This page is part of the CH ORF (R4) (v2.0.0: STU 2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

• Narrative Content
• XML
• JSON
• TTL

: Radiology Order - XML Representation

Raw xml | Download

<Bundle xmlns="http://hl7.org/fhir">
  <id value="radiology-order"/>
  <meta>
    <profile
             value="http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-document"/>
  </meta>
  <language value="de-CH"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:uuid:ac5fcff4-6f4c-4281-bc7c-451ee1047f15"/>
  </identifier>
  <type value="document"/>
  <timestamp value="2023-06-13T11:57:36+00:00"/>
  <entry>
    <fullUrl value="urn:uuid:c868aef5-ec90-4f43-be40-e5230fa49815"/>
    <resource>
      <Composition>
        <language value="de-CH"/>
        <text>
          <status value="extensions"/>
          <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="de-CH" lang="de-CH"><p><b>Generated Narrative: Composition</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Composition  (Language &quot;de-CH&quot;) </p></div><p><b>CH ORF Receiver</b>: <a href="#urnuuidb09d7c4d-a7b1-443c-8c3b-4d01675ad970">See above (urn:uuid:b09d7c4d-a7b1-443c-8c3b-4d01675ad970)</a></p><blockquote><p><b>EPR Data Enterer</b></p><blockquote><p><b>url</b></p><code>enterer</code></blockquote><p><b>value</b>: <a href="#urnuuidb6d4abb9-8c83-4d76-89d0-547c0b269f6d">See above (urn:uuid:b6d4abb9-8c83-4d76-89d0-547c0b269f6d)</a></p></blockquote><p><b>CH ORF Copy Receiver</b>: <a href="#urnuuid6e46d994-9eca-4c8f-a0e3-98c5911d45e2">See above (urn:uuid:6e46d994-9eca-4c8f-a0e3-98c5911d45e2)</a></p><p><b>status</b>: final</p><p><b>type</b>: 419891008 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#419891008)</span></p><p><b>category</b>: 721963009 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#721963009)</span></p><p><b>date</b>: 2023-06-13 11:57:36+0000</p><p><b>author</b>: <a href="#urnuuidde8d3b4f-1a57-48c0-9b03-a758ff8f2d2f">See above (urn:uuid:de8d3b4f-1a57-48c0-9b03-a758ff8f2d2f)</a></p><p><b>title</b>: Order and Referral by Form</p></div>
        </text>
        <extension
                   url="http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-receiver">
          <valueReference>
            <reference value="urn:uuid:b09d7c4d-a7b1-443c-8c3b-4d01675ad970"/>
          </valueReference>
        </extension>
        <extension
                   url="http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-epr-dataenterer">
          <extension url="enterer">
            <valueReference>
              <reference
                         value="urn:uuid:b6d4abb9-8c83-4d76-89d0-547c0b269f6d"/>
            </valueReference>
          </extension>
        </extension>
        <extension
                   url="http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-copyreceiver">
          <valueReference>
            <reference value="urn:uuid:6e46d994-9eca-4c8f-a0e3-98c5911d45e2"/>
          </valueReference>
        </extension>
        <status value="final"/>
        <type>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="419891008"/>
          </coding>
        </type>
        <category>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="721963009"/>
          </coding>
        </category>
        <subject>
          <reference value="urn:uuid:6e46d994-9eca-4c8f-a0e3-98c5911d45e2"/>
        </subject>
        <date value="2023-06-13T11:57:36+00:00"/>
        <author>
          <reference value="urn:uuid:de8d3b4f-1a57-48c0-9b03-a758ff8f2d2f"/>
        </author>
        <title value="Order and Referral by Form"/>
        <section>
          <title value="Order-Referral"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="93037-0"/>
              <display value="Portable medical order form"/>
            </coding>
          </code>
          <entry>
            <reference value="urn:uuid:1fa2627b-3cd4-4992-94e8-823610ed903e"/>
          </entry>
          <entry>
            <reference value="urn:uuid:bc5ac105-cdfe-49c0-b92b-fb378bed4f29"/>
          </entry>
          <entry>🔗 
            <reference
                       value="http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form"/>
          </entry>
        </section>
      </Composition>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:6e46d994-9eca-4c8f-a0e3-98c5911d45e2"/>
    <resource>
      <Patient>
        <language value="de-CH"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="de-CH" lang="de-CH"><p><b>Generated Narrative: Patient</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Patient  (Language &quot;de-CH&quot;) </p></div><p><b>name</b>: Susanna Ufferer , Leidend (MAIDEN)</p><p><b>telecom</b>: ph: 079 979 79 79, <a href="mailto:susanna@ufferer.ch">susanna@ufferer.ch</a></p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1970-03-14</p><p><b>address</b>: Musterweg 6a Zürich 8000 Schweiz </p></div>
        </text>
        <name>
          <family value="Ufferer"/>
          <given value="Susanna"/>
        </name>
        <name>
          <use value="maiden"/>
          <family value="Leidend"/>
        </name>
        <telecom>
          <system value="phone"/>
          <value value="079 979 79 79"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="susanna@ufferer.ch"/>
        </telecom>
        <gender value="female"/>
        <birthDate value="1970-03-14"/>
        <address>
          <line value="Musterweg"/>
          <line value="6a"/>
          <city value="Zürich"/>
          <postalCode value="8000"/>
          <country value="Schweiz"/>
        </address>
      </Patient>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:1fa2627b-3cd4-4992-94e8-823610ed903e"/>
    <resource>
      <QuestionnaireResponse>
        <meta>
          <profile
                   value="http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-questionnaireresponse"/>
        </meta>
        <language value="de-CH"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="de-CH" lang="de-CH"><p><b>Generated Narrative: QuestionnaireResponse</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource QuestionnaireResponse  (Language &quot;de-CH&quot;) </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-ch-orf-questionnaireresponse.html">CH ORF QuestionnaireResponse</a></p></div><p><b>questionnaire</b>: <a href="Questionnaire-order-referral-form.html">Order Referral Form</a></p><p><b>status</b>: completed</p><blockquote><p><b>item</b></p><p><b>linkId</b>: order</p><p><b>text</b>: Auftrag</p><blockquote><p><b>item</b></p><p><b>linkId</b>: order.placerOrderIdentifier</p><p><b>text</b>: Auftragsnummer des Auftraggebers</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: order.placerOrderIdentifierDomain</p><p><b>text</b>: Identifier Domain der Auftragsnummer des Auftraggebers</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: order.priority</p><p><b>text</b>: Auftragspriorität</p><blockquote><p><b>answer</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: receiver</p><p><b>text</b>: Empfänger</p><blockquote><p><b>item</b></p><p><b>linkId</b>: receiver.practitioner</p><p><b>text</b>: Empfangende Person</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: receiver.organization</p><p><b>text</b>: Empfangende Organisation</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient</p><p><b>text</b>: Patient</p><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.familyName</p><p><b>text</b>: Name</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.maidenName</p><p><b>text</b>: Ledigname</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.givenName</p><p><b>text</b>: Vorname</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.birthDate</p><p><b>text</b>: Geburtsdatum</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.gender</p><p><b>text</b>: Geschlecht</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.phone</p><p><b>text</b>: Telefon</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.email</p><p><b>text</b>: E-Mail</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.streetAddressLine</p><p><b>text</b>: Strasse, Hausnummer, Postfach etc.</p><blockquote><p><b>answer</b></p></blockquote><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.postalCode</p><p><b>text</b>: PLZ</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.city</p><p><b>text</b>: Ort</p><blockquote><p><b>answer</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.country</p><p><b>text</b>: Land</p><blockquote><p><b>answer</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: sender</p><p><b>text</b>: Absender</p><blockquote><p><b>item</b></p><p><b>linkId</b>: sender.author</p><p><b>text</b>: Verantwortlicher</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: sender.dataenterer</p><p><b>text</b>: Erfasser</p><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: receiverCopy</p><p><b>text</b>: Kopieempfänger (Kopie dieses Auftrags und aller daraus resultierenden Resultate)</p><blockquote><p><b>item</b></p><p><b>linkId</b>: receiverCopy.patient</p><p><b>text</b>: Patient selbst</p><blockquote><p><b>answer</b></p></blockquote></blockquote></blockquote></div>
        </text>
        <questionnaire
                       value="http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form"/>
        <status value="completed"/>
        <item>
          <linkId value="order"/>
          <text value="Auftrag"/>
          <item>
            <linkId value="order.placerOrderIdentifier"/>
            <text value="Auftragsnummer des Auftraggebers"/>
            <answer>
              <valueString value="2156286"/>
            </answer>
          </item>
          <item>
            <linkId value="order.placerOrderIdentifierDomain"/>
            <text
                  value="Identifier Domain der Auftragsnummer des Auftraggebers"/>
            <answer>
              <valueString value="urn:oid:2.999.1.3.4.5.6.7"/>
            </answer>
          </item>
          <item>
            <linkId value="order.priority"/>
            <text value="Auftragspriorität"/>
            <answer>
              <valueCoding>
                <system value="http://hl7.org/fhir/request-priority"/>
                <code value="routine"/>
              </valueCoding>
            </answer>
          </item>
        </item>
        <item>
          <linkId value="receiver"/>
          <text value="Empfänger"/>
          <item>
            <linkId value="receiver.practitioner"/>
            <text value="Empfangende Person"/>
            <item>
              <linkId value="receiver.practitioner.title"/>
              <text value="Titel"/>
              <answer>
                <valueString value="Dr. med."/>
              </answer>
            </item>
            <item>
              <linkId value="receiver.practitioner.familyName"/>
              <text value="Name"/>
              <answer>
                <valueString value="Rderfiller"/>
              </answer>
            </item>
            <item>
              <linkId value="receiver.practitioner.givenName"/>
              <text value="Vorname"/>
              <answer>
                <valueString value="Otto"/>
              </answer>
            </item>
            <item>
              <linkId value="receiver.practitioner.gln"/>
              <text value="GLN"/>
              <answer>
                <valueString value="7601000201041"/>
              </answer>
            </item>
            <item>
              <linkId value="receiver.practitioner.phone"/>
              <text value="Telefon"/>
              <answer>
                <valueString value="044 412 00 99"/>
              </answer>
            </item>
            <item>
              <linkId value="receiver.practitioner.email"/>
              <text value="E-Mail"/>
              <answer>
                <valueString value="o.rderfiller@happyhospital.ch"/>
              </answer>
            </item>
          </item>
          <item>
            <linkId value="receiver.organization"/>
            <text value="Empfangende Organisation"/>
            <item>
              <linkId value="receiver.organization.name"/>
              <text value="Name der Organisation"/>
              <answer>
                <valueString value="Klinik Happy Hospital"/>
              </answer>
            </item>
            <item>
              <linkId value="receiver.organization.streetAddressLine"/>
              <text value="Strasse, Hausnummer, Postfach etc."/>
              <answer>
                <valueString value="Seestrasse 133"/>
              </answer>
              <answer>
                <valueString value="Haus C"/>
              </answer>
            </item>
            <item>
              <linkId value="receiver.organization.postalCode"/>
              <text value="PLZ"/>
              <answer>
                <valueString value="8000"/>
              </answer>
            </item>
            <item>
              <linkId value="receiver.organization.city"/>
              <text value="Ort"/>
              <answer>
                <valueString value="Zürich"/>
              </answer>
            </item>
            <item>
              <linkId value="receiver.organization.country"/>
              <text value="Land"/>
              <answer>
                <valueString value="Schweiz"/>
              </answer>
            </item>
          </item>
        </item>
        <item>
          <linkId value="patient"/>
          <text value="Patient"/>
          <item>
            <linkId value="patient.familyName"/>
            <text value="Name"/>
            <answer>
              <valueString value="Ufferer"/>
            </answer>
          </item>
          <item>
            <linkId value="patient.maidenName"/>
            <text value="Ledigname"/>
            <answer>
              <valueString value="Leidend"/>
            </answer>
          </item>
          <item>
            <linkId value="patient.givenName"/>
            <text value="Vorname"/>
            <answer>
              <valueString value="Susanna"/>
            </answer>
          </item>
          <item>
            <linkId value="patient.birthDate"/>
            <text value="Geburtsdatum"/>
            <answer>
              <valueDate value="1970-03-14"/>
            </answer>
          </item>
          <item>
            <linkId value="patient.gender"/>
            <text value="Geschlecht"/>
            <answer>
              <valueCoding>
                <system value="http://hl7.org/fhir/administrative-gender"/>
                <code value="female"/>
              </valueCoding>
            </answer>
          </item>
          <item>
            <linkId value="patient.phone"/>
            <text value="Telefon"/>
            <answer>
              <valueString value="079 979 79 79"/>
            </answer>
          </item>
          <item>
            <linkId value="patient.email"/>
            <text value="E-Mail"/>
            <answer>
              <valueString value="susanna@ufferer.ch"/>
