: sender.author.practitioner.givenName
      questionnaire response.item.text:
        value: Vorname
      questionnaire response.item.answer:
        index: 0
    questionnaire response.item.item:
      index: 3
      questionnaire response.item.link id:
        value: sender.author.practitioner.gln
      questionnaire response.item.text:
        value: GLN
      questionnaire response.item.answer:
        index: 0
    questionnaire response.item.item:
      index: 4
      questionnaire response.item.link id:
        value: sender.author.practitioner.phone
      questionnaire response.item.text:
        value: Telefon
      questionnaire response.item.answer:
        index: 0
    questionnaire response.item.item:
      index: 5
      questionnaire response.item.link id:
        value: sender.author.practitioner.email
      questionnaire response.item.text:
        value: E-Mail
      questionnaire response.item.answer:
        index: 0
  questionnaire response.item.item:
    index: 1
    questionnaire response.item.link id:
      value: sender.author.organization
    questionnaire response.item.text:
      value: Verantwortliche Organisation
    questionnaire response.item.item:
      index: 0
      questionnaire response.item.link id:
        value: sender.author.organization.name
      questionnaire response.item.text:
        value: Name der Organisation
      questionnaire response.item.answer:
        index: 0
    questionnaire response.item.item:
      index: 1
      questionnaire response.item.link id:
        value: sender.author.organization.streetAddressLine
      questionnaire response.item.text:
        value: Strasse, Hausnummer, Postfach etc.
      questionnaire response.item.answer:
        index: 0
    questionnaire response.item.item:
      index: 2
      questionnaire response.item.link id:
        value: sender.author.organization.postalCode
      questionnaire response.item.text:
        value: PLZ
      questionnaire response.item.answer:
        index: 0
    questionnaire response.item.item:
      index: 3
      questionnaire response.item.link id:
        value: sender.author.organization.city
      questionnaire response.item.text:
        value: Ort
      questionnaire response.item.answer:
        index: 0
    questionnaire response.item.item:
      index: 4
      questionnaire response.item.link id:
        value: sender.author.organization.country
      questionnaire response.item.text:
        value: Land
      questionnaire response.item.answer:
        index: 0

value: Dr. med.

value: Lacer

value: Paul

value: 7601003334499

value: 044 987 65 43

value: Regional Hospital

value: Musterstrasse 129

value: 8000

value: Zürich

value: Schweiz

value: order.notificationContactDocument.practitioner.title

value: Titel

value: string

value: order.notificationContactDocument.practitioner.familyName

value: Name

value: string

value: order.notificationContactDocument.practitioner.givenName

value: Vorname

value: string

index: 3
questionnaire.item.link id:
  value: order.notificationContactDocument.practitioner.phone
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value
questionnaire.item.text:
  value: Telefon
questionnaire.item.type:
  value: string

index: 4
questionnaire.item.link id:
  value: order.notificationContactDocument.practitioner.email
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value
questionnaire.item.text:
  value: E-Mail
questionnaire.item.type:
  value: string

index: 6
questionnaire.item.link id:
  value: order.notificationContactDocumentResponse
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension:urgentNoficationContactForTheResponseToThisDocument
questionnaire.item.text:
  value: Dringender Benachrichtigungskontakt für die Antwort auf dieses Dokument
questionnaire.item.type:
  value: group
questionnaire.item.item:
  index: 0
  questionnaire.item.link id:
    value: order.notificationContactDocumentResponse.practitioner
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner
  questionnaire.item.text:
    value: Zu benachrichtigende Person
  questionnaire.item.type:
    value: group
  questionnaire.item.item:
    index: 0
    questionnaire.item.link id:
      value: order.notificationContactDocumentResponse.practitioner.title
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.prefix
    questionnaire.item.text:
      value: Titel
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 1
    questionnaire.item.link id:
      value: order.notificationContactDocumentResponse.practitioner.familyName
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.family
    questionnaire.item.text:
      value: Name
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 2
    questionnaire.item.link id:
      value: order.notificationContactDocumentResponse.practitioner.givenName
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.given
    questionnaire.item.text:
      value: Vorname
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 3
    questionnaire.item.link id:
      value: order.notificationContactDocumentResponse.practitioner.phone
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value
    questionnaire.item.text:
      value: Telefon
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 4
    questionnaire.item.link id:
      value: order.notificationContactDocumentResponse.practitioner.email
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value
    questionnaire.item.text:
      value: E-Mail
    questionnaire.item.type:
      value: string

index: 7
questionnaire.item.link id:
  value: order.priority
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.priority
questionnaire.item.text:
  value: Auftragspriorität
questionnaire.item.type:
  value: choice
questionnaire.item.answer option:
  index: 0
  questionnaire.item.answer option.value coding:
    coding.system:
      value: http://hl7.org/fhir/request-priority
    coding.code:
      value: routine
    coding.display:
      value: Die Anfrage hat normale Priorität.
  questionnaire.item.answer option.initial selected:
    value: true
questionnaire.item.answer option:
  index: 1
  questionnaire.item.answer option.value coding:
    coding.system:
      value: http://hl7.org/fhir/request-priority
    coding.code:
      value: urgent
    coding.display:
      value: Die Anfrage sollte dringend bearbeitet werden - höhere Priorität als normal.
questionnaire.item.answer option:
  index: 2
  questionnaire.item.answer option.value coding:
    coding.system:
      value: http://hl7.org/fhir/request-priority
    coding.code:
      value: asap
    coding.display:
      value: Die Anfrage sollte so schnell wie möglich bearbeitet werden - höhere Priorität als dringend.
questionnaire.item.answer option:
  index: 3
  questionnaire.item.answer option.value coding:
    coding.system:
      value: http://hl7.org/fhir/request-priority
    coding.code:
      value: stat
    coding.display:
      value: Die Anfrage sollte sofort bearbeitet werden - höchstmögliche Priorität. Z.B. bei einem Notfall.

