Prescription Search Support
1.1.0 - STU1

Prescription Search Support - Downloaded Version 1.1.0 See the Directory of published versions

## Questionnaire: TCConsentForm - JSON Profile

JSON representation of the 26491cef-c5c7-4c5f-b10b-839e938f6b3e questionnaire.

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    {
      "resourceType" : "Questionnaire",
      "id" : "26491cef-c5c7-4c5f-b10b-839e938f6b3e",
      "meta" : {
        "profile" : [
          🔗 "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-computablequestionnaire"
        ]
      },
      "language" : "en",
      "text" : {
        "status" : "extensions",
        "div" : "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><p class=\"res-header-id\"><b>Generated Narrative: Questionnaire 26491cef-c5c7-4c5f-b10b-839e938f6b3e</b></p><a name=\"26491cef-c5c7-4c5f-b10b-839e938f6b3e\"> </a><a name=\"hc26491cef-c5c7-4c5f-b10b-839e938f6b3e\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Language: en</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/uv/cpg/STU2/StructureDefinition-cpg-computablequestionnaire.html\">CPG Computable Questionnaire</a></p></div><b>Structure</b><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The linkID for the item\">LinkID</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the item can appear in the instance\">Cardinality</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Type</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the item\">Description &amp; Constraints</a><span style=\"float: right\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64, \" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireRoot\" class=\"hierarchy\"/> TCConsentForm</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">http://openhie.org/fhir/Questionnaire/hiv-case-report-questionnaire#1.1.0</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" id=\"item.tc\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> tc</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Terms and Conditions</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.tcpolicy\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-display.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"display\" class=\"hierarchy\"/> tcpolicy</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Door een account aan te maken gaat u akkoord met de [Gebruiksvoorwaarden en privacyverklaring](https://www.riziv.fgov.be/nl/thema-s/egezondheid/beslissingsondersteunend-platform-voor-voorschrijvers-meer-gepaste-zorg-en-minder-veiligheidsrisico-s/gebruiksvoorwaarden-en-privacyverklaring-voor-de-applicatie-pss).</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display\">display</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.tcversion\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-display.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"display\" class=\"hierarchy\"/> tcversion</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">version</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display\">display</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" id=\"item.consent\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-boolean.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" class=\"hierarchy\"/> consent</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Consent</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" id=\"item.anonymizationPreference\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> anonymizationPreference</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Statistical anonymization preference</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.anonymizationPreference\">2 options</a></td></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64, \" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name=\"opt-item.anonymizationPreference\"> </a><p><b>Answer options for anonymizationPreference </b></p><ul><li style=\"font-size: 11px\">null#cluster-anon (&quot;Ik geef toestemming om gegevens over mijn gebruik van deze app anoniem te verzamelen op het niveau van mijn onderwijsinstelling (cluster) voor statistische doeleinden.&quot;)</li><li style=\"font-size: 11px\">null#full-anon (&quot;Ik geef de voorkeur aan volledige anonimiteit wanneer voor statistische doeleinden gegevens worden verzameld over mijn gebruik van deze app.&quot;)</li></ul></div>"
      },
      "url" : "http://openhie.org/fhir/Questionnaire/hiv-case-report-questionnaire",
      "identifier" : [
        {
          "system" : "urn:ietf:rfc:3986",
          "value" : "urn:oid:2.16.840.1.113883.2.51.22.2.35.3"
        }
      ],
      "version" : "1.1.0",
      "name" : "TCConsentForm",
      "status" : "draft",
      "date" : "2026-02-27T16:08:13+01:00",
      "publisher" : "eHealth Platform",
      "contact" : [
        {
          "name" : "eHealth Platform",
          "telecom" : [
            {
              "system" : "url",
              "value" : "https://www.ehealth.fgov.be/standards/fhir/"
            },
            {
              "system" : "email",
              "value" : "support@be-ehealth-standards.atlassian.net"
            }
          ]
        },
        {
          "name" : "Message Structure eHealth",
          "telecom" : [
            {
              "system" : "email",
              "value" : "support@be-ehealth-standards.atlassian.net",
              "use" : "work"
            }
          ]
        }
      ],
      "jurisdiction" : [