            </answer>
          </item>
          <item>
            <linkId value="patient.streetAddressLine"/>
            <text value="Strasse, Hausnummer, Postfach etc."/>
            <answer>
              <valueString value="Musterweg"/>
            </answer>
            <answer>
              <valueString value="6a"/>
            </answer>
          </item>
          <item>
            <linkId value="patient.postalCode"/>
            <text value="PLZ"/>
            <answer>
              <valueString value="8000"/>
            </answer>
          </item>
          <item>
            <linkId value="patient.city"/>
            <text value="Ort"/>
            <answer>
              <valueString value="Zürich"/>
            </answer>
          </item>
          <item>
            <linkId value="patient.country"/>
            <text value="Land"/>
            <answer>
              <valueString value="Schweiz"/>
            </answer>
          </item>
        </item>
        <item>
          <linkId value="sender"/>
          <text value="Absender"/>
          <item>
            <linkId value="sender.author"/>
            <text value="Verantwortlicher"/>
            <item>
              <linkId value="sender.author.practitioner"/>
              <text value="Verantwortliche Person"/>
              <item>
                <linkId value="sender.author.practitioner.title"/>
                <text value="Titel"/>
                <answer>
                  <valueString value="Dr. med."/>
                </answer>
              </item>
              <item>
                <linkId value="sender.author.practitioner.familyName"/>
                <text value="Name"/>
                <answer>
                  <valueString value="Rderplacer"/>
                </answer>
              </item>
              <item>
                <linkId value="sender.author.practitioner.givenName"/>
                <text value="Vorname"/>
                <answer>
                  <valueString value="Ottilie"/>
                </answer>
              </item>
              <item>
                <linkId value="sender.author.practitioner.gln"/>
                <text value="GLN"/>
                <answer>
                  <valueString value="7601000618627"/>
                </answer>
              </item>
              <item>
                <linkId value="sender.author.practitioner.phone"/>
                <text value="Telefon"/>
                <answer>
                  <valueString value="044 333 22 11"/>
                </answer>
              </item>
              <item>
                <linkId value="sender.author.practitioner.email"/>
                <text value="E-Mail"/>
                <answer>
                  <valueString value="o.rderplacer@happydoctors.ch"/>
                </answer>
              </item>
            </item>
            <item>
              <linkId value="sender.author.organization"/>
              <text value="Verantwortliche Organisation"/>
              <item>
                <linkId value="sender.author.organization.name"/>
                <text value="Name der Organisation"/>
                <answer>
                  <valueString value="Praxis Happy Doctors"/>
                </answer>
              </item>
              <item>
                <linkId value="sender.author.organization.streetAddressLine"/>
                <text value="Strasse, Hausnummer, Postfach etc."/>
                <answer>
                  <valueString value="Kantonsstrasse 14"/>
                </answer>
                <answer>
                  <valueString value="Postfach 14"/>
                </answer>
              </item>
              <item>
                <linkId value="sender.author.organization.postalCode"/>
                <text value="PLZ"/>
                <answer>
                  <valueString value="8000"/>
                </answer>
              </item>
              <item>
                <linkId value="sender.author.organization.city"/>
                <text value="Ort"/>
                <answer>
                  <valueString value="Zürich"/>
                </answer>
              </item>
              <item>
                <linkId value="sender.author.organization.country"/>
                <text value="Land"/>
                <answer>
                  <valueString value="Schweiz"/>
                </answer>
              </item>
            </item>
          </item>
          <item>
            <linkId value="sender.dataenterer"/>
            <text value="Erfasser"/>
            <item>
              <linkId value="sender.dataenterer.practitioner"/>
              <text value="Erfassende Person"/>
              <item>
                <linkId value="sender.dataenterer.practitioner.familyName"/>
                <text value="Name"/>
                <answer>
                  <valueString value="Ataenterer"/>
                </answer>
              </item>
              <item>
                <linkId value="sender.dataenterer.practitioner.givenName"/>
                <text value="Vorname"/>
                <answer>
                  <valueString value="Doris"/>
                </answer>
              </item>
              <item>
                <linkId value="sender.dataenterer.practitioner.phone"/>
                <text value="Telefon"/>
                <answer>
                  <valueString value="044 333 22 11"/>
                </answer>
              </item>
              <item>
                <linkId value="sender.dataenterer.practitioner.email"/>
                <text value="E-Mail"/>
                <answer>
                  <valueString value="d.ataenterer@happydoctors.ch"/>
                </answer>
              </item>
            </item>
          </item>
        </item>
        <item>
          <linkId value="receiverCopy"/>
          <text
                value="Kopieempfänger (Kopie dieses Auftrags und aller daraus resultierenden Resultate)"/>
          <item>
            <linkId value="receiverCopy.patient"/>
            <text value="Patient selbst"/>
            <answer>
              <valueBoolean value="true"/>
            </answer>
          </item>
        </item>
      </QuestionnaireResponse>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:bc5ac105-cdfe-49c0-b92b-fb378bed4f29"/>
    <resource>
      <ServiceRequest>
        <language value="de-CH"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="de-CH" lang="de-CH"><p><b>Generated Narrative: ServiceRequest</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource ServiceRequest  (Language &quot;de-CH&quot;) </p></div><p><b>identifier</b>: Placer Identifier: 2156286</p><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>priority</b>: routine</p><p><b>subject</b>: <a href="#urnuuid6e46d994-9eca-4c8f-a0e3-98c5911d45e2">See above (urn:uuid:6e46d994-9eca-4c8f-a0e3-98c5911d45e2)</a></p><p><b>requester</b>: <a href="#urnuuidde8d3b4f-1a57-48c0-9b03-a758ff8f2d2f">See above (urn:uuid:de8d3b4f-1a57-48c0-9b03-a758ff8f2d2f)</a></p></div>
        </text>
        <identifier>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="PLAC"/>
            </coding>
          </type>
          <system value="urn:oid:2.999.1.3.4.5.6.7"/>
          <value value="2156286"/>
        </identifier>
        <status value="active"/>
        <intent value="order"/>
        <priority value="routine"/>
        <subject>
          <reference value="urn:uuid:6e46d994-9eca-4c8f-a0e3-98c5911d45e2"/>
        </subject>
        <requester>
          <reference value="urn:uuid:de8d3b4f-1a57-48c0-9b03-a758ff8f2d2f"/>
        </requester>
      </ServiceRequest>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form"/>
    <resource>
      <Questionnaire>
        <id value="order-referral-form"/>
        <meta>
          <versionId value="42"/>
          <lastUpdated value="2023-06-12T21:11:39.305+00:00"/>
          <source value="#dQEVCLkxu8TKSXYI"/>
          <profile
                   value="http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-questionnaire"/>
          <profile
                   value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire"/>
          <profile
                   value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap"/>
          <profile
                   value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-pop-exp"/>
        </meta>
        <language value="de-CH"/>
        <text>
          <status value="extensions"/>
          <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="de-CH" lang="de-CH"><p><b>Generated Narrative: Questionnaire</b><a name="order-referral-form"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Questionnaire &quot;order-referral-form&quot; Version &quot;42&quot; Updated &quot;2023-06-12 21:11:39+0000&quot;  (Language &quot;de-CH&quot;) </p><p style="margin-bottom: 0px">Information Source: #dQEVCLkxu8TKSXYI!</p><p style="margin-bottom: 0px">Profiles: <a href="StructureDefinition-ch-orf-questionnaire.html">CH ORF Questionnaire</a>, <a href="http://hl7.org/fhir/uv/sdc/STU3/StructureDefinition-sdc-questionnaire.html">SDCBaseQuestionnaire</a>, <a href="http://hl7.org/fhir/uv/sdc/STU3/StructureDefinition-sdc-questionnaire-extr-smap.html">Extractable Questionnaire - StructureMap</a>, <a href="http://hl7.org/fhir/uv/sdc/STU3/StructureDefinition-sdc-questionnaire-pop-exp.html">Populatable Questionnaire - Expression</a></p></div><p><b>Target structure map</b>: <a href="StructureMap-OrfQrToBundle.html">OrfQrToBundle</a></p><blockquote><p><b>Launch context resources</b></p><blockquote><p><b>url</b></p><code>name</code></blockquote><p><b>value</b>: Patient (Details: http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext code patient = 'Patient', stated as 'null')</p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Patient</p></blockquote><blockquote><p><b>Launch context resources</b></p><blockquote><p><b>url</b></p><code>name</code></blockquote><p><b>value</b>: User (Details: http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext code user = 'User', stated as 'User')</p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Practitioner</p><blockquote><p><b>url</b></p><code>description</code></blockquote><p><b>value</b>: The practitioner that is to be used to pre-populate the form</p></blockquote><p><b>Assembled From Questionnaire</b>: <a href="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-order">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-order|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-practitioner-nametel">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-practitioner-nametel|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-receiver">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-receiver|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-address">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-address|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-initiator">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-initiator|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-patient">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-patient|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-familydoctor">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-familydoctor|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-requestedencounter">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-requestedencounter|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-coverage">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-coverage|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-sender">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-sender|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-receivercopy">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-receivercopy|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-appointment">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-appointment|1.1.0</a></p><p><b>Assembled From Questionnaire</b>: <a href="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-consent">http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-consent|1.1.0</a></p><p><b>url</b>: <code>http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form</code></p><p><b>version</b>: 1.1.0-assembled</p><p><b>name</b>: OrderReferralForm</p><p><b>title</b>: Order Referral Form</p><p><b>status</b>: active</p><p><b>subjectType</b>: Patient</p><p><b>date</b>: 2022-07-07</p><p><b>publisher</b>: HL7 Switzerland</p><p><b>contact</b>: HL7 Switzerland: <a href="https://www.hl7.ch/">https://www.hl7.ch/</a></p><p><b>jurisdiction</b>: Switzerland <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.4.0/CodeSystem-ISO3166Part1.html">ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code</a>#CH)</span></p><p><b>copyright</b>: CC-BY-SA-4.0</p><blockquote><p><b>item</b></p><p><b>linkId</b>: order</p><p><b>text</b>: Auftrag</p><p><b>type</b>: group</p><p><b>required</b>: true</p><blockquote><p><b>item</b></p><p><b>linkId</b>: order.authoredOn</p><p><b>text</b>: Daum/Zeit der Auftragserteilung</p><p><b>type</b>: dateTime</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: order.placerOrderIdentifier</p><p><b>text</b>: Auftragsnummer des Auftraggebers</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>hidden</b>: true</p><p><b>linkId</b>: order.placerOrderIdentifierDomain</p><p><b>text</b>: Identifier Domain der Auftragsnummer des Auftraggebers</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: order.fillerOrderIdentifier</p><p><b>text</b>: Auftragsnummer des Auftragsempfängers</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>hidden</b>: true</p><p><b>linkId</b>: order.fillerOrderIdentifierDomain</p><p><b>text</b>: Identifier Domain der Auftragsnummer des Auftragsempfängers</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>hidden</b>: true</p><p><b>linkId</b>: order.precedentDocumentIdentifier</p><p><b>text</b>: Identifier des Vorgängerdokuments</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: order.notificationContactDocument</p><p><b>text</b>: Dringender Benachrichtigungskontakt für dieses Dokument</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: order.notificationContactDocumentResponse</p><p><b>text</b>: Dringender Benachrichtigungskontakt für die Antwort auf dieses Dokument</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: order.priority</p><p><b>text</b>: Auftragspriorität</p><p><b>type</b>: choice</p><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: receiver</p><p><b>text</b>: Empfänger</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p><p><b>linkId</b>: receiver.practitioner</p><p><b>text</b>: Empfangende Person</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>Variable</b>: <span title="text/fhirpath"><code>'receiver.organization.'