Adult Health Questionnaire for EBUS - XML Representation - Health New Zealand Te Whatu Ora Shared Care FHIR API v0.4.8

Health New Zealand Te Whatu Ora Shared Care FHIR API - Local Development build (v0.4.8) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
: Adult Health Questionnaire for EBUS - XML Representation

Active as of 2026-10-19
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<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="RespiratoryAdultHealthQuestionnaire"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Questionnaire RespiratoryAdultHealthQuestionnaire</b></p><a name="RespiratoryAdultHealthQuestionnaire"> </a><a name="hcRespiratoryAdultHealthQuestionnaire"> </a><b>Structure</b><table border="1" cellpadding="0" cellspacing="0" class="xhtTableBorder1"><tr class="xhtRowBorder2"><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th scope="col" style="" class="hierarchy xhtCellBorder1"><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 scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Other attributes of the item">Flags</a></th><th scope="col" style="" class="hierarchy xhtCellBorder1"><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,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck1.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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"/> RespiratoryAdultHealthQuestionnaire</td><td style="" class="hierarchy xhtCellBorder1">Questions about respiratory procedure health assessment</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Questionnaire</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/RespiratoryAdultHealthQuestionnaire#1.0.0</td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck10.png)" id="item.meta-specialty-code" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / </span>meta-specialty-code</td><td style="" class="hierarchy xhtCellBorder1">Specialty Code</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/extension-questionnaire-hidden.html" title="Is a hidden item"><img src="icon-qi-hidden.png" alt=""/></a><img src="icon-qi-hidden.png" alt=""/></td><td style="" class="hierarchy xhtCellBorder1">Initial Value: string = M65</td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck10.png)" id="item.meta-specialty-name" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / </span>meta-specialty-name</td><td style="" class="hierarchy xhtCellBorder1">Specialty Name</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/extension-questionnaire-hidden.html" title="Is a hidden item"><img src="icon-qi-hidden.png" alt=""/></a><img src="icon-qi-hidden.png" alt=""/></td><td style="" class="hierarchy xhtCellBorder1">Initial Value: string = Respiratory Medicine</td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck11.png)" id="item.Section0PatientID" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / </span>Section0PatientID</td><td style="" class="hierarchy xhtCellBorder1">Patient ID</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.Surname" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section0PatientID / </span>Surname</td><td style="" class="hierarchy xhtCellBorder1">Surname</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.FirstNames" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section0PatientID / </span>FirstNames</td><td style="" class="hierarchy xhtCellBorder1">First Names</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.NHI" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section0PatientID / </span>NHI</td><td style="" class="hierarchy xhtCellBorder1">NHI</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.DateOfBirth" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-date.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="date" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section0PatientID / </span>DateOfBirth</td><td style="" class="hierarchy xhtCellBorder1">Date of Birth</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date">date</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck100.png)" id="item.Sex" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section0PatientID / </span>Sex</td><td style="" class="hierarchy xhtCellBorder1">Sex</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck11.png)" id="item.Section1PatientDetails" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / </span>Section1PatientDetails</td><td style="" class="hierarchy xhtCellBorder1">Section 1 – Patient details</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.TodaysDate" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-date.png" alt="" style="background-color: white; background-color: inherit" title="date" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>TodaysDate</td><td style="" class="hierarchy xhtCellBorder1">Today's date</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date">date</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.Height" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-decimal.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="decimal" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>Height</td><td style="" class="hierarchy xhtCellBorder1">Your height (cm)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal">decimal</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.Weight" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-decimal.png" alt="" style="background-color: white; background-color: inherit" title="decimal" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>Weight</td><td style="" class="hierarchy xhtCellBorder1">Your weight (kg)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal">decimal</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.BMI" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-decimal.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="decimal" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>BMI</td><td style="" class="hierarchy xhtCellBorder1">BMI</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal">decimal</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.ProposedProcedure" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>ProposedProcedure</td><td style="" class="hierarchy xhtCellBorder1">Proposed surgery / procedure</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Initial Value: string = Endobronchial Ultrasound (EBUS)</td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck111.png)" id="item.ContactDetailsGroup" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-group.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="group" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>ContactDetailsGroup</td><td style="" class="hierarchy xhtCellBorder1">If a phone call is required for further information relating to this questionnaire, please provide details on how we can contact you.</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck1110.png)" id="item.ContactHomePhone" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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_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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / ContactDetailsGroup / </span>ContactHomePhone</td><td style="" class="hierarchy xhtCellBorder1">Home phone</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck1110.png)" id="item.ContactWorkPhone" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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_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-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / ContactDetailsGroup / </span>ContactWorkPhone</td><td style="" class="hierarchy xhtCellBorder1">Work phone</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck1110.png)" id="item.ContactMobilePhone" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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_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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / ContactDetailsGroup / </span>ContactMobilePhone</td><td style="" class="hierarchy xhtCellBorder1">Mobile phone</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck1100.png)" id="item.ContactEmail" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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_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-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / ContactDetailsGroup / </span>ContactEmail</td><td style="" class="hierarchy xhtCellBorder1">Email</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.HappyToLeaveMessage" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>HappyToLeaveMessage</td><td style="" class="hierarchy xhtCellBorder1">Are you happy for us to leave a message?