index: 1
questionnaire.item.link id:
  value: receiver
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension:receiver
questionnaire.item.text:
  value: Empfänger
questionnaire.item.type:
  value: group
questionnaire.item.item:
  index: 0
  questionnaire.item.link id:
    value: receiver.practitioner
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner
  questionnaire.item.text:
    value: Empfangende Person
  questionnaire.item.type:
    value: group
  questionnaire.item.item:
    index: 0
    questionnaire.item.link id:
      value: receiver.practitioner.title
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.prefix
    questionnaire.item.text:
      value: Titel
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 1
    questionnaire.item.link id:
      value: receiver.practitioner.familyName
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.family
    questionnaire.item.text:
      value: Name
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 2
    questionnaire.item.link id:
      value: receiver.practitioner.givenName
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.given
    questionnaire.item.text:
      value: Vorname
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 3
    questionnaire.item.link id:
      value: receiver.practitioner.gln
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.identifier:GLN.value
    questionnaire.item.text:
      value: GLN
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 4
    questionnaire.item.link id:
      value: receiver.practitioner.zsr
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.identifier:ZSR.value
    questionnaire.item.text:
      value: ZSR
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 5
    questionnaire.item.link id:
      value: receiver.practitioner.phone
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value
    questionnaire.item.text:
      value: Telefon
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 6
    questionnaire.item.link id:
      value: receiver.practitioner.email
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value
    questionnaire.item.text:
      value: E-Mail
    questionnaire.item.type:
      value: string
questionnaire.item.item:
  index: 1
  questionnaire.item.link id:
    value: receiver.organization
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.organization
  questionnaire.item.text:
    value: Empfangende Organisation
  questionnaire.item.type:
    value: group
  questionnaire.item.item:
    index: 0
    questionnaire.item.link id:
      value: receiver.organization.name
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.name
    questionnaire.item.text:
      value: Name der Organisation
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 1
    questionnaire.item.link id:
      value: receiver.organization.gln
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.identifier:GLN
    questionnaire.item.text:
      value: GLN
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 2
    questionnaire.item.link id:
      value: receiver.organization.streetAddressLine
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.address.line
    questionnaire.item.text:
      value: Strasse, Hausnummer, Postfach etc.
    questionnaire.item.type:
      value: string
    questionnaire.item.repeats:
      value: true
  questionnaire.item.item:
    index: 3
    questionnaire.item.link id:
      value: receiver.organization.postalCode
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.address.postalCode
    questionnaire.item.text:
      value: PLZ
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 4
    questionnaire.item.link id:
      value: receiver.organization.city
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.address.city
    questionnaire.item.text:
      value: Ort
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 5
    questionnaire.item.link id:
      value: receiver.organization.country
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.address.country
    questionnaire.item.text:
      value: Land
    questionnaire.item.type:
      value: string