</code></span>(<b>linkIdPrefix</b>)</p><p><b>linkId</b>: receiver.organization</p><p><b>text</b>: Empfangende Organisation</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: initiator</p><p><b>text</b>: Initiant dieser Anmeldung</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p><p><b>linkId</b>: initiator.legalrelation</p><p><b>text</b>: Juristische Beziehung zum Patienten</p><p><b>type</b>: choice</p><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: initiator.personalrelation</p><p><b>text</b>: Persönliche Beziehung zum Patienten?</p><p><b>type</b>: choice</p><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: initiator.practitionerRole</p><p><b>text</b>: Gesundheitsfachperson oder -organisation</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: initiator.relatedPerson</p><p><b>text</b>: Andere Person</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>Variable</b>: <span title="text/fhirpath"><code>'patient.'</code></span>(<b>linkIdPrefix</b>)</p><p><b>Variable</b>: <span title="text/fhirpath"><code>%patient.address</code></span>(<b>address</b>)</p><p><b>linkId</b>: patient</p><p><b>text</b>: Patient</p><p><b>type</b>: group</p><p><b>required</b>: true</p><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title="text/fhirpath"><code>%patient.name.where(use='official').family</code></span></p><p><b>linkId</b>: patient.familyName</p><p><b>text</b>: Name</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title="text/fhirpath"><code>%patient.name.where(use='maiden').family</code></span></p><p><b>linkId</b>: patient.maidenName</p><p><b>text</b>: Ledigname</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title="text/fhirpath"><code>%patient.name.where(use='official').given</code></span></p><p><b>linkId</b>: patient.givenName</p><p><b>text</b>: Vorname</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title="text/fhirpath"><code>%patient.identifier.where(type.coding.where(system='http://terminology.hl7.org/CodeSystem/v2-0203' and code='MR').exists()).value</code></span></p><p><b>linkId</b>: patient.localPid</p><p><b>text</b>: Lokale Patienten-ID</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>hidden</b>: true</p><p><b>linkId</b>: patient.localPidDomain</p><p><b>text</b>: Lokale Patienten-ID Domain</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title="text/fhirpath"><code>%patient.birthDate</code></span></p><p><b>linkId</b>: patient.birthDate</p><p><b>text</b>: Geburtsdatum</p><p><b>type</b>: date</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title="text/fhirpath"><code>%questionnaire.repeat(item).where(linkId='patient.gender').answerOption.valueCoding.where(code=%patient.gender)</code></span></p><p><b>linkId</b>: patient.gender</p><p><b>text</b>: Geschlecht</p><p><b>type</b>: choice</p><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title="text/fhirpath"><code>%patient.maritalStatus</code></span></p><p><b>linkId</b>: patient.maritalStatus</p><p><b>text</b>: Zivilstand</p><p><b>type</b>: choice</p><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title="text/fhirpath"><code>%patient.telecom.where(system='phone').value</code></span></p><p><b>linkId</b>: patient.phone</p><p><b>text</b>: Telefon</p><p><b>type</b>: string</p><p><b>repeats</b>: true</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title="text/fhirpath"><code>%patient.telecom.where(system='email').value</code></span></p><p><b>linkId</b>: patient.email</p><p><b>text</b>: E-Mail</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title="text/fhirpath"><code>%address.line</code></span></p><p><b>linkId</b>: patient.streetAddressLine</p><p><b>text</b>: Strasse, Hausnummer, Postfach etc.</p><p><b>type</b>: string</p><p><b>repeats</b>: true</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title="text/fhirpath"><code>%address.postalCode</code></span></p><p><b>linkId</b>: patient.postalCode</p><p><b>text</b>: PLZ</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title="text/fhirpath"><code>%address.city</code></span></p><p><b>linkId</b>: patient.city</p><p><b>text</b>: Ort</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title="text/fhirpath"><code>%address.country</code></span></p><p><b>linkId</b>: patient.country</p><p><b>text</b>: Land</p><p><b>type</b>: string</p></blockquote><blockquote><p><b>item</b></p><p><b>initial.exists().not()</b>: <span title="text/fhirpath"><code>%patient.communication.where(preferred=true).language.coding</code></span></p><p><b>linkId</b>: patient.languageOfCorrespondence</p><p><b>text</b>: Korrespondenzsprache</p><p><b>type</b>: choice</p><p><b>answerValueSet</b>: <a href="http://fhir.ch/ig/ch-epr-term/2.0.10/ValueSet-DocumentEntry.languageCode.html">DocumentEntry.languageCode</a></p></blockquote><blockquote><p><b>item</b></p><p><b>Variable</b>: <span title="text/fhirpath"><code>%patient.contact</code></span>(<b>contact</b>)</p><p><b>linkId</b>: patient.contactperson</p><p><b>text</b>: Kontaktperson</p><p><b>type</b>: group</p><p><b>repeats</b>: true</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: familydoctor</p><p><b>text</b>: Hausarzt</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: requestedEncounter</p><p><b>text</b>: Patientenaufnahme</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p><p><b>linkId</b>: requestedEncounter.class</p><p><b>text</b>: Voraussichtlich: Ambulant / Stationär / Notfall</p><p><b>type</b>: choice</p><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: requestedEncounter.desiredAccommodation</p><p><b>text</b>: Zimmerkategorie</p><p><b>type</b>: choice</p><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: coverage</p><p><b>text</b>: Kostenträger</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p><p><b>linkId</b>: coverage.beneficiary</p><p><b>text</b>: Begünstigter (Patient)</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: coverage.kvg</p><p><b>text</b>: Krankenkasse (nach KVG)</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: coverage.uvg</p><p><b>text</b>: Unfallversicherung (nach UVG)</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: coverage.vvg</p><p><b>text</b>: Zusatzversicherung (nach VVG)</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: coverage.iv</p><p><b>text</b>: Invalidenversicherung (IV)</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: coverage.mv</p><p><b>text</b>: Militärversicherung (MV)</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: coverage.self</p><p><b>text</b>: Selbstzahler</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: coverage.other</p><p><b>text</b>: Anderer Kostenträger</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: sender</p><p><b>text</b>: Absender</p><p><b>type</b>: group</p><p><b>required</b>: true</p><blockquote><p><b>item</b></p><p><b>Variable</b>: <span title="application/x-fhir-query"><code>PractitionerRole?practitioner={{%user.id}}</code></span>(<b>senderPractitionerRoles</b>)</p><p><b>Variable</b>: <span title="text/fhirpath"><code>%senderPractitionerRoles.entry[0].resource</code></span>(<b>senderPractitionerRole</b>)</p><p><b>Variable</b>: <span title="application/x-fhir-query"><code>Organization?_id={{%senderPractitionerRole.organization.reference}}</code></span>(<b>senderOrganizations</b>)</p><p><b>Variable</b>: <span title="text/fhirpath"><code>%senderOrganizations.entry[0].resource</code></span>(<b>senderOrganization</b>)</p><p><b>Variable</b>: <span title="text/fhirpath"><code>%senderOrganization.address</code></span>(<b>address</b>)</p><p><b>linkId</b>: sender.author</p><p><b>text</b>: Verantwortlicher</p><p><b>type</b>: group</p><p><b>required</b>: true</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: sender.dataenterer</p><p><b>text</b>: Erfasser</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: receiverCopy</p><p><b>text</b>: Kopieempfänger (Kopie dieses Auftrags und aller daraus resultierenden Resultate)</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p><p><b>linkId</b>: receiverCopy.practitionerRole</p><p><b>text</b>: Gesundheitsfachperson oder -organisation</p><p><b>type</b>: group</p><p><b>repeats</b>: true</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: receiverCopy.patient</p><p><b>text</b>: Patient selbst</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: receiverCopy.relatedPerson</p><p><b>text</b>: Andere Person</p><p><b>type</b>: group</p><p><b>repeats</b>: true</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: antecedentEpisodeOfCare</p><p><b>text</b>: Vorgängiger Aufenthalt in Spital / Heim</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p><p><b>linkId</b>: antecedentEpisodeOfCare.start</p><p><b>text</b>: Von</p><p><b>type</b>: dateTime</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: antecedentEpisodeOfCare.end</p><p><b>text</b>: Bis</p><p><b>type</b>: dateTime</p></blockquote><blockquote><p><b>item</b></p><p><b>Variable</b>: <span title="text/fhirpath"><code>'antecedentEpisodeOfCare.managingOrganization.'</code></span>(<b>linkIdPrefix</b>)</p><p><b>linkId</b>: antecedentEpisodeOfCare.managingOrganization</p><p><b>text</b>: Spital /Heim</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: appointment</p><p><b>text</b>: Ort und Zeit der Durchführung der angeforderten Leistung</p><p><b>type</b>: group</p><p><b>repeats</b>: true</p><blockquote><p><b>item</b></p><p><b>Variable</b>: <span title="text/fhirpath"><code>'appointment.location.'</code></span>(<b>linkIdPrefix</b>)</p><p><b>linkId</b>: appointment.location</p><p><b>text</b>: Ort der Durchführung</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: appointment.requestedPeriod</p><p><b>text</b>: Datum und Zeit, wann der Termin bevorzugt geplant werden soll</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: appointment.status</p><p><b>text</b>: Status</p><p><b>type</b>: choice</p><p><b>required</b>: true</p><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: appointment.patientInstruction</p><p><b>text</b>: Patienteninformation für diesen Termin</p><p><b>type</b>: string</p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: consent</p><p><b>text</b>: Einverständniserklärung</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.consent.statement</p><p><b>text</b>: Ist der Patient über die Anmeldung informiert und explizit einverstanden?</p><p><b>type</b>: choice</p><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>answerOption</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: note</p><p><b>text</b>: Bemerkungen</p><p><b>type</b>: group</p><p><b>repeats</b>: true</p><h3>Items</h3><table class="grid"><tr><td style="display: none">-</td><td><b>LinkId</b></td><td><b>Text</b></td><td><b>Type</b></td></tr><tr><td style="display: none">*</td><td>note.text</td><td>Kommentar</td><td>string</td></tr></table></blockquote></div>
        </text>
        <extension
                   url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-targetStructureMap">
          <valueCanonical
                          value="http://fhir.ch/ig/ch-orf/StructureMap/OrfQrToBundle"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext">
          <extension url="name">
            <valueCoding>
              <system
                      value="http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext"/>
              <code value="patient"/>
            </valueCoding>
          </extension>
          <extension url="type">
            <valueCode value="Patient"/>
          </extension>
        </extension>
        <extension
                   url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext">
          <extension url="name">
            <valueCoding>
              <system
                      value="http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext"/>
              <code value="user"/>
              <display value="User"/>
            </valueCoding>
          </extension>
          <extension url="type">
            <valueCode value="Practitioner"/>
          </extension>
          <extension url="description">
            <valueString
                         value="The practitioner that is to be used to pre-populate the form"/>
          </extension>
        </extension>
        <extension
                   url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom">
          <valueCanonical
                          value="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-order|1.1.0"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom">
          <valueCanonical
                          value="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-practitioner-nametel|1.1.0"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom">
          <valueCanonical
                          value="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-receiver|1.1.0"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom">
          <valueCanonical
                          value="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-address|1.1.0"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom">
          <valueCanonical
                          value="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-initiator|1.1.0"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom">
          <valueCanonical
                          value="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-patient|1.1.0"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom">
          <valueCanonical
                          value="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-familydoctor|1.1.0"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom">
          <valueCanonical
                          value="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-requestedencounter|1.1.0"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom">
          <valueCanonical
                          value="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-coverage|1.1.0"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom">
          <valueCanonical
                          value="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-sender|1.1.0"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom">
          <valueCanonical
                          value="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-receivercopy|1.1.0"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom">
          <valueCanonical
                          value="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-appointment|1.1.0"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom">
          <valueCanonical
                          value="http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-consent|1.1.0"/>
        </extension>
        <url
             value="http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form"/>
        <version value="1.1.0-assembled"/>
        <name value="OrderReferralForm"/>
        <title value="Order Referral Form"/>
        <status value="active"/>
        <subjectType value="Patient"/>
        <date value="2022-07-07"/>
        <publisher value="HL7 Switzerland"/>
        <contact>
          <name value="HL7 Switzerland"/>
          <telecom>
            <system value="url"/>