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.HappyToLeaveMessage">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.MessageWithPerson" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>MessageWithPerson</td><td style="" class="hierarchy xhtCellBorder1">With a person?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.HappyToLeaveMessage">HappyToLeaveMessage</a> = Yes (yes)</span><br/>Options: <a href="#opt-item.MessageWithPerson">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.MessageWithPersonName" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>MessageWithPersonName</td><td style="" class="hierarchy xhtCellBorder1">If yes, please give person's name</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <ul><li><a href="#item.HappyToLeaveMessage">HappyToLeaveMessage</a> = Yes (yes)</li><li><a href="#item.MessageWithPerson">MessageWithPerson</a> = Yes (yes)</li></ul></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.MessageOnAnswerPhone" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>MessageOnAnswerPhone</td><td style="" class="hierarchy xhtCellBorder1">On answer phone?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.HappyToLeaveMessage">HappyToLeaveMessage</a> = Yes (yes)</span><br/>Options: <a href="#opt-item.MessageOnAnswerPhone">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck100.png)" id="item.BestTimeToCall" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section1PatientDetails / </span>BestTimeToCall</td><td style="" class="hierarchy xhtCellBorder1">When is the best time for you to receive telephone calls from staff?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck11.png)" id="item.Section2DHBUseOnly" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / </span>Section2DHBUseOnly</td><td style="" class="hierarchy xhtCellBorder1">Section 2 – Capital and Coast DHB use only</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.AssessorName" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section2DHBUseOnly / </span>AssessorName</td><td style="" class="hierarchy xhtCellBorder1">Name</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.AssessorPosition" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section2DHBUseOnly / </span>AssessorPosition</td><td style="" class="hierarchy xhtCellBorder1">Position</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.AssessmentDate" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-date.png" alt="" style="background-color: white; background-color: inherit" title="date" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section2DHBUseOnly / </span>AssessmentDate</td><td style="" class="hierarchy xhtCellBorder1">Date</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date">date</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck100.png)" id="item.PreAnaesthesiaRequirements" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section2DHBUseOnly / </span>PreAnaesthesiaRequirements</td><td style="" class="hierarchy xhtCellBorder1">Pre-anaesthesia Requirements</td><td style="" class="hierarchy xhtCellBorder1">0..*</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.PreAnaesthesiaRequirements">5 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck11.png)" id="item.Section3MedicalConditions" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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: white; background-color: inherit" title="group" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / </span>Section3MedicalConditions</td><td style="" class="hierarchy xhtCellBorder1">Section 3 – Medical conditions</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.HighBloodPressure" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HighBloodPressure</td><td style="" class="hierarchy xhtCellBorder1">1. High blood pressure?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.HighBloodPressure">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.HighBloodPressureBPAtClinic" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HighBloodPressureBPAtClinic</td><td style="" class="hierarchy xhtCellBorder1">BP at clinic</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.HighBloodPressure">HighBloodPressure</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.HeartConditions" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HeartConditions</td><td style="" class="hierarchy xhtCellBorder1">2. Heart conditions (e.g. heart murmur, valve disease, chest pain or discomfort, angina, palpitations or irregular heart beat)?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.HeartConditions">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.HeartConditionsComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-text.png" alt="" style="background-color: white; background-color: inherit" title="text" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HeartConditionsComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.HeartConditions">HeartConditions</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.HeartLungSurgery" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HeartLungSurgery</td><td style="" class="hierarchy xhtCellBorder1">3. Heart/Lung surgery?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.HeartLungSurgery">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.HeartLungSurgeryComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HeartLungSurgeryComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.HeartLungSurgery">HeartLungSurgery</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.ICDorPacemaker" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>ICDorPacemaker</td><td style="" class="hierarchy xhtCellBorder1">4. Implanted cardiac defibrillator (ICD) or Pacemaker?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.ICDorPacemaker">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.ICDorPacemakerLastChecked" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>ICDorPacemakerLastChecked</td><td style="" class="hierarchy xhtCellBorder1">When was it last checked?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.ICDorPacemaker">ICDorPacemaker</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.ShortnessOfBreathAtNight" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>ShortnessOfBreathAtNight</td><td style="" class="hierarchy xhtCellBorder1">5. Shortness of breath at night?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.ShortnessOfBreathAtNight">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.ShortnessOfBreathAtNightComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>ShortnessOfBreathAtNightComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.ShortnessOfBreathAtNight">ShortnessOfBreathAtNight</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.BlackoutsOrFainting" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>BlackoutsOrFainting</td><td style="" class="hierarchy xhtCellBorder1">6. Blackouts or fainting?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.BlackoutsOrFainting">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.BlackoutsOrFaintingCircumstances" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>BlackoutsOrFaintingCircumstances</td><td style="" class="hierarchy xhtCellBorder1">Under what circumstances?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.BlackoutsOrFainting">BlackoutsOrFainting</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.SwollenAnkles" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>SwollenAnkles</td><td style="" class="hierarchy xhtCellBorder1">7. Swollen ankles?