index: 2
questionnaire.item.link id:
  value: patient
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.subject
questionnaire.item.text:
  value: Patient
questionnaire.item.type:
  value: group
questionnaire.item.required:
  value: true
questionnaire.item.item:
  index: 0
  questionnaire.item.link id:
    value: patient.familyName
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.name.family
  questionnaire.item.text:
    value: Name
  questionnaire.item.type:
    value: string
questionnaire.item.item:
  index: 1
  questionnaire.item.link id:
    value: patient.maidenName
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.name.family
  questionnaire.item.text:
    value: Ledigname
  questionnaire.item.type:
    value: string
questionnaire.item.item:
  index: 2
  questionnaire.item.link id:
    value: patient.givenName
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.name.given
  questionnaire.item.text:
    value: Vorname
  questionnaire.item.type:
    value: string
questionnaire.item.item:
  index: 3
  questionnaire.item.link id:
    value: patient.localPid
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.identifier:LocalPid.value
  questionnaire.item.text:
    value: Lokale Patienten-ID
  questionnaire.item.type:
    value: string
questionnaire.item.item:
  index: 4
  element.extension:
    index: 0
    extension.url:
      value: http://hl7.org/fhir/StructureDefinition/questionnaire-hidden
    extension.value boolean:
      value: true
  questionnaire.item.link id:
    value: patient.localPidDomain
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.identifier:LocalPid.system
  questionnaire.item.text:
    value: Lokale Patienten-ID Domain
  questionnaire.item.type:
    value: string
questionnaire.item.item:
  index: 5
  questionnaire.item.link id:
    value: patient.birthDate
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.birthDate
  questionnaire.item.text:
    value: Geburtsdatum
  questionnaire.item.type:
    value: date
questionnaire.item.item:
  index: 6
  questionnaire.item.link id:
    value: patient.gender
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.gender
  questionnaire.item.text:
    value: Geschlecht
  questionnaire.item.type:
    value: choice
  questionnaire.item.answer option:
    index: 0
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://hl7.org/fhir/administrative-gender
      coding.code:
        value: male
      coding.display:
        value: Männlich
    questionnaire.item.answer option.initial selected:
      value: true
  questionnaire.item.answer option:
    index: 1
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://hl7.org/fhir/administrative-gender
      coding.code:
        value: female
      coding.display:
        value: Weiblich
  questionnaire.item.answer option:
    index: 2
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://hl7.org/fhir/administrative-gender
      coding.code:
        value: other
      coding.display:
        value: Anderes
questionnaire.item.item:
  index: 7
  questionnaire.item.link id:
    value: patient.maritalStatus
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.maritalStatus
  questionnaire.item.text:
    value: Zivilstand
  questionnaire.item.type:
    value: choice
  questionnaire.item.answer option:
    index: 0
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus
      coding.code:
        value: 1
      coding.display:
        value: ledig
  questionnaire.item.answer option:
    index: 1
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus
      coding.code:
        value: 2
      coding.display:
        value: verheiratet
  questionnaire.item.answer option:
    index: 2
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus
      coding.code:
        value: 3
      coding.display:
        value: verwitwet
  questionnaire.item.answer option:
    index: 3
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus
      coding.code:
        value: 4
      coding.display:
        value: geschieden
  questionnaire.item.answer option:
    index: 4
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus
      coding.code:
        value: 5
      coding.display:
        value: unverheiratet
  questionnaire.item.answer option:
    index: 5
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus
      coding.code:
        value: 6
      coding.display:
        value: in eingetragener Partnerschaft
  questionnaire.item.answer option:
    index: 6
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus
      coding.code:
        value: 7
      coding.display:
        value: aufgelöste Partnerschaft
  questionnaire.item.answer option:
    index: 7
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus
      coding.code:
        value: 9
      coding.display:
        value: unbekannt
questionnaire.item.item:
  index: 8
  questionnaire.item.link id:
    value: patient.phone

value: Telefon

value: string

value: true

index: 9
questionnaire.item.link id:
  value: patient.email
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.telecom.value
questionnaire.item.text:
  value: E-Mail
questionnaire.item.type:
  value: string

index: 10
questionnaire.item.link id:
  value: patient.streetAddressLine
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.address.line
questionnaire.item.text:
  value: Strasse, Hausnummer, Postfach etc.
questionnaire.item.type:
  value: string
questionnaire.item.repeats:
  value: true

index: 11
questionnaire.item.link id:
  value: patient.postalCode
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.address.postalCode
questionnaire.item.text:
  value: PLZ
questionnaire.item.type:
  value: string

index: 12
questionnaire.item.link id:
  value: patient.city
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.address.city
questionnaire.item.text:
  value: Ort
questionnaire.item.type:
  value: string

index: 13
questionnaire.item.link id:
  value: patient.country
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.address.country
questionnaire.item.text:
  value: Land
questionnaire.item.type:
  value: string

index: 14
questionnaire.item.link id:
  value: patient.languageOfCorrespondance
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.communication:languageOfCorrespondance
questionnaire.item.text:
  value: Korrespondenssprache
questionnaire.item.type:
  value: choice
questionnaire.item.answer value set:
  value: http://fhir.ch/ig/ch-epr-term/ValueSet/DocumentEntry.languageCode
  link: http://fhir.ch/ig/ch-epr-term/ValueSet/DocumentEntry.languageCode

index: 15
questionnaire.item.link id:
  value: patient.contactperson
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.contact
questionnaire.item.text:
  value: Kontaktperson
questionnaire.item.type:
  value: group
questionnaire.item.item:
  index: 0
  questionnaire.item.link id:
    value: patient.contactperson.relationship
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.contact.relationship.text
  questionnaire.item.text:
    value: Beziehung
  questionnaire.item.type:
    value: string
questionnaire.item.item:
  index: 1
  questionnaire.item.link id:
    value: patient.contactperson.familyName
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.contact.name.family
  questionnaire.item.text:
    value: Name
  questionnaire.item.type:
    value: string
questionnaire.item.item:
  index: 2
  questionnaire.item.link id:
    value: patient.contactperson.givenName
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.contact.name.given
  questionnaire.item.text:
    value: Vorname
  questionnaire.item.type:
    value: string
questionnaire.item.item:
  index: 3
  questionnaire.item.link id:
    value: patient.contactperson.phone
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.contact.telecom.value
  questionnaire.item.text:
    value: Telefon
  questionnaire.item.type:
    value: string
  questionnaire.item.repeats:
    value: true
questionnaire.item.item:
  index: 4
  questionnaire.item.link id:
    value: patient.contactperson.email
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.contact.telecom.value
  questionnaire.item.text:
    value: E-Mail
  questionnaire.item.type:
    value: string