            <value value="https://www.hl7.ch/"/>
          </telecom>
        </contact>
        <jurisdiction>
          <coding>
            <system value="urn:iso:std:iso:3166"/>
            <code value="CH"/>
          </coding>
        </jurisdiction>
        <copyright value="CC-BY-SA-4.0"/>
        <item>
          <linkId value="order"/>
          <text value="Auftrag"/>
          <type value="group"/>
          <required value="true"/>
          <item>
            <linkId value="order.authoredOn"/>
            <text value="Daum/Zeit der Auftragserteilung"/>
            <type value="dateTime"/>
          </item>
          <item>
            <linkId value="order.placerOrderIdentifier"/>
            <text value="Auftragsnummer des Auftraggebers"/>
            <type value="string"/>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/questionnaire-hidden">
              <valueBoolean value="true"/>
            </extension>
            <linkId value="order.placerOrderIdentifierDomain"/>
            <text
                  value="Identifier Domain der Auftragsnummer des Auftraggebers"/>
            <type value="string"/>
          </item>
          <item>
            <linkId value="order.fillerOrderIdentifier"/>
            <text value="Auftragsnummer des Auftragsempfängers"/>
            <type value="string"/>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/questionnaire-hidden">
              <valueBoolean value="true"/>
            </extension>
            <linkId value="order.fillerOrderIdentifierDomain"/>
            <text
                  value="Identifier Domain der Auftragsnummer des Auftragsempfängers"/>
            <type value="string"/>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/questionnaire-hidden">
              <valueBoolean value="true"/>
            </extension>
            <linkId value="order.precedentDocumentIdentifier"/>
            <text value="Identifier des Vorgängerdokuments"/>
            <type value="string"/>
          </item>
          <item>
            <linkId value="order.notificationContactDocument"/>
            <text
                  value="Dringender Benachrichtigungskontakt für dieses Dokument"/>
            <type value="group"/>
            <item>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/variable">
                <valueExpression>
                  <name value="linkIdPrefix"/>
                  <language value="text/fhirpath"/>
                  <expression
                              value="'order.notificationContactDocument.practitioner.'"/>
                </valueExpression>
              </extension>
              <linkId value="order.notificationContactDocument.practitioner"/>
              <text value="Zu benachrichtigende Person"/>
              <type value="group"/>
              <item>
                <linkId
                        value="order.notificationContactDocument.practitioner.title"/>
                <text value="Titel"/>
                <type value="string"/>
              </item>
              <item>
                <linkId
                        value="order.notificationContactDocument.practitioner.familyName"/>
                <text value="Name"/>
                <type value="string"/>
              </item>
              <item>
                <linkId
                        value="order.notificationContactDocument.practitioner.givenName"/>
                <text value="Vorname"/>
                <type value="string"/>
              </item>
              <item>
                <linkId
                        value="order.notificationContactDocument.practitioner.phone"/>
                <text value="Telefon"/>
                <type value="string"/>
              </item>
              <item>
                <linkId
                        value="order.notificationContactDocument.practitioner.email"/>
                <text value="E-Mail"/>
                <type value="string"/>
              </item>
            </item>
          </item>
          <item>
            <linkId value="order.notificationContactDocumentResponse"/>
            <text
                  value="Dringender Benachrichtigungskontakt für die Antwort auf dieses Dokument"/>
            <type value="group"/>
            <item>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/variable">
                <valueExpression>
                  <name value="linkIdPrefix"/>
                  <language value="text/fhirpath"/>
                  <expression
                              value="'order.notificationContactDocumentResponse.practitioner.'"/>
                </valueExpression>
              </extension>
              <linkId
                      value="order.notificationContactDocumentResponse.practitioner"/>
              <text value="Zu benachrichtigende Person"/>
              <type value="group"/>
              <item>
                <linkId
                        value="order.notificationContactDocumentResponse.practitioner.title"/>
                <text value="Titel"/>
                <type value="string"/>
              </item>
              <item>
                <linkId
                        value="order.notificationContactDocumentResponse.practitioner.familyName"/>
                <text value="Name"/>
                <type value="string"/>
              </item>
              <item>
                <linkId
                        value="order.notificationContactDocumentResponse.practitioner.givenName"/>
                <text value="Vorname"/>
                <type value="string"/>
              </item>
              <item>
                <linkId
                        value="order.notificationContactDocumentResponse.practitioner.phone"/>
                <text value="Telefon"/>
                <type value="string"/>
              </item>
              <item>
                <linkId
                        value="order.notificationContactDocumentResponse.practitioner.email"/>
                <text value="E-Mail"/>
                <type value="string"/>
              </item>
            </item>
          </item>
          <item>
            <linkId value="order.priority"/>
            <text value="Auftragspriorität"/>
            <type value="choice"/>
            <answerOption>
              <valueCoding>
                <system value="http://hl7.org/fhir/request-priority"/>
                <code value="routine"/>
                <display value="Die Anfrage hat normale Priorität."/>
              </valueCoding>
              <initialSelected value="true"/>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://hl7.org/fhir/request-priority"/>
                <code value="urgent"/>
                <display
                         value="Die Anfrage sollte dringend bearbeitet werden - höhere Priorität als normal."/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://hl7.org/fhir/request-priority"/>
                <code value="asap"/>
                <display
                         value="Die Anfrage sollte so schnell wie möglich bearbeitet werden - höhere Priorität als dringend."/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://hl7.org/fhir/request-priority"/>
                <code value="stat"/>
                <display
                         value="Die Anfrage sollte sofort bearbeitet werden - höchstmögliche Priorität. Z.B. bei einem Notfall."/>
              </valueCoding>
            </answerOption>
          </item>
        </item>
        <item>
          <linkId value="receiver"/>
          <text value="Empfänger"/>
          <type value="group"/>
          <item>
            <linkId value="receiver.practitioner"/>
            <text value="Empfangende Person"/>
            <type value="group"/>
            <item>
              <linkId value="receiver.practitioner.title"/>
              <text value="Titel"/>
              <type value="string"/>
            </item>
            <item>
              <linkId value="receiver.practitioner.familyName"/>
              <text value="Name"/>
              <type value="string"/>
            </item>
            <item>
              <linkId value="receiver.practitioner.givenName"/>
              <text value="Vorname"/>
              <type value="string"/>
            </item>
            <item>
              <linkId value="receiver.practitioner.gln"/>
              <text value="GLN"/>
              <type value="string"/>
            </item>
            <item>
              <linkId value="receiver.practitioner.zsr"/>
              <text value="ZSR"/>
              <type value="string"/>
            </item>
            <item>
              <linkId value="receiver.practitioner.phone"/>
              <text value="Telefon"/>
              <type value="string"/>
            </item>
            <item>
              <linkId value="receiver.practitioner.email"/>
              <text value="E-Mail"/>
              <type value="string"/>
            </item>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/variable">
              <valueExpression>
                <name value="linkIdPrefix"/>
                <language value="text/fhirpath"/>
                <expression value="'receiver.organization.'"/>
              </valueExpression>
            </extension>
            <linkId value="receiver.organization"/>
            <text value="Empfangende Organisation"/>
            <type value="group"/>
            <item>
              <linkId value="receiver.organization.name"/>
              <text value="Name der Organisation"/>
              <type value="string"/>
            </item>
            <item>
              <linkId value="receiver.organization.gln"/>
              <text value="GLN"/>
              <type value="string"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.line"/>
                </valueExpression>
              </extension>
              <linkId value="receiver.organization.streetAddressLine"/>
              <text value="Strasse, Hausnummer, Postfach etc."/>
              <type value="string"/>
              <repeats value="true"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.postalCode"/>
                </valueExpression>
              </extension>
              <linkId value="receiver.organization.postalCode"/>
              <text value="PLZ"/>
              <type value="string"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.city"/>
                </valueExpression>
              </extension>
              <linkId value="receiver.organization.city"/>
              <text value="Ort"/>
              <type value="string"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.country"/>
                </valueExpression>
              </extension>
              <linkId value="receiver.organization.country"/>
              <text value="Land"/>
              <type value="string"/>
            </item>
          </item>
        </item>
        <item>
          <linkId value="initiator"/>
          <text value="Initiant dieser Anmeldung"/>
          <type value="group"/>
          <item>
            <linkId value="initiator.legalrelation"/>
            <text value="Juristische Beziehung zum Patienten"/>
            <type value="choice"/>
            <answerOption>
              <valueCoding>
                <system value="http://snomed.info/sct"/>
                <code value="373068000"/>
                <display value="Nicht definiert"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://snomed.info/sct"/>
                <code value="58626002"/>
                <display value="Gesetzlicher Vertreter"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="initiator.personalrelation"/>
            <text value="Persönliche Beziehung zum Patienten?"/>
            <type value="choice"/>
            <answerOption>
              <valueCoding>
                <system value="http://snomed.info/sct"/>
                <code value="66089001"/>
                <display value="Tochter"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://snomed.info/sct"/>
                <code value="65616008"/>
                <display value="Sohn"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://snomed.info/sct"/>
                <code value="127849001"/>
                <display value="Ehemann"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://snomed.info/sct"/>
                <code value="127850001"/>
                <display value="Ehefrau"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://snomed.info/sct"/>
                <code value="394921008"/>
                <display value="Partner (eingetragene  Partnerschaft)"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://snomed.info/sct"/>
                <code value="70924004"/>
                <display value="Bruder"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://snomed.info/sct"/>
                <code value="27733009"/>
                <display value="Schwester"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://snomed.info/sct"/>
                <code value="72705000"/>
                <display value="Mutter"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://snomed.info/sct"/>
                <code value="66839005"/>
                <display value="Vater"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://snomed.info/sct"/>
                <code value="48385004"/>
                <display value="Bekannt"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="initiator.practitionerRole"/>
            <text value="Gesundheitsfachperson oder -organisation"/>
            <type value="group"/>
            <item>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/variable">
                <valueExpression>
                  <name value="linkIdPrefix"/>
                  <language value="text/fhirpath"/>
                  <expression
                              value="'initiator.practitionerRole.practitioner.'"/>
                </valueExpression>
              </extension>
              <linkId value="initiator.practitionerRole.practitioner"/>
              <text value="Gesundheitsfachperson"/>
              <type value="group"/>
              <item>
                <linkId
                        value="initiator.practitionerRole.practitioner.title"/>
                <text value="Titel"/>
                <type value="string"/>
              </item>
              <item>
                <linkId
                        value="initiator.practitionerRole.practitioner.familyName"/>
                <text value="Name"/>
                <type value="string"/>
              </item>
              <item>
                <linkId
                        value="initiator.practitionerRole.practitioner.givenName"/>
                <text value="Vorname"/>
                <type value="string"/>
              </item>
              <item>
                <linkId
                        value="initiator.practitionerRole.practitioner.phone"/>
                <text value="Telefon"/>
                <type value="string"/>
              </item>