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.SwollenAnkles">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.SwollenAnklesComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>SwollenAnklesComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.SwollenAnkles">SwollenAnkles</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.BreathingDifficulties" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>BreathingDifficulties</td><td style="" class="hierarchy xhtCellBorder1">8. Breathing difficulties (e.g. asthma, emphysema, C.O.R.D., bronchitis)?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.BreathingDifficulties">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.BreathingDifficultiesComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>BreathingDifficultiesComment</td><td style="" class="hierarchy xhtCellBorder1">(Please bring peak flow recordings with you if available)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.BreathingDifficulties">BreathingDifficulties</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.SteroidsForBreathing" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>SteroidsForBreathing</td><td style="" class="hierarchy xhtCellBorder1">9. Have you taken steroids for your breathing difficulty in the past 5 years?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.SteroidsForBreathing">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.SteroidsForBreathingLastCourse" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>SteroidsForBreathingLastCourse</td><td style="" class="hierarchy xhtCellBorder1">When was the last course?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.SteroidsForBreathing">SteroidsForBreathing</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.SleepApnoea" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>SleepApnoea</td><td style="" class="hierarchy xhtCellBorder1">10. Sleep apnoea (or have you been told you stop breathing while asleep)?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.SleepApnoea">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.SleepApnoeaComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-text.png" alt="" style="background-color: white; background-color: inherit" title="text" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>SleepApnoeaComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.SleepApnoea">SleepApnoea</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.KidneyCondition" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>KidneyCondition</td><td style="" class="hierarchy xhtCellBorder1">11. Kidney (Renal) condition?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.KidneyCondition">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.KidneyConditionComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>KidneyConditionComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.KidneyCondition">KidneyCondition</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.Diabetes" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>Diabetes</td><td style="" class="hierarchy xhtCellBorder1">12. Diabetes?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.Diabetes">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.DiabetesType" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>DiabetesType</td><td style="" class="hierarchy xhtCellBorder1">Please tick which type</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.Diabetes">Diabetes</a> = Yes (yes)</span><br/>Options: <a href="#opt-item.DiabetesType">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.DiabetesManagement" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>DiabetesManagement</td><td style="" class="hierarchy xhtCellBorder1">Do you currently use (please tick):</td><td style="" class="hierarchy xhtCellBorder1">0..*</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.Diabetes">Diabetes</a> = Yes (yes)</span><br/>Options: <a href="#opt-item.DiabetesManagement">3 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.Stroke" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>Stroke</td><td style="" class="hierarchy xhtCellBorder1">13. Stroke (Cerebrovascular accident or CVA)?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.Stroke">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.StrokeComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-text.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="text" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>StrokeComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.Stroke">Stroke</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.SuddenLossVisionSpeechMovement" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>SuddenLossVisionSpeechMovement</td><td style="" class="hierarchy xhtCellBorder1">14. Sudden loss of vision, speech or movement?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.SuddenLossVisionSpeechMovement">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.SuddenLossVisionSpeechMovementComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>SuddenLossVisionSpeechMovementComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.SuddenLossVisionSpeechMovement">SuddenLossVisionSpeechMovement</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.BloodClotsOrBleedingDisorder" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>BloodClotsOrBleedingDisorder</td><td style="" class="hierarchy xhtCellBorder1">15. Blood clots in lungs or legs or a bleeding disorder (PE, DVT, thrombosis)?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.BloodClotsOrBleedingDisorder">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.BloodClotsOrBleedingDisorderComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-text.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="text" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>BloodClotsOrBleedingDisorderComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.BloodClotsOrBleedingDisorder">BloodClotsOrBleedingDisorder</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.HeartburnRefluxHiatusHernia" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HeartburnRefluxHiatusHernia</td><td style="" class="hierarchy xhtCellBorder1">16. Heartburn/reflux of acid/hiatus hernia?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.HeartburnRefluxHiatusHernia">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.HeartburnRefluxHiatusHerniaComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HeartburnRefluxHiatusHerniaComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.HeartburnRefluxHiatusHernia">HeartburnRefluxHiatusHernia</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.ThyroidProblems" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>ThyroidProblems</td><td style="" class="hierarchy xhtCellBorder1">17. Thyroid problems?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.ThyroidProblems">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.ThyroidProblemsComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>ThyroidProblemsComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.ThyroidProblems">ThyroidProblems</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.Dementia" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>Dementia</td><td style="" class="hierarchy xhtCellBorder1">18. Dementia? (e.g. Alzheimer's, forgetfulness)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.Dementia">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.DementiaComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-text.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="text" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>DementiaComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.Dementia">Dementia</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.Epilepsy" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>Epilepsy</td><td style="" class="hierarchy xhtCellBorder1">19. Epilepsy?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.Epilepsy">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.EpilepsySeizureFrequency" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>EpilepsySeizureFrequency</td><td style="" class="hierarchy xhtCellBorder1">How often do you have seizures?