# Antimicrobiology - S2 Get data to collect - Response - 1.3. Questionnaire - Prescription Search Support v1.1.0

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **Antimicrobiology - S2 Get data to collect - Response - 1.3. Questionnaire**

## Example Questionnaire: Antimicrobiology - S2 Get data to collect - Response - 1.3. Questionnaire
Branch:



## Resource Content

```json
{
  "resourceType" : "Questionnaire",
  "id" : "30551ce1-5a28-4356-b684-2e639094ad4c",
  "meta" : {
    "profile" : ["https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/PSSDataAcquisitionForm"]
  },
  "language" : "nl-BE",
  "url" : "https://www.ehealth.fgov.be/standards/fhir/pss/Questionnaire/30551ce1-5a28-4356-b684-2e639094ad4c",
  "identifier" : [{
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.2.51.22.2.35.1"
  }],
  "version" : "1.1.0",
  "status" : "active",
  "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" : "sp_excMand_knownPathogen_vag",
    "text" : "Oorzakelijke kiem vulvo-vaginitis",
    "_text" : {
      "extension" : [{
        "extension" : [{
          "url" : "lang",
          "valueCode" : "fr-BE"
        },
        {
          "url" : "content",
          "valueString" : "Germe causal vulvo vaginite"
        }],
        "url" : "http://hl7.org/fhir/StructureDefinition/translation"
      }]
    },
    "type" : "choice",
    "required" : true,
    "repeats" : false,
    "answerOption" : [{
      "extension" : [{
        "url" : "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
        "valueCanonical" : "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/CandidaCodes"
      }],
      "valueCoding" : {
        "code" : "pv_candida_vag",
        "display" : "Candida vaginitis",
        "_display" : {
          "extension" : [{
            "extension" : [{
              "url" : "lang",
              "valueCode" : "fr-BE"
            },
            {
              "url" : "content",
              "valueString" : "Vaginite à candida"
            }],
            "url" : "http://hl7.org/fhir/StructureDefinition/translation"
          }]
        }
      }
    },
    {
      "extension" : [{
        "url" : "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
        "valueCanonical" : "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/TrichomonasCodes"
      }],
      "valueCoding" : {
        "code" : "pv_trichomonas_vag",
        "display" : "Trichomonas vaginalis",
        "_display" : {
          "extension" : [{
            "extension" : [{
              "url" : "lang",
              "valueCode" : "fr-BE"
            },
            {
              "url" : "content",
              "valueString" : "Trichomonas vaginalis"
            }],
            "url" : "http://hl7.org/fhir/StructureDefinition/translation"
          }]
        }
      }
    },
    {
      "extension" : [{
        "url" : "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
        "valueCanonical" : "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/BacterialCodes"
      }],
      "valueCoding" : {
        "code" : "pv_bacterial_vag",
        "display" : "Bacteriële vaginose",
        "_display" : {
          "extension" : [{
            "extension" : [{
              "url" : "lang",
              "valueCode" : "fr-BE"
            },
            {
              "url" : "content",
              "valueString" : "Vaginose bactérienne"
            }],
            "url" : "http://hl7.org/fhir/StructureDefinition/translation"
          }]
        }
      }
    }]
  },
  {
    "extension" : [{
      "url" : "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
      "valueCanonical" : "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/PregnancyCodes"
    }],
    "linkId" : "pv_pregnant",
    "text" : "Zwangerschap",
    "_text" : {
      "extension" : [{
        "extension" : [{
          "url" : "lang",
          "valueCode" : "fr-BE"
        },
        {
          "url" : "content",
          "valueString" : "Grossesse"
        }],
        "url" : "http://hl7.org/fhir/StructureDefinition/translation"
      }]
    },
    "type" : "boolean"
  },
  {
    "linkId" : "sp_exc_causalPathogen_ure",
    "text" : "Oorzakelijke kiem Urethritis",
    "_text" : {
      "extension" : [{
        "extension" : [{
          "url" : "lang",
          "valueCode" : "fr-BE"
        },
        {
          "url" : "content",
          "valueString" : "Germe causal Urétrite"
        }],
        "url" : "http://hl7.org/fhir/StructureDefinition/translation"