index: 3
questionnaire.item.link id:
  value: requestedEncounter
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.extension:requestedEncounterDetails
questionnaire.item.text:
  value: Patientenaufnahme
questionnaire.item.type:
  value: group
questionnaire.item.item:
  index: 0
  questionnaire.item.link id:
    value: requestedEncounter.class
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-encounter#Encounter.class
  questionnaire.item.text:
    value: Voraussichtlich: Ambulant / Stationär / Notfall
  questionnaire.item.type:
    value: choice
  questionnaire.item.answer option:
    index: 0
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/v3-ActCode
      coding.code:
        value: AMB
      coding.display:
        value: Ambulant
  questionnaire.item.answer option:
    index: 1
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/v3-ActCode
      coding.code:
        value: IMP
      coding.display:
        value: Stationär
  questionnaire.item.answer option:
    index: 2
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/v3-ActCode
      coding.code:
        value: EMER
      coding.display:
        value: Notfall
questionnaire.item.item:
  index: 1
  questionnaire.item.link id:
    value: requestedEncounter.desiredAccommodation
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-encounter#Encounter.extension:desiredAccommodation
  questionnaire.item.text:
    value: Zimmerkategorie
  questionnaire.item.type:
    value: choice
  questionnaire.item.answer option:
    index: 0
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://fhir.ch/ig/ch-core/CodeSystem/bfs-medstats-21-encountertype
      coding.code:
        value: 1
      coding.display:
        value: allgemein
  questionnaire.item.answer option:
    index: 1
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://fhir.ch/ig/ch-core/CodeSystem/bfs-medstats-21-encountertype
      coding.code:
        value: 2
      coding.display:
        value: halbprivat
  questionnaire.item.answer option:
    index: 2
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://fhir.ch/ig/ch-core/CodeSystem/bfs-medstats-21-encountertype
      coding.code:
        value: 3
      coding.display:
        value: privat

index: 4
questionnaire.item.link id:
  value: coverage
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.insurance
questionnaire.item.text:
  value: Kostenträger
questionnaire.item.type:
  value: group
questionnaire.item.item:
  index: 0
  questionnaire.item.link id:
    value: coverage.beneficiary
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.beneficiary
  questionnaire.item.text:
    value: Begünstigter (Patient)
  questionnaire.item.type:
    value: group
  questionnaire.item.item:
    index: 0
    questionnaire.item.link id:
      value: coverage.beneficiary.ahvn13
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.identifier:AHVN13
    questionnaire.item.text:
      value: AHV-Nr. des Patienten
    questionnaire.item.type:
      value: string
questionnaire.item.item:
  index: 1
  questionnaire.item.link id:
    value: coverage.kvg
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type
  questionnaire.item.text:
    value: Krankenkasse (nach KVG)
  questionnaire.item.type:
    value: group
  questionnaire.item.item:
    index: 0
    questionnaire.item.link id:
      value: coverage.kvg.name
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor
    questionnaire.item.text:
      value: Name der Versicherung
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 1
    questionnaire.item.link id:
      value: coverage.kvg.insuranceCardNumber
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier
    questionnaire.item.text:
      value: Kennnummer der Versichertenkarte
    questionnaire.item.type:
      value: string
questionnaire.item.item:
  index: 2
  questionnaire.item.link id:
    value: coverage.uvg
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type
  questionnaire.item.text:
    value: Unfallversicherung (nach UVG)
  questionnaire.item.type:
    value: group
  questionnaire.item.item:
    index: 0
    questionnaire.item.link id:
      value: coverage.uvg.name
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor
    questionnaire.item.text:
      value: Name der Versicherung
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 1
    questionnaire.item.link id:
      value: coverage.uvg.claimNumber
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier
    questionnaire.item.text:
      value: Schadennummer
    questionnaire.item.type:
      value: string
questionnaire.item.item:
  index: 3
  questionnaire.item.link id:
    value: coverage.vvg
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type
  questionnaire.item.text:
    value: Zusatzversicherung (nach VVG)
  questionnaire.item.type:
    value: group
  questionnaire.item.item:
    index: 0
    questionnaire.item.link id:
      value: coverage.vvg.name
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor
    questionnaire.item.text:
      value: Name der Versicherung
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 1
    questionnaire.item.link id:
      value: coverage.vvg.insuranceCardNumber
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier
    questionnaire.item.text:
      value: Kennnummer der Versichertenkarte
    questionnaire.item.type:
      value: string
questionnaire.item.item:
  index: 4
  questionnaire.item.link id:
    value: coverage.iv
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type
  questionnaire.item.text:
    value: Invalidenversicherung (IV)
  questionnaire.item.type:
    value: group
  questionnaire.item.item:
    index: 0
    questionnaire.item.link id:
      value: coverage.iv.verfuegungsnummer
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier
    questionnaire.item.text:
      value: IV-Verfügungsnummer
    questionnaire.item.type:
      value: string
questionnaire.item.item:
  index: 5
  questionnaire.item.link id:
    value: coverage.mv
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type
  questionnaire.item.text:
    value: Militärversicherung (MV)
  questionnaire.item.type:
    value: group
  questionnaire.item.item:
    index: 0
    questionnaire.item.link id:
      value: coverage.mv.versichertennummer
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier
    questionnaire.item.text:
      value: MV-Versichertennummer
    questionnaire.item.type:
      value: string
questionnaire.item.item:
  index: 6
  questionnaire.item.link id:
    value: coverage.self
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type
  questionnaire.item.text:
    value: Selbstzahler
  questionnaire.item.type:
    value: group
  questionnaire.item.item:
    index: 0
    questionnaire.item.link id:
      value: coverage.self.patient
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor
    questionnaire.item.text:
      value: Patient selbst
    questionnaire.item.type:
      value: boolean
  questionnaire.item.item:
    index: 1
    questionnaire.item.link id:
      value: coverage.self.patientRelatedPerson
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor
    questionnaire.item.text:
      value: Andere Person
    questionnaire.item.type:
      value: boolean
    questionnaire.item.enable when:
      index: 0
      questionnaire.item.enable when.question:
        value: coverage.self.patient
      questionnaire.item.enable when.operator:
        value: =
      questionnaire.item.enable when.answer boolean:
        value: false
  questionnaire.item.item:
    index: 2
    questionnaire.item.link id:
      value: coverage.self.relatedPerson
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor