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.Epilepsy">Epilepsy</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.EpilepsyLastSeizure" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>EpilepsyLastSeizure</td><td style="" class="hierarchy xhtCellBorder1">When was your last seizure?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.Epilepsy">Epilepsy</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.Arthritis" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>Arthritis</td><td style="" class="hierarchy xhtCellBorder1">20. Arthritis?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.Arthritis">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.ArthritisComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>ArthritisComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.Arthritis">Arthritis</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.JointReplacementOrMetalware" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>JointReplacementOrMetalware</td><td style="" class="hierarchy xhtCellBorder1">21. Joint replacement or orthopaedic metalware?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.JointReplacementOrMetalware">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.JointReplacementOrMetalwareType" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>JointReplacementOrMetalwareType</td><td style="" class="hierarchy xhtCellBorder1">What type?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.JointReplacementOrMetalware">JointReplacementOrMetalware</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.MuscleOrNeurologicalDisease" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>MuscleOrNeurologicalDisease</td><td style="" class="hierarchy xhtCellBorder1">22. Muscle or Neurological disease (e.g. MS, Parkinson's, Muscular dystrophy)?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.MuscleOrNeurologicalDisease">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.MuscleOrNeurologicalDiseaseComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-text.png" alt="" style="background-color: white; background-color: inherit" title="text" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>MuscleOrNeurologicalDiseaseComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.MuscleOrNeurologicalDisease">MuscleOrNeurologicalDisease</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.JawOrNeckProblems" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>JawOrNeckProblems</td><td style="" class="hierarchy xhtCellBorder1">23. Jaw or neck problems?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.JawOrNeckProblems">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.JawOrNeckProblemsComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>JawOrNeckProblemsComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.JawOrNeckProblems">JawOrNeckProblems</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.HepatitisOrLiverCondition" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HepatitisOrLiverCondition</td><td style="" class="hierarchy xhtCellBorder1">24. Hepatitis A, B, C, jaundice or liver condition?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.HepatitisOrLiverCondition">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.HepatitisOrLiverConditionComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>HepatitisOrLiverConditionComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.HepatitisOrLiverCondition">HepatitisOrLiverCondition</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.TransmittableDisease" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>TransmittableDisease</td><td style="" class="hierarchy xhtCellBorder1">25. Transmittable disease (such as MRSA, 'golden staph', boils, skin or other infection, septicaemia, HIV, VRSA)?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.TransmittableDisease">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.TransmittableDiseaseComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-text.png" alt="" style="background-color: white; background-color: inherit" title="text" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>TransmittableDiseaseComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.TransmittableDisease">TransmittableDisease</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.Tuberculosis" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>Tuberculosis</td><td style="" class="hierarchy xhtCellBorder1">26. Tuberculosis (TB)?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.Tuberculosis">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.TuberculosisTreatment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>TuberculosisTreatment</td><td style="" class="hierarchy xhtCellBorder1">Have you had or are you on treatment for this?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.Tuberculosis">Tuberculosis</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.FamilyConditions" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>FamilyConditions</td><td style="" class="hierarchy xhtCellBorder1">27. Are there any conditions that run in your family? (e.g. malignant hyperthermia, thalassaemia, muscular dystrophy)?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.FamilyConditions">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.FamilyConditionsComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-text.png" alt="" style="background-color: white; background-color: inherit" title="text" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>FamilyConditionsComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.FamilyConditions">FamilyConditions</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.Anaemia" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>Anaemia</td><td style="" class="hierarchy xhtCellBorder1">28. Anaemia?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.Anaemia">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.AnaemiaComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>AnaemiaComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.Anaemia">Anaemia</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.PreviousBloodTransfusion" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>PreviousBloodTransfusion</td><td style="" class="hierarchy xhtCellBorder1">29. Previous blood transfusion?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.PreviousBloodTransfusion">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.PreviousBloodTransfusionComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>PreviousBloodTransfusionComment</td><td style="" class="hierarchy xhtCellBorder1">When was the last?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.PreviousBloodTransfusion">PreviousBloodTransfusion</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.BloodTransfusionRefusal" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>BloodTransfusionRefusal</td><td style="" class="hierarchy xhtCellBorder1">30. Do you have any reasons which might stop you from accepting a blood transfusion?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.BloodTransfusionRefusal">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.BloodTransfusionRefusalComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-text.png" alt="" style="background-color: white; background-color: inherit" title="text" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>BloodTransfusionRefusalComment</td><td style="" class="hierarchy xhtCellBorder1">What was the reason?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.BloodTransfusionRefusal">BloodTransfusionRefusal</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.Phobias" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>Phobias</td><td style="" class="hierarchy xhtCellBorder1">31. Phobias (e.g. claustrophobia, anxiety attacks)?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.Phobias">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.PhobiasComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-text.png" alt="" style="background-color: white; background-color: inherit" title="text" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>PhobiasComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.Phobias">Phobias</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.TravelledOverseas" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>TravelledOverseas</td><td style="" class="hierarchy xhtCellBorder1">32. Travelled overseas in the last 6 months?