        {
          "coding" : [
            {
              "system" : "urn:iso:std:iso:3166",
              "code" : "BE",
              "display" : "Belgium"
            }
          ]
        }
      ],
      "item" : [
        {
          "linkId" : "tc",
          "text" : "Terms and Conditions",
          "type" : "group",
          "required" : true,
          "repeats" : false,
          "item" : [
            {
              "linkId" : "tcpolicy",
              "text" : "Door een account aan te maken gaat u akkoord met de [Gebruiksvoorwaarden en privacyverklaring](https://www.riziv.fgov.be/nl/thema-s/egezondheid/beslissingsondersteunend-platform-voor-voorschrijvers-meer-gepaste-zorg-en-minder-veiligheidsrisico-s/gebruiksvoorwaarden-en-privacyverklaring-voor-de-applicatie-pss).",
              "_text" : {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/rendering-markdown",
                    "valueMarkdown" : "Door een account aan te maken gaat u akkoord met de [Gebruiksvoorwaarden en privacyverklaring](https://www.riziv.fgov.be/nl/thema-s/egezondheid/beslissingsondersteunend-platform-voor-voorschrijvers-meer-gepaste-zorg-en-minder-veiligheidsrisico-s/gebruiksvoorwaarden-en-privacyverklaring-voor-de-applicatie-pss)."
                  },
                  {
                    "extension" : [
                      {
                        "url" : "lang",
                        "valueCode" : "fr-BE"
                      },
                      {
                        "url" : "content",
                        "valueString" : "En créant un compte, vous acceptez les [Conditions d'utilisation et politique de confidentialité](https://www.inami.fgov.be/fr/themes/esante/plateforme-d-aide-a-la-decision-pour-les-prescripteurs-des-soins-plus-adaptes-et-moins-de-risques-de-securite/conditions-d-utilisation-et-politique-de-confidentialite-pour-l-application-pss).",
                        "_valueString" : {
                          "extension" : [
                            {
                              "url" : "http://hl7.org/fhir/StructureDefinition/rendering-markdown",
                              "valueMarkdown" : "En créant un compte, vous acceptez les [Conditions d'utilisation et politique de confidentialité](https://www.inami.fgov.be/fr/themes/esante/plateforme-d-aide-a-la-decision-pour-les-prescripteurs-des-soins-plus-adaptes-et-moins-de-risques-de-securite/conditions-d-utilisation-et-politique-de-confidentialite-pour-l-application-pss"
                            }
                          ]
                        }
                      }
                    ],
                    "url" : "http://hl7.org/fhir/StructureDefinition/translation"
                  }
                ]
              },
              "type" : "display"
            },
            {
              "linkId" : "tcversion",
              "text" : "version",
              "type" : "display"
            },
            {
              "linkId" : "consent",
              "text" : "Consent",
              "type" : "boolean",
              "required" : true,
              "repeats" : false
            }
          ]
        },
        {
          "linkId" : "anonymizationPreference",
          "text" : "Statistical anonymization preference",
          "type" : "choice",
          "required" : true,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "code" : "cluster-anon",
                "display" : "Ik geef toestemming om gegevens over mijn gebruik van deze app anoniem te verzamelen op het niveau van mijn onderwijsinstelling (cluster) voor statistische doeleinden.",
                "_display" : {
                  "extension" : [
                    {
                      "extension" : [
                        {
                          "url" : "lang",
                          "valueCode" : "fr-BE"
                        },
                        {
                          "url" : "content",
                          "valueString" : "Je donne mon consentement pour que les données concernant mon utilisation de cette application soient collectées anonymement au niveau de mon établissement d'enseignement (cluster) à des fins statistiques."
                        }
                      ],
                      "url" : "http://hl7.org/fhir/StructureDefinition/translation"
                    }
                  ]
                }
              }
            },
            {
              "valueCoding" : {
                "code" : "full-anon",
                "display" : "Ik geef de voorkeur aan volledige anonimiteit wanneer voor statistische doeleinden gegevens worden verzameld over mijn gebruik van deze app.",
                "_display" : {
                  "extension" : [
                    {
                      "extension" : [
                        {
                          "url" : "lang",
                          "valueCode" : "fr-BE"
                        },
                        {
                          "url" : "content",
                          "valueString" : "Je préfère une anonymité totale lors de la collecte de données sur mon utilisation de cette application à des fins statistiques."
                        }
                      ],
                      "url" : "http://hl7.org/fhir/StructureDefinition/translation"
                    }
                  ]
                }
              }
            }
          ]
        }
      ]
    }