value: Andere Person

value: group

index: 0
questionnaire.item.enable when.question:
  value: coverage.self.patientRelatedPerson
questionnaire.item.enable when.operator:
  value: =
questionnaire.item.enable when.answer boolean:
  value: true

index: 0
questionnaire.item.link id:
  value: coverage.self.relatedPerson.familyName
questionnaire.item.definition:
  value: http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.name.family
questionnaire.item.text:
  value: Name
questionnaire.item.type:
  value: string

index: 1
questionnaire.item.link id:
  value: coverage.self.relatedPerson.givenName
questionnaire.item.definition:
  value: http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.name.given
questionnaire.item.text:
  value: Vorname
questionnaire.item.type:
  value: string

index: 2
questionnaire.item.link id:
  value: coverage.self.relatedPerson.phone
questionnaire.item.definition:
  value: http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.telecom.value
questionnaire.item.text:
  value: Telefon
questionnaire.item.type:
  value: string
questionnaire.item.repeats:
  value: true

index: 3
questionnaire.item.link id:
  value: coverage.self.relatedPerson.email
questionnaire.item.definition:
  value: http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.telecom.value
questionnaire.item.text:
  value: E-Mail
questionnaire.item.type:
  value: string

index: 4
questionnaire.item.link id:
  value: coverage.self.relatedPerson.streetAddressLine
questionnaire.item.definition:
  value: http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.address.line
questionnaire.item.text:
  value: Strasse, Hausnummer, Postfach etc.
questionnaire.item.type:
  value: string
questionnaire.item.repeats:
  value: true

index: 5
questionnaire.item.link id:
  value: coverage.self.relatedPerson.postalCode
questionnaire.item.definition:
  value: http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.address.postalCode
questionnaire.item.text:
  value: PLZ
questionnaire.item.type:
  value: string

index: 6
questionnaire.item.link id:
  value: coverage.self.relatedPerson.city
questionnaire.item.definition:
  value: http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.address.city
questionnaire.item.text:
  value: Ort
questionnaire.item.type:
  value: string

index: 7
questionnaire.item.link id:
  value: coverage.self.relatedPerson.country
questionnaire.item.definition:
  value: http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.address.country
questionnaire.item.text:
  value: Land
questionnaire.item.type:
  value: string

index: 7
questionnaire.item.link id:
  value: coverage.other
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type
questionnaire.item.text:
  value: Anderer Kostenträger
questionnaire.item.type:
  value: group
questionnaire.item.item:
  index: 0
  questionnaire.item.link id:
    value: coverage.other.name
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor
  questionnaire.item.text:
    value: Name des Kostenträgers
  questionnaire.item.type:
    value: string
questionnaire.item.item:
  index: 1
  questionnaire.item.link id:
    value: coverage.other.id
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier
  questionnaire.item.text:
    value: Beliebige ID
  questionnaire.item.type:
    value: string
questionnaire.item.item:
  index: 2
  questionnaire.item.link id:
    value: coverage.other.id.note
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier.type.text
  questionnaire.item.text:
    value: Bemerkung zur ID
  questionnaire.item.type:
    value: string