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.TravelledOverseas">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.TravelledOverseasHospitalised" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>TravelledOverseasHospitalised</td><td style="" class="hierarchy xhtCellBorder1">Were you hospitalised?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.TravelledOverseas">TravelledOverseas</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.VisualOrHearingImpairment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>VisualOrHearingImpairment</td><td style="" class="hierarchy xhtCellBorder1">33. A visual or hearing impairment?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.VisualOrHearingImpairment">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.VisualOrHearingImpairmentComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>VisualOrHearingImpairmentComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.VisualOrHearingImpairment">VisualOrHearingImpairment</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.CurrentPainProblems" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>CurrentPainProblems</td><td style="" class="hierarchy xhtCellBorder1">34. Do you have any current pain problems?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.CurrentPainProblems">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.CurrentPainProblemsLocation" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>CurrentPainProblemsLocation</td><td style="" class="hierarchy xhtCellBorder1">What is the location of the pain?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.CurrentPainProblems">CurrentPainProblems</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck100.png)" id="item.OtherRelevantMedicalCondition" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-text.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="text" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section3MedicalConditions / </span>OtherRelevantMedicalCondition</td><td style="" class="hierarchy xhtCellBorder1">35. Is there any other relevant medical condition that you need to tell us about?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck11.png)" id="item.Section4HealthProfessionals" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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: white; background-color: inherit" title="group" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / </span>Section4HealthProfessionals</td><td style="" class="hierarchy xhtCellBorder1">Section 4 – Health professionals</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck101.png)" id="item.HealthProfessionalsGroup" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-group.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="group" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section4HealthProfessionals / </span>HealthProfessionalsGroup</td><td style="" class="hierarchy xhtCellBorder1">List the name(s) of the hospital/clinic/doctors/surgeons/nurses you see.</td><td style="" class="hierarchy xhtCellBorder1">0..*</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck1010.png)" id="item.HealthProfessionalName" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section4HealthProfessionals / HealthProfessionalsGroup / </span>HealthProfessionalName</td><td style="" class="hierarchy xhtCellBorder1">Doctor's name</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck1010.png)" id="item.HealthProfessionalReason" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section4HealthProfessionals / HealthProfessionalsGroup / </span>HealthProfessionalReason</td><td style="" class="hierarchy xhtCellBorder1">Reason you see this doctor</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck1000.png)" id="item.HealthProfessionalLastVisit" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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_blank.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-date.png" alt="" style="background-color: white; background-color: inherit" title="date" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section4HealthProfessionals / HealthProfessionalsGroup / </span>HealthProfessionalLastVisit</td><td style="" class="hierarchy xhtCellBorder1">Date of last visit</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date">date</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck11.png)" id="item.Section5FitnessAndLifestyle" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / </span>Section5FitnessAndLifestyle</td><td style="" class="hierarchy xhtCellBorder1">Section 5 – Fitness and lifestyle</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.StairsWithoutStoppingNow" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>StairsWithoutStoppingNow</td><td style="" class="hierarchy xhtCellBorder1">1. What can you do without stopping or getting breathless?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.StairsWithoutStoppingNow">4 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.ManageAroundHouse" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>ManageAroundHouse</td><td style="" class="hierarchy xhtCellBorder1">2. Can you manage around the house?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.ManageAroundHouse">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.ChangedInLast6Months" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>ChangedInLast6Months</td><td style="" class="hierarchy xhtCellBorder1">3. Has this changed in the last 6 months?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.ChangedInLast6Months">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.StairsWithoutStopping6MonthsAgo" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>StairsWithoutStopping6MonthsAgo</td><td style="" class="hierarchy xhtCellBorder1">If yes, what could you do without stopping or getting breathless 6 months ago?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.ChangedInLast6Months">ChangedInLast6Months</a> = Yes (yes)</span><br/>Options: <a href="#opt-item.StairsWithoutStopping6MonthsAgo">4 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.WhatStopsWalking" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-text.png" alt="" style="background-color: white; background-color: inherit" title="text" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>WhatStopsWalking</td><td style="" class="hierarchy xhtCellBorder1">4. What stops or restricts you from walking now? (e.g. getting breathless, pain in joints, pain in calf muscles)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.DoYouSmoke" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>DoYouSmoke</td><td style="" class="hierarchy xhtCellBorder1">5. Do you smoke?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.DoYouSmoke">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.SmokeHowManyPerDay" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-integer.png" alt="" style="background-color: white; background-color: inherit" title="integer" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>SmokeHowManyPerDay</td><td style="" class="hierarchy xhtCellBorder1">How many per day?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer">integer</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.DoYouSmoke">DoYouSmoke</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.EverSmoked" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>EverSmoked</td><td style="" class="hierarchy xhtCellBorder1">6. Have you ever smoked?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.EverSmoked">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.WhenDidYouStopSmoking" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>WhenDidYouStopSmoking</td><td style="" class="hierarchy xhtCellBorder1">If so, when did you stop?