              <item>
                <linkId
                        value="initiator.practitionerRole.practitioner.email"/>
                <text value="E-Mail"/>
                <type value="string"/>
              </item>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/variable">
                <valueExpression>
                  <name value="linkIdPrefix"/>
                  <language value="text/fhirpath"/>
                  <expression
                              value="'initiator.practitionerRole.organization.'"/>
                </valueExpression>
              </extension>
              <linkId value="initiator.practitionerRole.organization"/>
              <text value="Gesundheitsorganisatiton"/>
              <type value="group"/>
              <item>
                <linkId value="initiator.practitionerRole.organization.name"/>
                <text value="Name der Organisation"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.line"/>
                  </valueExpression>
                </extension>
                <linkId
                        value="initiator.practitionerRole.organization.streetAddressLine"/>
                <text value="Strasse, Hausnummer, Postfach etc."/>
                <type value="string"/>
                <repeats value="true"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.postalCode"/>
                  </valueExpression>
                </extension>
                <linkId
                        value="initiator.practitionerRole.organization.postalCode"/>
                <text value="PLZ"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.city"/>
                  </valueExpression>
                </extension>
                <linkId value="initiator.practitionerRole.organization.city"/>
                <text value="Ort"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.country"/>
                  </valueExpression>
                </extension>
                <linkId
                        value="initiator.practitionerRole.organization.country"/>
                <text value="Land"/>
                <type value="string"/>
              </item>
            </item>
          </item>
          <item>
            <linkId value="initiator.relatedPerson"/>
            <text value="Andere Person"/>
            <type value="group"/>
            <item>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/variable">
                <valueExpression>
                  <name value="linkIdPrefix"/>
                  <language value="text/fhirpath"/>
                  <expression value="'initiator.relatedPerson.'"/>
                </valueExpression>
              </extension>
              <linkId value="initiator.relatedPerson.familyName"/>
              <text value="Name"/>
              <type value="string"/>
            </item>
            <item>
              <linkId value="initiator.relatedPerson.givenName"/>
              <text value="Vorname"/>
              <type value="string"/>
            </item>
            <item>
              <linkId value="initiator.relatedPerson.phone"/>
              <text value="Telefon"/>
              <type value="string"/>
              <repeats value="true"/>
            </item>
            <item>
              <linkId value="initiator.relatedPerson.email"/>
              <text value="E-Mail"/>
              <type value="string"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.line"/>
                </valueExpression>
              </extension>
              <linkId value="initiator.relatedPerson.streetAddressLine"/>
              <text value="Strasse, Hausnummer, Postfach etc."/>
              <type value="string"/>
              <repeats value="true"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.postalCode"/>
                </valueExpression>
              </extension>
              <linkId value="initiator.relatedPerson.postalCode"/>
              <text value="PLZ"/>
              <type value="string"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.city"/>
                </valueExpression>
              </extension>
              <linkId value="initiator.relatedPerson.city"/>
              <text value="Ort"/>
              <type value="string"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.country"/>
                </valueExpression>
              </extension>
              <linkId value="initiator.relatedPerson.country"/>
              <text value="Land"/>
              <type value="string"/>
            </item>
          </item>
        </item>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/variable">
            <valueExpression>
              <name value="linkIdPrefix"/>
              <language value="text/fhirpath"/>
              <expression value="'patient.'"/>
            </valueExpression>
          </extension>
          <extension url="http://hl7.org/fhir/StructureDefinition/variable">
            <valueExpression>
              <name value="address"/>
              <language value="text/fhirpath"/>
              <expression value="%patient.address"/>
            </valueExpression>
          </extension>
          <linkId value="patient"/>
          <text value="Patient"/>
          <type value="group"/>
          <required value="true"/>
          <item>
            <extension
                       url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
              <valueExpression>
                <language value="text/fhirpath"/>
                <expression
                            value="%patient.name.where(use='official').family"/>
              </valueExpression>
            </extension>
            <linkId value="patient.familyName"/>
            <text value="Name"/>
            <type value="string"/>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
              <valueExpression>
                <language value="text/fhirpath"/>
                <expression value="%patient.name.where(use='maiden').family"/>
              </valueExpression>
            </extension>
            <linkId value="patient.maidenName"/>
            <text value="Ledigname"/>
            <type value="string"/>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
              <valueExpression>
                <language value="text/fhirpath"/>
                <expression
                            value="%patient.name.where(use='official').given"/>
              </valueExpression>
            </extension>
            <linkId value="patient.givenName"/>
            <text value="Vorname"/>
            <type value="string"/>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
              <valueExpression>
                <language value="text/fhirpath"/>
                <expression
                            value="%patient.identifier.where(type.coding.where(system='http://terminology.hl7.org/CodeSystem/v2-0203' and code='MR').exists()).value"/>
              </valueExpression>
            </extension>
            <linkId value="patient.localPid"/>
            <text value="Lokale Patienten-ID"/>
            <type value="string"/>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/questionnaire-hidden">
              <valueBoolean value="true"/>
            </extension>
            <linkId value="patient.localPidDomain"/>
            <text value="Lokale Patienten-ID Domain"/>
            <type value="string"/>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
              <valueExpression>
                <language value="text/fhirpath"/>
                <expression value="%patient.birthDate"/>
              </valueExpression>
            </extension>
            <linkId value="patient.birthDate"/>
            <text value="Geburtsdatum"/>
            <type value="date"/>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
              <valueExpression>
                <language value="text/fhirpath"/>
                <expression
                            value="%questionnaire.repeat(item).where(linkId='patient.gender').answerOption.valueCoding.where(code=%patient.gender)"/>
              </valueExpression>
            </extension>
            <linkId value="patient.gender"/>
            <text value="Geschlecht"/>
            <type value="choice"/>
            <answerOption>
              <valueCoding>
                <system value="http://hl7.org/fhir/administrative-gender"/>
                <code value="male"/>
                <display value="Männlich"/>
              </valueCoding>
              <initialSelected value="true"/>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://hl7.org/fhir/administrative-gender"/>
                <code value="female"/>
                <display value="Weiblich"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://hl7.org/fhir/administrative-gender"/>
                <code value="other"/>
                <display value="Anderes"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
              <valueExpression>
                <language value="text/fhirpath"/>
                <expression value="%patient.maritalStatus"/>
              </valueExpression>
            </extension>
            <linkId value="patient.maritalStatus"/>
            <text value="Zivilstand"/>
            <type value="choice"/>
            <answerOption>
              <valueCoding>
                <system
                        value="http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus"/>
                <code value="1"/>
                <display value="ledig"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system
                        value="http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus"/>
                <code value="2"/>
                <display value="verheiratet"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system
                        value="http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus"/>
                <code value="3"/>
                <display value="verwitwet"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system
                        value="http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus"/>
                <code value="4"/>
                <display value="geschieden"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system
                        value="http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus"/>
                <code value="5"/>
                <display value="unverheiratet"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system
                        value="http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus"/>
                <code value="6"/>
                <display value="in eingetragener Partnerschaft"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system
                        value="http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus"/>
                <code value="7"/>
                <display value="aufgelöste Partnerschaft"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system
                        value="http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus"/>
                <code value="9"/>
                <display value="unbekannt"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
              <valueExpression>
                <language value="text/fhirpath"/>
                <expression
                            value="%patient.telecom.where(system='phone').value"/>
              </valueExpression>
            </extension>
            <linkId value="patient.phone"/>
            <text value="Telefon"/>
            <type value="string"/>
            <repeats value="true"/>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
              <valueExpression>
                <language value="text/fhirpath"/>
                <expression
                            value="%patient.telecom.where(system='email').value"/>
              </valueExpression>
            </extension>
            <linkId value="patient.email"/>
            <text value="E-Mail"/>
            <type value="string"/>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
              <valueExpression>
                <language value="text/fhirpath"/>
                <expression value="%address.line"/>
              </valueExpression>
            </extension>
            <linkId value="patient.streetAddressLine"/>
            <text value="Strasse, Hausnummer, Postfach etc."/>
            <type value="string"/>
            <repeats value="true"/>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
              <valueExpression>
                <language value="text/fhirpath"/>
                <expression value="%address.postalCode"/>
              </valueExpression>
            </extension>
            <linkId value="patient.postalCode"/>
            <text value="PLZ"/>
            <type value="string"/>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
              <valueExpression>
                <language value="text/fhirpath"/>
                <expression value="%address.city"/>
              </valueExpression>
            </extension>
            <linkId value="patient.city"/>
            <text value="Ort"/>
            <type value="string"/>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
              <valueExpression>
                <language value="text/fhirpath"/>
                <expression value="%address.country"/>
              </valueExpression>
            </extension>
            <linkId value="patient.country"/>
            <text value="Land"/>
            <type value="string"/>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
              <valueExpression>
                <language value="text/fhirpath"/>
                <expression
                            value="%patient.communication.where(preferred=true).language.coding"/>
              </valueExpression>
            </extension>
            <linkId value="patient.languageOfCorrespondence"/>
            <text value="Korrespondenzsprache"/>
            <type value="choice"/>
            <answerValueSet
                            value="http://fhir.ch/ig/ch-epr-term/ValueSet/DocumentEntry.languageCode"/>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/variable">
              <valueExpression>
                <name value="contact"/>
                <language value="text/fhirpath"/>
                <expression value="%patient.contact"/>
              </valueExpression>
            </extension>
            <linkId value="patient.contactperson"/>
            <text value="Kontaktperson"/>
            <type value="group"/>
            <repeats value="true"/>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%contact.relationship.text"/>
                </valueExpression>
              </extension>
              <linkId value="patient.contactperson.relationship"/>
              <text value="Beziehung"/>
              <type value="string"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%contact.name.family"/>
                </valueExpression>