index: 5
questionnaire.item.link id:
  value: sender
questionnaire.item.text:
  value: Absender
questionnaire.item.type:
  value: group
questionnaire.item.required:
  value: true
questionnaire.item.item:
  index: 0
  questionnaire.item.link id:
    value: sender.author
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.author
  questionnaire.item.text:
    value: Verantwortlicher
  questionnaire.item.type:
    value: group
  questionnaire.item.required:
    value: true
  questionnaire.item.item:
    index: 0
    questionnaire.item.link id:
      value: sender.author.practitioner
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner
    questionnaire.item.text:
      value: Verantwortliche Person
    questionnaire.item.type:
      value: group
    questionnaire.item.item:
      index: 0
      questionnaire.item.link id:
        value: sender.author.practitioner.title
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.prefix
      questionnaire.item.text:
        value: Titel
      questionnaire.item.type:
        value: string
    questionnaire.item.item:
      index: 1
      questionnaire.item.link id:
        value: sender.author.practitioner.familyName
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.family
      questionnaire.item.text:
        value: Name
      questionnaire.item.type:
        value: string
    questionnaire.item.item:
      index: 2
      questionnaire.item.link id:
        value: sender.author.practitioner.givenName
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.given
      questionnaire.item.text:
        value: Vorname
      questionnaire.item.type:
        value: string
    questionnaire.item.item:
      index: 3
      questionnaire.item.link id:
        value: sender.author.practitioner.gln
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.identifier:GLN.value
      questionnaire.item.text:
        value: GLN
      questionnaire.item.type:
        value: string
    questionnaire.item.item:
      index: 4
      questionnaire.item.link id:
        value: sender.author.practitioner.zsr
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.identifier:ZSR.value
      questionnaire.item.text:
        value: ZSR
      questionnaire.item.type:
        value: string
    questionnaire.item.item:
      index: 5
      questionnaire.item.link id:
        value: sender.author.practitioner.phone
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value
      questionnaire.item.text:
        value: Telefon
      questionnaire.item.type:
        value: string
    questionnaire.item.item:
      index: 6
      questionnaire.item.link id:
        value: sender.author.practitioner.email
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value
      questionnaire.item.text:
        value: E-Mail
      questionnaire.item.type:
        value: string
  questionnaire.item.item:
    index: 1
    questionnaire.item.link id:
      value: sender.author.organization
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.organization
    questionnaire.item.text:
      value: Verantwortliche Organisation
    questionnaire.item.type:
      value: group
    questionnaire.item.item:
      index: 0
      questionnaire.item.link id:
        value: sender.author.organization.name
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.name
      questionnaire.item.text:
        value: Name der Organisation
      questionnaire.item.type:
        value: string
    questionnaire.item.item:
      index: 1
      questionnaire.item.link id:
        value: sender.author.organization.gln
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.identifier:GLN
      questionnaire.item.text:
        value: GLN
      questionnaire.item.type:
        value: string
    questionnaire.item.item:
      index: 2
      questionnaire.item.link id:
        value: sender.author.organization.streetAddressLine
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.address.line
      questionnaire.item.text:
        value: Strasse, Hausnummer, Postfach etc.
      questionnaire.item.type:
        value: string
      questionnaire.item.repeats:
        value: true
    questionnaire.item.item:
      index: 3
      questionnaire.item.link id:
        value: sender.author.organization.postalCode
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.address.postalCode
      questionnaire.item.text:
        value: PLZ
      questionnaire.item.type:
        value: string
    questionnaire.item.item:
      index: 4
      questionnaire.item.link id:
        value: sender.author.organization.city
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.address.city
      questionnaire.item.text:
        value: Ort
      questionnaire.item.type:
        value: string
    questionnaire.item.item:
      index: 5
      questionnaire.item.link id:
        value: sender.author.organization.country
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.address.country
      questionnaire.item.text:
        value: Land
      questionnaire.item.type:
        value: string
questionnaire.item.item:
  index: 1
  questionnaire.item.link id:
    value: sender.dataenterer
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension:dataEnterer
  questionnaire.item.text:
    value: Erfasser
  questionnaire.item.type:
    value: group
  questionnaire.item.item:
    index: 0
    questionnaire.item.link id:
      value: sender.dataenterer.practitioner
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner
    questionnaire.item.text:
      value: Erfassende Person
    questionnaire.item.type:
      value: group
    questionnaire.item.item:
      index: 0
      questionnaire.item.link id:
        value: sender.dataenterer.practitioner.familyName
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.family
      questionnaire.item.text:
        value: Name
      questionnaire.item.type:
        value: string

index: 1
questionnaire.item.link id:
  value: sender.dataenterer.practitioner.givenName
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.given
questionnaire.item.text:
  value: Vorname
questionnaire.item.type:
  value: string

index: 2
questionnaire.item.link id:
  value: sender.dataenterer.practitioner.phone
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value
questionnaire.item.text:
  value: Telefon
questionnaire.item.type:
  value: string

index: 3
questionnaire.item.link id:
  value: sender.dataenterer.practitioner.email
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value
questionnaire.item.text:
  value: E-Mail
questionnaire.item.type:
  value: string