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.EverSmoked">EverSmoked</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.DrinkAlcoholRegularly" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>DrinkAlcoholRegularly</td><td style="" class="hierarchy xhtCellBorder1">7. Do you drink alcohol regularly?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.DrinkAlcoholRegularly">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.AlcoholHowMuchPerWeek" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>AlcoholHowMuchPerWeek</td><td style="" class="hierarchy xhtCellBorder1">How much per week?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.DrinkAlcoholRegularly">DrinkAlcoholRegularly</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.PregnantOrMayBePregnant" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>PregnantOrMayBePregnant</td><td style="" class="hierarchy xhtCellBorder1">8. Are you or do you think you may be pregnant?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.PregnantOrMayBePregnant">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck100.png)" id="item.PregnancyWeeks" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-integer.png" alt="" style="background-color: white; background-color: inherit" title="integer" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section5FitnessAndLifestyle / </span>PregnancyWeeks</td><td style="" class="hierarchy xhtCellBorder1">If yes – how many weeks?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer">integer</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.PregnantOrMayBePregnant">PregnantOrMayBePregnant</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck11.png)" id="item.Section6Allergies" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / </span>Section6Allergies</td><td style="" class="hierarchy xhtCellBorder1">Section 6 – Allergies</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.AllergiesOrReactions" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section6Allergies / </span>AllergiesOrReactions</td><td style="" class="hierarchy xhtCellBorder1">1. Allergies or reactions to medicines (sticking plasters, food, paint, latex / rubber products or x-ray dye)?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.AllergiesOrReactions">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck100.png)" id="item.AllergiesDescription" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-text.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="text" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section6Allergies / </span>AllergiesDescription</td><td style="" class="hierarchy xhtCellBorder1">Please describe what happens to you:</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.AllergiesOrReactions">AllergiesOrReactions</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck11.png)" id="item.Section7Medications" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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: white; background-color: inherit" title="group" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / </span>Section7Medications</td><td style="" class="hierarchy xhtCellBorder1">Section 7 – Medications</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck101.png)" id="item.MedicationsGroup" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-group.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="group" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section7Medications / </span>MedicationsGroup</td><td style="" class="hierarchy xhtCellBorder1">Medication / Therapy</td><td style="" class="hierarchy xhtCellBorder1">0..*</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck1010.png)" id="item.MedicationName" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section7Medications / MedicationsGroup / </span>MedicationName</td><td style="" class="hierarchy xhtCellBorder1">Name of Medication/Therapy</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck1010.png)" id="item.MedicationHowMuch" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section7Medications / MedicationsGroup / </span>MedicationHowMuch</td><td style="" class="hierarchy xhtCellBorder1">How much?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck1000.png)" id="item.MedicationHowOften" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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_blank.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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section7Medications / MedicationsGroup / </span>MedicationHowOften</td><td style="" class="hierarchy xhtCellBorder1">How often each day? (Breakfast, lunch, tea)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck11.png)" id="item.Section8PreviousSurgeryAnaesthesia" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / </span>Section8PreviousSurgeryAnaesthesia</td><td style="" class="hierarchy xhtCellBorder1">Section 8 – Previous surgery / anaesthesia</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.PreviousSurgeryOrAdmission" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section8PreviousSurgeryAnaesthesia / </span>PreviousSurgeryOrAdmission</td><td style="" class="hierarchy xhtCellBorder1">1. Have you ever had surgery or been admitted to hospital before? (Including day surgery)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.PreviousSurgeryOrAdmission">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck101.png)" id="item.PreviousSurgeryGroup" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-group.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="group" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section8PreviousSurgeryAnaesthesia / </span>PreviousSurgeryGroup</td><td style="" class="hierarchy xhtCellBorder1">If yes, when, what for and what hospital was that in?</td><td style="" class="hierarchy xhtCellBorder1">0..*</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.PreviousSurgeryOrAdmission">PreviousSurgeryOrAdmission</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck1010.png)" id="item.PreviousSurgeryOperationIllness" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section8PreviousSurgeryAnaesthesia / PreviousSurgeryGroup / </span>PreviousSurgeryOperationIllness</td><td style="" class="hierarchy xhtCellBorder1">Operation / Illness</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck1010.png)" id="item.PreviousSurgeryYear" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section8PreviousSurgeryAnaesthesia / PreviousSurgeryGroup / </span>PreviousSurgeryYear</td><td style="" class="hierarchy xhtCellBorder1">Year</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck1000.png)" id="item.PreviousSurgeryHospital" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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_blank.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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section8PreviousSurgeryAnaesthesia / PreviousSurgeryGroup / </span>PreviousSurgeryHospital</td><td style="" class="hierarchy xhtCellBorder1">Hospital</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck11.png)" id="item.Section9AnaesthesiaRelatedIssues" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / </span>Section9AnaesthesiaRelatedIssues</td><td style="" class="hierarchy xhtCellBorder1">Section 9 – Anaesthesia related issues</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.ProblemsUnderAnaesthetic" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section9AnaesthesiaRelatedIssues / </span>ProblemsUnderAnaesthetic</td><td style="" class="hierarchy xhtCellBorder1">1. Have you had any problems while under an anaesthetic?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.ProblemsUnderAnaesthetic">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.ProblemsUnderAnaestheticComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section9AnaesthesiaRelatedIssues / </span>ProblemsUnderAnaestheticComment</td><td style="" class="hierarchy xhtCellBorder1">(e.g. slow to wake, nausea and vomiting, post surgery confusion, agitation)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.ProblemsUnderAnaesthetic">ProblemsUnderAnaesthetic</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.RelativeProblemsUnderAnaesthetic" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section9AnaesthesiaRelatedIssues / </span>RelativeProblemsUnderAnaesthetic</td><td style="" class="hierarchy xhtCellBorder1">2. Has any blood relative had problems while under an anaesthetic?