      }]
    },
    "type" : "choice",
    "repeats" : false,
    "answerOption" : [{
      "extension" : [{
        "url" : "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
        "valueCanonical" : "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/ChlamydiaCodes"
      }],
      "valueCoding" : {
        "code" : "pv_causalPatChlamydia_ure",
        "display" : "Chlamydia",
        "_display" : {
          "extension" : [{
            "extension" : [{
              "url" : "lang",
              "valueCode" : "fr-BE"
            },
            {
              "url" : "content",
              "valueString" : "Chlamydia"
            }],
            "url" : "http://hl7.org/fhir/StructureDefinition/translation"
          }]
        }
      }
    },
    {
      "extension" : [{
        "url" : "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
        "valueCanonical" : "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/GonokokCodes"
      }],
      "valueCoding" : {
        "code" : "pv_causalPatGonokok_ure",
        "display" : "Gonokok",
        "_display" : {
          "extension" : [{
            "extension" : [{
              "url" : "lang",
              "valueCode" : "fr-BE"
            },
            {
              "url" : "content",
              "valueString" : "Gonocoque"
            }],
            "url" : "http://hl7.org/fhir/StructureDefinition/translation"
          }]
        }
      }
    },
    {
      "extension" : [{
        "url" : "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
        "valueCanonical" : "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/MycoplasmaCodes"
      }],
      "valueCoding" : {
        "code" : "pv_causalPatMycoplasma_ure",
        "display" : "Mycoplasma genitalium",
        "_display" : {
          "extension" : [{
            "extension" : [{
              "url" : "lang",
              "valueCode" : "fr-BE"
            },
            {
              "url" : "content",
              "valueString" : "Mycoplasma genitalium"
            }],
            "url" : "http://hl7.org/fhir/StructureDefinition/translation"
          }]
        }
      }
    },
    {
      "extension" : [{
        "url" : "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
        "valueCanonical" : "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/OtherCodes"
      }],
      "valueCoding" : {
        "code" : "pv_causalPatOther_ure",
        "display" : "Andere",
        "_display" : {
          "extension" : [{
            "extension" : [{
              "url" : "lang",
              "valueCode" : "fr-BE"
            },
            {
              "url" : "content",
              "valueString" : "Autres"
            }],
            "url" : "http://hl7.org/fhir/StructureDefinition/translation"
          }]
        }
      }
    }]
  },
  {
    "linkId" : "sp_riskPatient_ast",
    "text" : "Risicopatiënt",
    "_text" : {
      "extension" : [{
        "extension" : [{
          "url" : "lang",
          "valueCode" : "fr-BE"
        },
        {
          "url" : "content",
          "valueString" : "Patient à risque"
        }],
        "url" : "http://hl7.org/fhir/StructureDefinition/translation"
      }]
    },
    "type" : "boolean",
    "item" : [{
      "extension" : [{
        "url" : "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
        "valueCanonical" : "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/CompromisedImmuneSystemCodes"
      }],
      "linkId" : "pv_compromisedImmuneSystem",
      "text" : "Gecompromitteerd immuunsysteem",
      "_text" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "fr-BE"
          },
          {
            "url" : "content",
            "valueString" : "Immunosuppression / système immunitaire déprimé"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "type" : "boolean"
    },
    {
      "extension" : [{
        "url" : "https://www.ehealth.fgov.be/standards/fhir/pss/StructureDefinition/CodeValueSet",
        "valueCanonical" : "https://www.ehealth.fgov.be/standards/fhir/pss/ValueSet/OncologyPatientCodes"
      }],
      "linkId" : "pv_oncologyPatient",
      "text" : "Oncologische patiënt",
      "_text" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "fr-BE"
          },
          {
            "url" : "content",
            "valueString" : "Patient oncologique"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "type" : "boolean"
    }]
  }]
}

```