index: 6
questionnaire.item.link id:
  value: receiverCopy
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension:copyReceiver
questionnaire.item.text:
  value: Kopieempfänger (Kopie dieses Auftrags und aller daraus resultierenden Resultate)
questionnaire.item.type:
  value: group
questionnaire.item.item:
  index: 0
  questionnaire.item.link id:
    value: receiverCopy.practitionerRole
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole
  questionnaire.item.text:
    value: Gesundheitsfachperson oder -organisation
  questionnaire.item.type:
    value: group
  questionnaire.item.repeats:
    value: true
  questionnaire.item.item:
    index: 0
    questionnaire.item.link id:
      value: receiverCopy.practitionerRole.practitioner
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner
    questionnaire.item.text:
      value: Gesundheitsfachperson
    questionnaire.item.type:
      value: group
    questionnaire.item.item:
      index: 0
      questionnaire.item.link id:
        value: receiverCopy.practitionerRole.practitioner.title
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-humanname#HumanName.prefix
      questionnaire.item.text:
        value: Titel
      questionnaire.item.type:
        value: string
    questionnaire.item.item:
      index: 1
      questionnaire.item.link id:
        value: receiverCopy.practitionerRole.practitioner.familyName
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-humanname#HumanName.family
      questionnaire.item.text:
        value: Name
      questionnaire.item.type:
        value: string
    questionnaire.item.item:
      index: 2
      questionnaire.item.link id:
        value: receiverCopy.practitionerRole.practitioner.givenName
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-humanname#HumanName.given
      questionnaire.item.text:
        value: Vorname
      questionnaire.item.type:
        value: string
    questionnaire.item.item:
      index: 3
      questionnaire.item.link id:
        value: receiverCopy.practitionerRole.practitioner.phone
      questionnaire.item.definition:
        value: http://hl7.org/fhir/StructureDefinition/ContactPoint#ContactPoint.value
      questionnaire.item.text:
        value: Telefon
      questionnaire.item.type:
        value: string
    questionnaire.item.item:
      index: 4
      questionnaire.item.link id:
        value: receiverCopy.practitionerRole.practitioner.email
      questionnaire.item.definition:
        value: http://hl7.org/fhir/StructureDefinition/ContactPoint#ContactPoint.value
      questionnaire.item.text:
        value: E-Mail
      questionnaire.item.type:
        value: string
  questionnaire.item.item:
    index: 1
    questionnaire.item.link id:
      value: receiverCopy.practitionerRole.organization
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.organization
    questionnaire.item.text:
      value: Gesundheitsorganisatiton
    questionnaire.item.type:
      value: group
    questionnaire.item.item:
      index: 0
      questionnaire.item.link id:
        value: receiverCopy.practitionerRole.organization.name
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.name
      questionnaire.item.text:
        value: Name der Organisation
      questionnaire.item.type:
        value: string
    questionnaire.item.item:
      index: 1
      questionnaire.item.link id:
        value: receiverCopy.practitionerRole.organization.streetAddressLine
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-address#Address.line
      questionnaire.item.text:
        value: Strasse, Hausnummer, Postfach etc.
      questionnaire.item.type:
        value: string
      questionnaire.item.repeats:
        value: true
    questionnaire.item.item:
      index: 2
      questionnaire.item.link id:
        value: receiverCopy.practitionerRole.organization.postalCode
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-address#Address.postalCode
      questionnaire.item.text:
        value: PLZ
      questionnaire.item.type:
        value: string
    questionnaire.item.item:
      index: 3
      questionnaire.item.link id:
        value: receiverCopy.practitionerRole.organization.city
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-address#Address.city
      questionnaire.item.text:
        value: Ort
      questionnaire.item.type:
        value: string
    questionnaire.item.item:
      index: 4
      questionnaire.item.link id:
        value: receiverCopy.practitionerRole.organization.country
      questionnaire.item.definition:
        value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-address#Address.country
      questionnaire.item.text:
        value: Land
      questionnaire.item.type:
        value: string
questionnaire.item.item:
  index: 1
  questionnaire.item.link id:
    value: receiverCopy.patient
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient
  questionnaire.item.text:
    value: Patient selbst
  questionnaire.item.type:
    value: boolean
questionnaire.item.item:
  index: 2
  questionnaire.item.link id:
    value: receiverCopy.relatedPerson
  questionnaire.item.definition:
    value: http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson
  questionnaire.item.text:
    value: Andere Person
  questionnaire.item.type:
    value: group
  questionnaire.item.repeats:
    value: true
  questionnaire.item.item:
    index: 0
    questionnaire.item.link id:
      value: receiverCopy.relatedPerson.familyName
    questionnaire.item.definition:
      value: http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.name.family
    questionnaire.item.text:
      value: Name
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 1
    questionnaire.item.link id:
      value: receiverCopy.relatedPerson.givenName
    questionnaire.item.definition:
      value: http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.name.given
    questionnaire.item.text:
      value: Vorame
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 2
    questionnaire.item.link id:
      value: receiverCopy.relatedPerson.phone
    questionnaire.item.definition:
      value: http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.telecom.value
    questionnaire.item.text:
      value: Telefon
    questionnaire.item.type:
      value: string
    questionnaire.item.repeats:
      value: true
  questionnaire.item.item:
    index: 3
    questionnaire.item.link id:
      value: receiverCopy.relatedPerson.email
    questionnaire.item.definition:
      value: http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.telecom.value

value: E-Mail

value: string

index: 4
questionnaire.item.link id:
  value: receiverCopy.relatedPerson.streetAddressLine
questionnaire.item.definition:
  value: http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.address.line
questionnaire.item.text:
  value: Strasse, Hausnummer, Postfach etc.
questionnaire.item.type:
  value: string
questionnaire.item.repeats:
  value: true

index: 5
questionnaire.item.link id:
  value: receiverCopy.relatedPerson.postalCode
questionnaire.item.definition:
  value: http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.address.postalCode
questionnaire.item.text:
  value: PLZ
questionnaire.item.type:
  value: string