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.RelativeProblemsUnderAnaesthetic">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.RelativeProblemsUnderAnaestheticComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section9AnaesthesiaRelatedIssues / </span>RelativeProblemsUnderAnaestheticComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.RelativeProblemsUnderAnaesthetic">RelativeProblemsUnderAnaesthetic</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.AttendedPreAnaesthesiaAssessment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section9AnaesthesiaRelatedIssues / </span>AttendedPreAnaesthesiaAssessment</td><td style="" class="hierarchy xhtCellBorder1">3. Have you attended a pre-anaesthesia assessment before?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.AttendedPreAnaesthesiaAssessment">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck100.png)" id="item.AttendedPreAnaesthesiaAssessmentLastTime" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section9AnaesthesiaRelatedIssues / </span>AttendedPreAnaesthesiaAssessmentLastTime</td><td style="" class="hierarchy xhtCellBorder1">When was the last time?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.AttendedPreAnaesthesiaAssessment">AttendedPreAnaesthesiaAssessment</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck11.png)" id="item.Section10DischargePlanning" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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: white; background-color: inherit" title="group" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / </span>Section10DischargePlanning</td><td style="" class="hierarchy xhtCellBorder1">Section 10 – Discharge planning</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.RequirePhysicalSupportOrAids" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>RequirePhysicalSupportOrAids</td><td style="" class="hierarchy xhtCellBorder1">1. Do you require any physical support or aids?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.RequirePhysicalSupportOrAids">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.RequirePhysicalSupportOrAidsDetails" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>RequirePhysicalSupportOrAidsDetails</td><td style="" class="hierarchy xhtCellBorder1">If so what?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.RequirePhysicalSupportOrAids">RequirePhysicalSupportOrAids</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.LiveAlone" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>LiveAlone</td><td style="" class="hierarchy xhtCellBorder1">2. Do you live alone?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.LiveAlone">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.LiveAloneComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>LiveAloneComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.LiveAlone">LiveAlone</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.ProblemsWithDailyActivities" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>ProblemsWithDailyActivities</td><td style="" class="hierarchy xhtCellBorder1">3. Do you have any problems with daily activities?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.ProblemsWithDailyActivities">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.ProblemsWithDailyActivitiesComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>ProblemsWithDailyActivitiesComment</td><td style="" class="hierarchy xhtCellBorder1">(e.g. showering, bathing, dressing)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.ProblemsWithDailyActivities">ProblemsWithDailyActivities</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.WhoWillTakeYouHome" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>WhoWillTakeYouHome</td><td style="" class="hierarchy xhtCellBorder1">4. Who will be taking you home?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.WhoWillTakeYouHome">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.WhoWillTakeYouHomeComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>WhoWillTakeYouHomeComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.WhoWillTakeYouHome">WhoWillTakeYouHome</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.SomeoneToStayOvernight" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>SomeoneToStayOvernight</td><td style="" class="hierarchy xhtCellBorder1">5. Do you have someone to stay overnight with you when you get home?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.SomeoneToStayOvernight">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.SomeoneToStayOvernightComment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-text.png" alt="" style="background-color: white; background-color: inherit" title="text" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>SomeoneToStayOvernightComment</td><td style="" class="hierarchy xhtCellBorder1">If yes, or not certain, please comment</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.SomeoneToStayOvernight">SomeoneToStayOvernight</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.UsingCommunitySupportServices" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>UsingCommunitySupportServices</td><td style="" class="hierarchy xhtCellBorder1">6. Are you currently using any community support services?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.UsingCommunitySupportServices">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.CommunitySupportServicesList" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>CommunitySupportServicesList</td><td style="" class="hierarchy xhtCellBorder1">If so please list:</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.UsingCommunitySupportServices">UsingCommunitySupportServices</a> = Yes (yes)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.SpeakUnderstandEnglish" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>SpeakUnderstandEnglish</td><td style="" class="hierarchy xhtCellBorder1">7. Do you speak and understand English?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Options: <a href="#opt-item.SpeakUnderstandEnglish">2 options</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.FirstLanguage" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>FirstLanguage</td><td style="" class="hierarchy xhtCellBorder1">If not, what is your first language?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Enable When: <span><a href="#item.SpeakUnderstandEnglish">SpeakUnderstandEnglish</a> = No (no)</span></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck100.png)" id="item.AnythingToDiscuss" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-text.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="text" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section10DischargePlanning / </span>AnythingToDiscuss</td><td style="" class="hierarchy xhtCellBorder1">8. Is there anything in particular you would like to discuss?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck01.png)" id="item.Section11PatientDeclaration" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><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-group.png" alt="" style="background-color: white; background-color: inherit" title="group" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / </span>Section11PatientDeclaration</td><td style="" class="hierarchy xhtCellBorder1">Section 11 – Patient declaration</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck010.png)" id="item.DeclarationStatement" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.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"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section11PatientDeclaration / </span>DeclarationStatement</td><td style="" class="hierarchy xhtCellBorder1">The above health information is a true and accurate account of my health status.