              </extension>
              <linkId value="patient.contactperson.familyName"/>
              <text value="Name"/>
              <type value="string"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%contact.name.given"/>
                </valueExpression>
              </extension>
              <linkId value="patient.contactperson.givenName"/>
              <text value="Vorname"/>
              <type value="string"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression
                              value="%contact.telecom.where(system='phone').value"/>
                </valueExpression>
              </extension>
              <linkId value="patient.contactperson.phone"/>
              <text value="Telefon"/>
              <type value="string"/>
              <repeats value="true"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression
                              value="%contact.telecom.where(system='email').value"/>
                </valueExpression>
              </extension>
              <linkId value="patient.contactperson.email"/>
              <text value="E-Mail"/>
              <type value="string"/>
            </item>
          </item>
          <item>
            <linkId value="familydoctor"/>
            <text value="Hausarzt"/>
            <type value="group"/>
            <item>
              <linkId value="familydoctor.practitioner"/>
              <text value="Hausarzt Person"/>
              <type value="group"/>
              <item>
                <linkId value="familydoctor.practitioner.title"/>
                <text value="Titel"/>
                <type value="string"/>
              </item>
              <item>
                <linkId value="familydoctor.practitioner.familyName"/>
                <text value="Name"/>
                <type value="string"/>
              </item>
              <item>
                <linkId value="familydoctor.practitioner.givenName"/>
                <text value="Vorname"/>
                <type value="string"/>
              </item>
              <item>
                <linkId value="familydoctor.practitioner.gln"/>
                <text value="GLN"/>
                <type value="string"/>
              </item>
              <item>
                <linkId value="familydoctor.practitioner.zsr"/>
                <text value="ZSR"/>
                <type value="string"/>
              </item>
              <item>
                <linkId value="familydoctor.practitioner.phone"/>
                <text value="Telefon"/>
                <type value="string"/>
              </item>
              <item>
                <linkId value="familydoctor.practitioner.email"/>
                <text value="E-Mail"/>
                <type value="string"/>
              </item>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/variable">
                <valueExpression>
                  <name value="linkIdPrefix"/>
                  <language value="text/fhirpath"/>
                  <expression value="'familydoctor.organization.'"/>
                </valueExpression>
              </extension>
              <linkId value="familydoctor.organization"/>
              <text value="Hausarzt Organisation"/>
              <type value="group"/>
              <item>
                <linkId value="familydoctor.organization.name"/>
                <text value="Name der Organisation"/>
                <type value="string"/>
              </item>
              <item>
                <linkId value="familydoctor.organization.gln"/>
                <text value="GLN"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.line"/>
                  </valueExpression>
                </extension>
                <linkId value="familydoctor.organization.streetAddressLine"/>
                <text value="Strasse, Hausnummer, Postfach etc."/>
                <type value="string"/>
                <repeats value="true"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.postalCode"/>
                  </valueExpression>
                </extension>
                <linkId value="familydoctor.organization.postalCode"/>
                <text value="PLZ"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.city"/>
                  </valueExpression>
                </extension>
                <linkId value="familydoctor.organization.city"/>
                <text value="Ort"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.country"/>
                  </valueExpression>
                </extension>
                <linkId value="familydoctor.organization.country"/>
                <text value="Land"/>
                <type value="string"/>
              </item>
            </item>
          </item>
        </item>
        <item>
          <linkId value="requestedEncounter"/>
          <text value="Patientenaufnahme"/>
          <type value="group"/>
          <item>
            <linkId value="requestedEncounter.class"/>
            <text value="Voraussichtlich: Ambulant / Stationär / Notfall"/>
            <type value="choice"/>
            <answerOption>
              <valueCoding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
                <code value="AMB"/>
                <display value="Ambulant"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
                <code value="IMP"/>
                <display value="Stationär"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
                <code value="EMER"/>
                <display value="Notfall"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="requestedEncounter.desiredAccommodation"/>
            <text value="Zimmerkategorie"/>
            <type value="choice"/>
            <answerOption>
              <valueCoding>
                <system
                        value="http://fhir.ch/ig/ch-core/CodeSystem/bfs-medstats-21-encountertype"/>
                <code value="1"/>
                <display value="allgemein"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system
                        value="http://fhir.ch/ig/ch-core/CodeSystem/bfs-medstats-21-encountertype"/>
                <code value="2"/>
                <display value="halbprivat"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system
                        value="http://fhir.ch/ig/ch-core/CodeSystem/bfs-medstats-21-encountertype"/>
                <code value="3"/>
                <display value="privat"/>
              </valueCoding>
            </answerOption>
          </item>
        </item>
        <item>
          <linkId value="coverage"/>
          <text value="Kostenträger"/>
          <type value="group"/>
          <item>
            <linkId value="coverage.beneficiary"/>
            <text value="Begünstigter (Patient)"/>
            <type value="group"/>
            <item>
              <linkId value="coverage.beneficiary.ahvn13"/>
              <text value="AHV-Nr. des Patienten"/>
              <type value="string"/>
            </item>
          </item>
          <item>
            <linkId value="coverage.kvg"/>
            <text value="Krankenkasse (nach KVG)"/>
            <type value="group"/>
            <item>
              <linkId value="coverage.kvg.name"/>
              <text value="Name der Versicherung"/>
              <type value="string"/>
            </item>
            <item>
              <linkId value="coverage.kvg.insuranceCardNumber"/>
              <text value="Kennnummer der Versichertenkarte"/>
              <type value="string"/>
            </item>
          </item>
          <item>
            <linkId value="coverage.uvg"/>
            <text value="Unfallversicherung (nach UVG)"/>
            <type value="group"/>
            <item>
              <linkId value="coverage.uvg.name"/>
              <text value="Name der Versicherung"/>
              <type value="string"/>
            </item>
            <item>
              <linkId value="coverage.uvg.claimNumber"/>
              <text value="Schadennummer"/>
              <type value="string"/>
            </item>
          </item>
          <item>
            <linkId value="coverage.vvg"/>
            <text value="Zusatzversicherung (nach VVG)"/>
            <type value="group"/>
            <item>
              <linkId value="coverage.vvg.name"/>
              <text value="Name der Versicherung"/>
              <type value="string"/>
            </item>
            <item>
              <linkId value="coverage.vvg.insuranceCardNumber"/>
              <text value="Kennnummer der Versichertenkarte"/>
              <type value="string"/>
            </item>
          </item>
          <item>
            <linkId value="coverage.iv"/>
            <text value="Invalidenversicherung (IV)"/>
            <type value="group"/>
            <item>
              <linkId value="coverage.iv.verfuegungsnummer"/>
              <text value="IV-Verfügungsnummer"/>
              <type value="string"/>
            </item>
          </item>
          <item>
            <linkId value="coverage.mv"/>
            <text value="Militärversicherung (MV)"/>
            <type value="group"/>
            <item>
              <linkId value="coverage.mv.versichertennummer"/>
              <text value="MV-Versichertennummer"/>
              <type value="string"/>
            </item>
          </item>
          <item>
            <linkId value="coverage.self"/>
            <text value="Selbstzahler"/>
            <type value="group"/>
            <item>
              <linkId value="coverage.self.patient"/>
              <text value="Patient selbst"/>
              <type value="boolean"/>
            </item>
            <item>
              <linkId value="coverage.self.patientRelatedPerson"/>
              <text value="Andere Person"/>
              <type value="boolean"/>
              <enableWhen>
                <question value="coverage.self.patient"/>
                <operator value="="/>
                <answerBoolean value="false"/>
              </enableWhen>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/variable">
                <valueExpression>
                  <name value="linkIdPrefix"/>
                  <language value="text/fhirpath"/>
                  <expression value="'coverage.self.relatedPerson.'"/>
                </valueExpression>
              </extension>
              <linkId value="coverage.self.relatedPerson"/>
              <text value="Andere Person"/>
              <type value="group"/>
              <enableWhen>
                <question value="coverage.self.patientRelatedPerson"/>
                <operator value="="/>
                <answerBoolean value="true"/>
              </enableWhen>
              <item>
                <linkId value="coverage.self.relatedPerson.familyName"/>
                <text value="Name"/>
                <type value="string"/>
              </item>
              <item>
                <linkId value="coverage.self.relatedPerson.givenName"/>
                <text value="Vorname"/>
                <type value="string"/>
              </item>
              <item>
                <linkId value="coverage.self.relatedPerson.phone"/>
                <text value="Telefon"/>
                <type value="string"/>
                <repeats value="true"/>
              </item>
              <item>
                <linkId value="coverage.self.relatedPerson.email"/>
                <text value="E-Mail"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.line"/>
                  </valueExpression>
                </extension>
                <linkId
                        value="coverage.self.relatedPerson.streetAddressLine"/>
                <text value="Strasse, Hausnummer, Postfach etc."/>
                <type value="string"/>
                <repeats value="true"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.postalCode"/>
                  </valueExpression>
                </extension>
                <linkId value="coverage.self.relatedPerson.postalCode"/>
                <text value="PLZ"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.city"/>
                  </valueExpression>
                </extension>
                <linkId value="coverage.self.relatedPerson.city"/>
                <text value="Ort"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.country"/>
                  </valueExpression>
                </extension>
                <linkId value="coverage.self.relatedPerson.country"/>
                <text value="Land"/>
                <type value="string"/>
              </item>
            </item>
          </item>
          <item>
            <linkId value="coverage.other"/>
            <text value="Anderer Kostenträger"/>
            <type value="group"/>
            <item>
              <linkId value="coverage.other.name"/>
              <text value="Name des Kostenträgers"/>
              <type value="string"/>
            </item>
            <item>
              <linkId value="coverage.other.id"/>
              <text value="Beliebige ID"/>
              <type value="string"/>
            </item>
            <item>
              <linkId value="coverage.other.id.note"/>
              <text value="Bemerkung zur ID"/>
              <type value="string"/>
            </item>
          </item>
        </item>
        <item>
          <linkId value="sender"/>
          <text value="Absender"/>
          <type value="group"/>
          <required value="true"/>
          <item>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/variable">
              <valueExpression>
                <name value="senderPractitionerRoles"/>
                <language value="application/x-fhir-query"/>
                <expression
                            value="PractitionerRole?practitioner={{%user.id}}"/>
              </valueExpression>
            </extension>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/variable">
              <valueExpression>
                <name value="senderPractitionerRole"/>
                <language value="text/fhirpath"/>
                <expression
                            value="%senderPractitionerRoles.entry[0].resource"/>
              </valueExpression>
            </extension>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/variable">
              <valueExpression>
                <name value="senderOrganizations"/>
                <language value="application/x-fhir-query"/>
                <expression
                            value="Organization?_id={{%senderPractitionerRole.organization.reference}}"/>
              </valueExpression>
            </extension>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/variable">
              <valueExpression>
                <name value="senderOrganization"/>
                <language value="text/fhirpath"/>
                <expression value="%senderOrganizations.entry[0].resource"/>
              </valueExpression>
            </extension>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/variable">