index: 6
questionnaire.item.link id:
  value: receiverCopy.relatedPerson.city
questionnaire.item.definition:
  value: http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.address.city
questionnaire.item.text:
  value: Ort
questionnaire.item.type:
  value: string

index: 7
questionnaire.item.link id:
  value: receiverCopy.relatedPerson.country
questionnaire.item.definition:
  value: http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.address.country
questionnaire.item.text:
  value: Land
questionnaire.item.type:
  value: string

index: 7
questionnaire.item.link id:
  value: appointment
questionnaire.item.definition:
  value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.extension:locationAndTime
questionnaire.item.text:
  value: Ort und Zeit der Durchführung der angeforderten Leistung
questionnaire.item.type:
  value: group
questionnaire.item.repeats:
  value: true
questionnaire.item.item:
  index: 0
  questionnaire.item.link id:
    value: appointment.location
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-appointment#Appointment.participant.actor
  questionnaire.item.text:
    value: Ort der Durchführung
  questionnaire.item.type:
    value: group
  questionnaire.item.required:
    value: true
  questionnaire.item.item:
    index: 0
    questionnaire.item.link id:
      value: appointment.location.name
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-location#Location.name
    questionnaire.item.text:
      value: Name
    questionnaire.item.type:
      value: string
    questionnaire.item.required:
      value: true
  questionnaire.item.item:
    index: 1
    questionnaire.item.link id:
      value: appointment.location.phone
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-location#Location.telecom.value
    questionnaire.item.text:
      value: Telefon
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 2
    questionnaire.item.link id:
      value: appointment.location.email
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-location#Location.telecom.value
    questionnaire.item.text:
      value: E-Mail
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 3
    questionnaire.item.link id:
      value: appointment.location.streetAddressLine
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-location#Location.address.line
    questionnaire.item.text:
      value: Strasse, Hausnummer, Postfach etc.
    questionnaire.item.type:
      value: string
    questionnaire.item.repeats:
      value: true
  questionnaire.item.item:
    index: 4
    questionnaire.item.link id:
      value: appointment.location.postalCode
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-location#Location.address.postalCode
    questionnaire.item.text:
      value: PLZ
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 5
    questionnaire.item.link id:
      value: appointment.location.city
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-location#Location.address.city
    questionnaire.item.text:
      value: Ort
    questionnaire.item.type:
      value: string
  questionnaire.item.item:
    index: 6
    questionnaire.item.link id:
      value: appointment.location.country
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-location#Location.address.country
    questionnaire.item.text:
      value: Land
    questionnaire.item.type:
      value: string
questionnaire.item.item:
  index: 1
  questionnaire.item.link id:
    value: appointment.requestedPeriod
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-appointment#Appointment.requestedPeriod
  questionnaire.item.text:
    value: Datum und Zeit, wann der Termin bevorzugt geplant werden soll
  questionnaire.item.type:
    value: group
  questionnaire.item.item:
    index: 0
    questionnaire.item.link id:
      value: appointment.requestedPeriod.start
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-appointment#Appointment.requestedPeriod.start
    questionnaire.item.text:
      value: Von
    questionnaire.item.type:
      value: dateTime
  questionnaire.item.item:
    index: 1
    questionnaire.item.link id:
      value: appointment.requestedPeriod.end
    questionnaire.item.definition:
      value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-appointment#Appointment.requestedPeriod.end
    questionnaire.item.text:
      value: Bis
    questionnaire.item.type:
      value: dateTime
questionnaire.item.item:
  index: 2
  questionnaire.item.link id:
    value: appointment.status
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-appointment#Appointment.status
  questionnaire.item.text:
    value: Status
  questionnaire.item.type:
    value: choice
  questionnaire.item.required:
    value: true
  questionnaire.item.answer option:
    index: 0
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://hl7.org/fhir/appointmentstatus
      coding.code:
        value: proposed
      coding.display:
        value: Wunsch des Patienten (vorgeschlagen)
    questionnaire.item.answer option.initial selected:
      value: true
  questionnaire.item.answer option:
    index: 1
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://hl7.org/fhir/appointmentstatus
      coding.code:
        value: pending
      coding.display:
        value: Vom Patienten bestätigt, aber vom Leistungserbringer noch nicht (ausstehend)
  questionnaire.item.answer option:
    index: 2
    questionnaire.item.answer option.value coding:
      coding.system:
        value: http://hl7.org/fhir/appointmentstatus
      coding.code:
        value: booked
      coding.display:
        value: Vom Patienten und Leistungserbringer bestätigt (gebucht)
questionnaire.item.item:
  index: 3
  questionnaire.item.link id:
    value: appointment.patientInstruction
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-appointment#Appointment.patientInstruction
  questionnaire.item.text:
    value: Patienteninformation für diesen Termin
  questionnaire.item.type:
    value: string

index: 8
questionnaire.item.link id:
  value: note
questionnaire.item.text:
  value: Bemerkungen
questionnaire.item.type:
  value: group
questionnaire.item.repeats:
  value: true
questionnaire.item.item:
  index: 0
  questionnaire.item.link id:
    value: note.text
  questionnaire.item.definition:
    value: http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.note.text
  questionnaire.item.text:
    value: Kommentar
  questionnaire.item.type:
    value: string
  questionnaire.item.required:
    value: true