              <valueExpression>
                <name value="address"/>
                <language value="text/fhirpath"/>
                <expression value="%senderOrganization.address"/>
              </valueExpression>
            </extension>
            <linkId value="sender.author"/>
            <text value="Verantwortlicher"/>
            <type value="group"/>
            <required value="true"/>
            <item>
              <linkId value="sender.author.practitioner"/>
              <text value="Verantwortliche Person"/>
              <type value="group"/>
              <item>
                <linkId value="sender.author.practitioner.title"/>
                <text value="Titel"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%user.name.family"/>
                  </valueExpression>
                </extension>
                <linkId value="sender.author.practitioner.familyName"/>
                <text value="Name"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%user.name.given"/>
                  </valueExpression>
                </extension>
                <linkId value="sender.author.practitioner.givenName"/>
                <text value="Vorname"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression
                                value="%user.identifier.where(system='urn:oid:2.51.1.3').value"/>
                  </valueExpression>
                </extension>
                <linkId value="sender.author.practitioner.gln"/>
                <text value="GLN"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression
                                value="%user.identifier.where(system='urn:oid:2.16.756.5.30.1.123.100.2.1.1').value"/>
                  </valueExpression>
                </extension>
                <linkId value="sender.author.practitioner.zsr"/>
                <text value="ZSR"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression
                                value="%user.telecom.where(system='phone').value"/>
                  </valueExpression>
                </extension>
                <linkId value="sender.author.practitioner.phone"/>
                <text value="Telefon"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression
                                value="%user.telecom.where(system='email').value"/>
                  </valueExpression>
                </extension>
                <linkId value="sender.author.practitioner.email"/>
                <text value="E-Mail"/>
                <type value="string"/>
              </item>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/variable">
                <valueExpression>
                  <name value="linkIdPrefix"/>
                  <language value="text/fhirpath"/>
                  <expression value="'sender.author.organization.'"/>
                </valueExpression>
              </extension>
              <linkId value="sender.author.organization"/>
              <text value="Verantwortliche Organisation"/>
              <type value="group"/>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%senderOrganization.name"/>
                  </valueExpression>
                </extension>
                <linkId value="sender.author.organization.name"/>
                <text value="Name der Organisation"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression
                                value="%senderOrganization.identifier.where(system='urn:oid:2.51.1.3').value"/>
                  </valueExpression>
                </extension>
                <linkId value="sender.author.organization.gln"/>
                <text value="GLN"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.line"/>
                  </valueExpression>
                </extension>
                <linkId value="sender.author.organization.streetAddressLine"/>
                <text value="Strasse, Hausnummer, Postfach etc."/>
                <type value="string"/>
                <repeats value="true"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.postalCode"/>
                  </valueExpression>
                </extension>
                <linkId value="sender.author.organization.postalCode"/>
                <text value="PLZ"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.city"/>
                  </valueExpression>
                </extension>
                <linkId value="sender.author.organization.city"/>
                <text value="Ort"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.country"/>
                  </valueExpression>
                </extension>
                <linkId value="sender.author.organization.country"/>
                <text value="Land"/>
                <type value="string"/>
              </item>
            </item>
          </item>
          <item>
            <linkId value="sender.dataenterer"/>
            <text value="Erfasser"/>
            <type value="group"/>
            <item>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/variable">
                <valueExpression>
                  <name value="linkIdPrefix"/>
                  <language value="text/fhirpath"/>
                  <expression value="'sender.dataenterer.practitioner.'"/>
                </valueExpression>
              </extension>
              <linkId value="sender.dataenterer.practitioner"/>
              <text value="Erfassende Person"/>
              <type value="group"/>
              <item>
                <linkId value="sender.dataenterer.practitioner.title"/>
                <text value="Titel"/>
                <type value="string"/>
              </item>
              <item>
                <linkId value="sender.dataenterer.practitioner.familyName"/>
                <text value="Name"/>
                <type value="string"/>
              </item>
              <item>
                <linkId value="sender.dataenterer.practitioner.givenName"/>
                <text value="Vorname"/>
                <type value="string"/>
              </item>
              <item>
                <linkId value="sender.dataenterer.practitioner.phone"/>
                <text value="Telefon"/>
                <type value="string"/>
              </item>
              <item>
                <linkId value="sender.dataenterer.practitioner.email"/>
                <text value="E-Mail"/>
                <type value="string"/>
              </item>
            </item>
          </item>
        </item>
        <item>
          <linkId value="receiverCopy"/>
          <text
                value="Kopieempfänger (Kopie dieses Auftrags und aller daraus resultierenden Resultate)"/>
          <type value="group"/>
          <item>
            <linkId value="receiverCopy.practitionerRole"/>
            <text value="Gesundheitsfachperson oder -organisation"/>
            <type value="group"/>
            <repeats value="true"/>
            <item>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/variable">
                <valueExpression>
                  <name value="linkIdPrefix"/>
                  <language value="text/fhirpath"/>
                  <expression
                              value="'receiverCopy.practitionerRole.practitioner.'"/>
                </valueExpression>
              </extension>
              <linkId value="receiverCopy.practitionerRole.practitioner"/>
              <text value="Gesundheitsfachperson"/>
              <type value="group"/>
              <item>
                <linkId
                        value="receiverCopy.practitionerRole.practitioner.title"/>
                <text value="Titel"/>
                <type value="string"/>
              </item>
              <item>
                <linkId
                        value="receiverCopy.practitionerRole.practitioner.familyName"/>
                <text value="Name"/>
                <type value="string"/>
              </item>
              <item>
                <linkId
                        value="receiverCopy.practitionerRole.practitioner.givenName"/>
                <text value="Vorname"/>
                <type value="string"/>
              </item>
              <item>
                <linkId
                        value="receiverCopy.practitionerRole.practitioner.phone"/>
                <text value="Telefon"/>
                <type value="string"/>
              </item>
              <item>
                <linkId
                        value="receiverCopy.practitionerRole.practitioner.email"/>
                <text value="E-Mail"/>
                <type value="string"/>
              </item>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/variable">
                <valueExpression>
                  <name value="linkIdPrefix"/>
                  <language value="text/fhirpath"/>
                  <expression
                              value="'receiverCopy.practitionerRole.organization.'"/>
                </valueExpression>
              </extension>
              <linkId value="receiverCopy.practitionerRole.organization"/>
              <text value="Gesundheitsorganisatiton"/>
              <type value="group"/>
              <item>
                <linkId
                        value="receiverCopy.practitionerRole.organization.name"/>
                <text value="Name der Organisation"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.line"/>
                  </valueExpression>
                </extension>
                <linkId
                        value="receiverCopy.practitionerRole.organization.streetAddressLine"/>
                <text value="Strasse, Hausnummer, Postfach etc."/>
                <type value="string"/>
                <repeats value="true"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.postalCode"/>
                  </valueExpression>
                </extension>
                <linkId
                        value="receiverCopy.practitionerRole.organization.postalCode"/>
                <text value="PLZ"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.city"/>
                  </valueExpression>
                </extension>
                <linkId
                        value="receiverCopy.practitionerRole.organization.city"/>
                <text value="Ort"/>
                <type value="string"/>
              </item>
              <item>
                <extension
                           url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                  <valueExpression>
                    <language value="text/fhirpath"/>
                    <expression value="%address.country"/>
                  </valueExpression>
                </extension>
                <linkId
                        value="receiverCopy.practitionerRole.organization.country"/>
                <text value="Land"/>
                <type value="string"/>
              </item>
            </item>
          </item>
          <item>
            <linkId value="receiverCopy.patient"/>
            <text value="Patient selbst"/>
            <type value="boolean"/>
          </item>
          <item>
            <linkId value="receiverCopy.relatedPerson"/>
            <text value="Andere Person"/>
            <type value="group"/>
            <repeats value="true"/>
            <item>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/variable">
                <valueExpression>
                  <name value="linkIdPrefix"/>
                  <language value="text/fhirpath"/>
                  <expression value="'receiverCopy.relatedPerson.'"/>
                </valueExpression>
              </extension>
              <linkId value="receiverCopy.relatedPerson.familyName"/>
              <text value="Name"/>
              <type value="string"/>
            </item>
            <item>
              <linkId value="receiverCopy.relatedPerson.givenName"/>
              <text value="Vorname"/>
              <type value="string"/>
            </item>
            <item>
              <linkId value="receiverCopy.relatedPerson.phone"/>
              <text value="Telefon"/>
              <type value="string"/>
              <repeats value="true"/>
            </item>
            <item>
              <linkId value="receiverCopy.relatedPerson.email"/>
              <text value="E-Mail"/>
              <type value="string"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.line"/>
                </valueExpression>
              </extension>
              <linkId value="receiverCopy.relatedPerson.streetAddressLine"/>
              <text value="Strasse, Hausnummer, Postfach etc."/>
              <type value="string"/>
              <repeats value="true"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.postalCode"/>
                </valueExpression>
              </extension>
              <linkId value="receiverCopy.relatedPerson.postalCode"/>
              <text value="PLZ"/>
              <type value="string"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.city"/>
                </valueExpression>
              </extension>
              <linkId value="receiverCopy.relatedPerson.city"/>
              <text value="Ort"/>
              <type value="string"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.country"/>
                </valueExpression>
              </extension>
              <linkId value="receiverCopy.relatedPerson.country"/>
              <text value="Land"/>
              <type value="string"/>
            </item>
          </item>
        </item>
        <item>
          <linkId value="antecedentEpisodeOfCare"/>
          <text value="Vorgängiger Aufenthalt in Spital / Heim"/>
          <type value="group"/>
          <item>
            <linkId value="antecedentEpisodeOfCare.start"/>
            <text value="Von"/>
            <type value="dateTime"/>
          </item>
          <item>
            <linkId value="antecedentEpisodeOfCare.end"/>
            <text value="Bis"/>
            <type value="dateTime"/>
          </item>
          <item>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/variable">
              <valueExpression>
                <name value="linkIdPrefix"/>
                <language value="text/fhirpath"/>
                <expression
                            value="'antecedentEpisodeOfCare.managingOrganization.'"/>
              </valueExpression>
            </extension>
            <linkId value="antecedentEpisodeOfCare.managingOrganization"/>
            <text value="Spital /Heim"/>
            <type value="group"/>
            <item>
              <linkId
                      value="antecedentEpisodeOfCare.managingOrganization.name"/>
              <text value="Name der Organisation"/>
              <type value="string"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.line"/>
                </valueExpression>
              </extension>
              <linkId
                      value="antecedentEpisodeOfCare.managingOrganization.streetAddressLine"/>
              <text value="Strasse, Hausnummer, Postfach etc."/>
              <type value="string"/>
              <repeats value="true"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.postalCode"/>
                </valueExpression>
              </extension>
              <linkId
                      value="antecedentEpisodeOfCare.managingOrganization.postalCode"/>
              <text value="PLZ"/>
              <type value="string"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.city"/>
                </valueExpression>
              </extension>
              <linkId
                      value="antecedentEpisodeOfCare.managingOrganization.city"/>
              <text value="Ort"/>
              <type value="string"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.country"/>
                </valueExpression>
              </extension>
              <linkId
                      value="antecedentEpisodeOfCare.managingOrganization.country"/>
              <text value="Land"/>
              <type value="string"/>
            </item>
          </item>
        </item>
        <item>
          <linkId value="appointment"/>
          <text
                value="Ort und Zeit der Durchführung der angeforderten Leistung"/>
          <type value="group"/>
          <repeats value="true"/>
          <item>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/variable">
              <valueExpression>
                <name value="linkIdPrefix"/>
                <language value="text/fhirpath"/>
                <expression value="'appointment.location.'"/>
              </valueExpression>
            </extension>
            <linkId value="appointment.location"/>
            <text value="Ort der Durchführung"/>
            <type value="group"/>
            <item>
              <linkId value="appointment.location.name"/>
              <text value="Name"/>
              <type value="string"/>
              <required value="true"/>
            </item>
            <item>
              <linkId value="appointment.location.phone"/>
              <text value="Telefon"/>
              <type value="string"/>
            </item>
            <item>
              <linkId value="appointment.location.email"/>
              <text value="E-Mail"/>
              <type value="string"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.line"/>
                </valueExpression>
              </extension>
              <linkId value="appointment.location.streetAddressLine"/>
              <text value="Strasse, Hausnummer, Postfach etc."/>
              <type value="string"/>
              <repeats value="true"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.postalCode"/>
                </valueExpression>
              </extension>
              <linkId value="appointment.location.postalCode"/>
              <text value="PLZ"/>
              <type value="string"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.city"/>
                </valueExpression>
              </extension>
              <linkId value="appointment.location.city"/>
              <text value="Ort"/>
              <type value="string"/>
            </item>
            <item>
              <extension
                         url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
                <valueExpression>
                  <language value="text/fhirpath"/>
                  <expression value="%address.country"/>
                </valueExpression>
              </extension>
              <linkId value="appointment.location.country"/>
              <text value="Land"/>
              <type value="string"/>
            </item>
          </item>
          <item>
            <linkId value="appointment.requestedPeriod"/>
            <text
                  value="Datum und Zeit, wann der Termin bevorzugt geplant werden soll"/>
            <type value="group"/>
            <item>
              <linkId value="appointment.requestedPeriod.start"/>
              <text value="Von"/>
              <type value="dateTime"/>
            </item>
            <item>
              <linkId value="appointment.requestedPeriod.end"/>
              <text value="Bis"/>
              <type value="dateTime"/>
            </item>
          </item>
          <item>
            <linkId value="appointment.status"/>
            <text value="Status"/>
            <type value="choice"/>
            <required value="true"/>
            <answerOption>
              <valueCoding>
                <system value="http://hl7.org/fhir/appointmentstatus"/>
                <code value="proposed"/>
                <display value="Wunsch des Patienten (vorgeschlagen)"/>
              </valueCoding>
              <initialSelected value="true"/>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://hl7.org/fhir/appointmentstatus"/>
                <code value="pending"/>
                <display
                         value="Vom Patienten bestätigt, aber vom Leistungserbringer noch nicht (ausstehend)"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://hl7.org/fhir/appointmentstatus"/>
                <code value="booked"/>
                <display
                         value="Vom Patienten und Leistungserbringer bestätigt (gebucht)"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="appointment.patientInstruction"/>
            <text value="Patienteninformation für diesen Termin"/>
            <type value="string"/>
          </item>
        </item>
        <item>
          <linkId value="consent"/>
          <text value="Einverständniserklärung"/>
          <type value="group"/>
          <item>
            <linkId value="patient.consent.statement"/>
            <text
                  value="Ist der Patient über die Anmeldung informiert und explizit einverstanden?"/>
            <type value="choice"/>
            <answerOption>
              <valueCoding>
                <system
                        value="http://fhir.ch/ig/ch-orf/CodeSystem/ch-orf-cs-consentstatus"/>
                <code value="ExplicitAgreement"/>
                <display
                         value="Patient is informed and has explicitly agreed"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system
                        value="http://fhir.ch/ig/ch-orf/CodeSystem/ch-orf-cs-consentstatus"/>
                <code value="Other"/>
                <display
                         value="Other situation such as 'implicit agreement', 'agreed by legal guardian'  etc."/>
              </valueCoding>
            </answerOption>
            <item>
              <linkId value="patient.consent.statement.note"/>
              <text value="Anmerkung"/>
              <type value="string"/>
            </item>
          </item>
        </item>
        <item>
          <linkId value="note"/>
          <text value="Bemerkungen"/>
          <type value="group"/>
          <repeats value="true"/>
          <item>
            <linkId value="note.text"/>
            <text value="Kommentar"/>
            <type value="string"/>
          </item>
        </item>
      </Questionnaire>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:b09d7c4d-a7b1-443c-8c3b-4d01675ad970"/>
    <resource>
      <PractitionerRole>
        <language value="de-CH"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="de-CH" lang="de-CH"><p><b>Generated Narrative: PractitionerRole</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource PractitionerRole  (Language &quot;de-CH&quot;) </p></div><p><b>practitioner</b>: <a href="#urnuuida4e7a174-e3d1-4096-b93b-eb11ba1f22e8">See above (urn:uuid:a4e7a174-e3d1-4096-b93b-eb11ba1f22e8)</a></p><p><b>organization</b>: <a href="#urnuuid1ab1aa55-3096-4a6f-affc-a06a0d1d5786">See above (urn:uuid:1ab1aa55-3096-4a6f-affc-a06a0d1d5786)</a></p></div>
        </text>
        <practitioner>
          <reference value="urn:uuid:a4e7a174-e3d1-4096-b93b-eb11ba1f22e8"/>
        </practitioner>
        <organization>
          <reference value="urn:uuid:1ab1aa55-3096-4a6f-affc-a06a0d1d5786"/>
        </organization>
      </PractitionerRole>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:a4e7a174-e3d1-4096-b93b-eb11ba1f22e8"/>
    <resource>
      <Practitioner>
        <language value="de-CH"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="de-CH" lang="de-CH"><p><b>Generated Narrative: Practitioner</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Practitioner  (Language &quot;de-CH&quot;) </p></div><p><b>identifier</b>: id: 7601000201041</p><p><b>name</b>: Otto Rderfiller </p><p><b>telecom</b>: ph: 044 412 00 99, <a href="mailto:o.rderfiller@happyhospital.ch">o.rderfiller@happyhospital.ch</a></p></div>
        </text>
        <identifier>
          <system value="urn:oid:2.51.1.3"/>
          <value value="7601000201041"/>
        </identifier>
        <name>
          <family value="Rderfiller"/>
          <given value="Otto"/>
          <prefix value="Dr. med.">
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier">
              <valueCode value="AC"/>
            </extension>
          </prefix>
        </name>
        <telecom>
          <system value="phone"/>
          <value value="044 412 00 99"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="o.rderfiller@happyhospital.ch"/>
        </telecom>
      </Practitioner>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:1ab1aa55-3096-4a6f-affc-a06a0d1d5786"/>
    <resource>
      <Organization>
        <language value="de-CH"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="de-CH" lang="de-CH"><p><b>Generated Narrative: Organization</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Organization  (Language &quot;de-CH&quot;) </p></div><p><b>name</b>: Klinik Happy Hospital</p><p><b>address</b>: Seestrasse 133 Haus C Zürich 8000 Schweiz </p></div>
        </text>
        <name value="Klinik Happy Hospital"/>
        <address>
          <line value="Seestrasse 133"/>
          <line value="Haus C"/>
          <city value="Zürich"/>
          <postalCode value="8000"/>
          <country value="Schweiz"/>
        </address>
      </Organization>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:de8d3b4f-1a57-48c0-9b03-a758ff8f2d2f"/>
    <resource>
      <PractitionerRole>
        <language value="de-CH"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="de-CH" lang="de-CH"><p><b>Generated Narrative: PractitionerRole</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource PractitionerRole  (Language &quot;de-CH&quot;) </p></div><p><b>practitioner</b>: <a href="#urnuuid0bba65f4-88a0-442d-91fa-1e95b54c954c">See above (urn:uuid:0bba65f4-88a0-442d-91fa-1e95b54c954c)</a></p><p><b>organization</b>: <a href="#urnuuidf19b34ca-5f0d-449d-b6a1-0ca9c1257df0">See above (urn:uuid:f19b34ca-5f0d-449d-b6a1-0ca9c1257df0)</a></p></div>
        </text>
        <practitioner>
          <reference value="urn:uuid:0bba65f4-88a0-442d-91fa-1e95b54c954c"/>
        </practitioner>
        <organization>
          <reference value="urn:uuid:f19b34ca-5f0d-449d-b6a1-0ca9c1257df0"/>
        </organization>
      </PractitionerRole>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:0bba65f4-88a0-442d-91fa-1e95b54c954c"/>
    <resource>
      <Practitioner>
        <language value="de-CH"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="de-CH" lang="de-CH"><p><b>Generated Narrative: Practitioner</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Practitioner  (Language &quot;de-CH&quot;) </p></div><p><b>identifier</b>: id: 7601000618627</p><p><b>name</b>: Ottilie Rderplacer </p><p><b>telecom</b>: ph: 044 333 22 11, <a href="mailto:o.rderplacer@happydoctors.ch">o.rderplacer@happydoctors.ch</a></p></div>
        </text>
        <identifier>
          <system value="urn:oid:2.51.1.3"/>
          <value value="7601000618627"/>
        </identifier>
        <name>
          <family value="Rderplacer"/>
          <given value="Ottilie"/>
          <prefix value="Dr. med.">
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier">
              <valueCode value="AC"/>
            </extension>
          </prefix>
        </name>
        <telecom>
          <system value="phone"/>
          <value value="044 333 22 11"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="o.rderplacer@happydoctors.ch"/>
        </telecom>
      </Practitioner>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:f19b34ca-5f0d-449d-b6a1-0ca9c1257df0"/>
    <resource>
      <Organization>
        <language value="de-CH"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="de-CH" lang="de-CH"><p><b>Generated Narrative: Organization</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Organization  (Language &quot;de-CH&quot;) </p></div><p><b>name</b>: Praxis Happy Doctors</p><p><b>address</b>: Kantonsstrasse 14 Postfach 14 Zürich 8000 Schweiz </p></div>
        </text>
        <name value="Praxis Happy Doctors"/>
        <address>
          <line value="Kantonsstrasse 14"/>
          <line value="Postfach 14"/>
          <city value="Zürich"/>
          <postalCode value="8000"/>
          <country value="Schweiz"/>
        </address>
      </Organization>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:b6d4abb9-8c83-4d76-89d0-547c0b269f6d"/>
    <resource>
      <PractitionerRole>
        <language value="de-CH"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="de-CH" lang="de-CH"><p><b>Generated Narrative: PractitionerRole</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource PractitionerRole  (Language &quot;de-CH&quot;) </p></div><p><b>practitioner</b>: <a href="#urnuuidcb7715e3-dbd4-4dc4-8f75-013074c88aba">See above (urn:uuid:cb7715e3-dbd4-4dc4-8f75-013074c88aba)</a></p><p><b>organization</b>: <a href="#urnuuidf19b34ca-5f0d-449d-b6a1-0ca9c1257df0">See above (urn:uuid:f19b34ca-5f0d-449d-b6a1-0ca9c1257df0)</a></p></div>
        </text>
        <practitioner>
          <reference value="urn:uuid:cb7715e3-dbd4-4dc4-8f75-013074c88aba"/>
        </practitioner>
        <organization>
          <reference value="urn:uuid:f19b34ca-5f0d-449d-b6a1-0ca9c1257df0"/>
        </organization>
      </PractitionerRole>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:cb7715e3-dbd4-4dc4-8f75-013074c88aba"/>
    <resource>
      <Practitioner>
        <language value="de-CH"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="de-CH" lang="de-CH"><p><b>Generated Narrative: Practitioner</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Practitioner  (Language &quot;de-CH&quot;) </p></div><p><b>name</b>: Doris Ataenterer </p><p><b>telecom</b>: ph: 044 333 22 11, <a href="mailto:d.ataenterer@happydoctors.ch">d.ataenterer@happydoctors.ch</a></p></div>
        </text>
        <name>
          <family value="Ataenterer"/>
          <given value="Doris"/>
        </name>
        <telecom>
          <system value="phone"/>
          <value value="044 333 22 11"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="d.ataenterer@happydoctors.ch"/>
        </telecom>
      </Practitioner>
    </resource>
  </entry>
</Bundle>