</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck010.png)" id="item.PatientSignature" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section11PatientDeclaration / </span>PatientSignature</td><td style="" class="hierarchy xhtCellBorder1">Patient's signature</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck000.png)" id="item.DeclarationDate" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.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-date.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="date" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">RespiratoryAdultHealthQuestionnaire / Section11PatientDeclaration / </span>DeclarationDate</td><td style="" class="hierarchy xhtCellBorder1">Date</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date">date</a></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr><td colspan="6" class="hierarchy"><br/><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" 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.HappyToLeaveMessage"> </a><p><b>Answer options for HappyToLeaveMessage </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.MessageWithPerson"> </a><p><b>Answer options for MessageWithPerson </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.MessageOnAnswerPhone"> </a><p><b>Answer options for MessageOnAnswerPhone </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.PreAnaesthesiaRequirements"> </a><p><b>Answer options for PreAnaesthesiaRequirements </b></p><ul><li style="font-size: 11px">null#nurse-telephone-call (&quot;Nurse telephone call&quot;)</li><li style="font-size: 11px">null#routine (&quot;Routine&quot;)</li><li style="font-size: 11px">null#complex (&quot;Complex&quot;)</li><li style="font-size: 11px">null#high-risk (&quot;High risk&quot;)</li><li style="font-size: 11px">null#paediatric-specialist (&quot;Paediatric specialist&quot;)</li></ul><a name="opt-item.HighBloodPressure"> </a><p><b>Answer options for HighBloodPressure </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.HeartConditions"> </a><p><b>Answer options for HeartConditions </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.HeartLungSurgery"> </a><p><b>Answer options for HeartLungSurgery </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.ICDorPacemaker"> </a><p><b>Answer options for ICDorPacemaker </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.ShortnessOfBreathAtNight"> </a><p><b>Answer options for ShortnessOfBreathAtNight </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.BlackoutsOrFainting"> </a><p><b>Answer options for BlackoutsOrFainting </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.SwollenAnkles"> </a><p><b>Answer options for SwollenAnkles </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.BreathingDifficulties"> </a><p><b>Answer options for BreathingDifficulties </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.SteroidsForBreathing"> </a><p><b>Answer options for SteroidsForBreathing </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.SleepApnoea"> </a><p><b>Answer options for SleepApnoea </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.KidneyCondition"> </a><p><b>Answer options for KidneyCondition </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.Diabetes"> </a><p><b>Answer options for Diabetes </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.DiabetesType"> </a><p><b>Answer options for DiabetesType </b></p><ul><li style="font-size: 11px">null#type-1 (&quot;Type 1&quot;)</li><li style="font-size: 11px">null#type-2 (&quot;Type 2&quot;)</li></ul><a name="opt-item.DiabetesManagement"> </a><p><b>Answer options for DiabetesManagement </b></p><ul><li style="font-size: 11px">null#insulin (&quot;Insulin&quot;)</li><li style="font-size: 11px">null#tablets (&quot;Tablets&quot;)</li><li style="font-size: 11px">null#diet-control (&quot;Diet control&quot;)</li></ul><a name="opt-item.Stroke"> </a><p><b>Answer options for Stroke </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.SuddenLossVisionSpeechMovement"> </a><p><b>Answer options for SuddenLossVisionSpeechMovement </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.BloodClotsOrBleedingDisorder"> </a><p><b>Answer options for BloodClotsOrBleedingDisorder </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.HeartburnRefluxHiatusHernia"> </a><p><b>Answer options for HeartburnRefluxHiatusHernia </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.ThyroidProblems"> </a><p><b>Answer options for ThyroidProblems </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.Dementia"> </a><p><b>Answer options for Dementia </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.Epilepsy"> </a><p><b>Answer options for Epilepsy </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.Arthritis"> </a><p><b>Answer options for Arthritis </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.JointReplacementOrMetalware"> </a><p><b>Answer options for JointReplacementOrMetalware </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.MuscleOrNeurologicalDisease"> </a><p><b>Answer options for MuscleOrNeurologicalDisease </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.JawOrNeckProblems"> </a><p><b>Answer options for JawOrNeckProblems </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.HepatitisOrLiverCondition"> </a><p><b>Answer options for HepatitisOrLiverCondition </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.TransmittableDisease"> </a><p><b>Answer options for TransmittableDisease </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.Tuberculosis"> </a><p><b>Answer options for Tuberculosis </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.FamilyConditions"> </a><p><b>Answer options for FamilyConditions </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.Anaemia"> </a><p><b>Answer options for Anaemia </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.PreviousBloodTransfusion"> </a><p><b>Answer options for PreviousBloodTransfusion </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.BloodTransfusionRefusal"> </a><p><b>Answer options for BloodTransfusionRefusal </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.Phobias"> </a><p><b>Answer options for Phobias </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.TravelledOverseas"> </a><p><b>Answer options for TravelledOverseas </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.VisualOrHearingImpairment"> </a><p><b>Answer options for VisualOrHearingImpairment </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.CurrentPainProblems"> </a><p><b>Answer options for CurrentPainProblems </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.StairsWithoutStoppingNow"> </a><p><b>Answer options for StairsWithoutStoppingNow </b></p><ul><li style="font-size: 11px">null#10-stairs (&quot;10 stairs&quot;)</li><li style="font-size: 11px">null#20-stairs (&quot;20 stairs&quot;)</li><li style="font-size: 11px">null#30-stairs (&quot;30 stairs&quot;)</li><li style="font-size: 11px">null#40-stairs (&quot;40 stairs&quot;)</li></ul><a name="opt-item.ManageAroundHouse"> </a><p><b>Answer options for ManageAroundHouse </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.ChangedInLast6Months"> </a><p><b>Answer options for ChangedInLast6Months </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.StairsWithoutStopping6MonthsAgo"> </a><p><b>Answer options for StairsWithoutStopping6MonthsAgo </b></p><ul><li style="font-size: 11px">null#10-stairs (&quot;10 stairs&quot;)</li><li style="font-size: 11px">null#20-stairs (&quot;20 stairs&quot;)</li><li style="font-size: 11px">null#30-stairs (&quot;30 stairs&quot;)</li><li style="font-size: 11px">null#40-stairs (&quot;40 stairs&quot;)</li></ul><a name="opt-item.DoYouSmoke"> </a><p><b>Answer options for DoYouSmoke </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.EverSmoked"> </a><p><b>Answer options for EverSmoked </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.DrinkAlcoholRegularly"> </a><p><b>Answer options for DrinkAlcoholRegularly </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.PregnantOrMayBePregnant"> </a><p><b>Answer options for PregnantOrMayBePregnant </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.AllergiesOrReactions"> </a><p><b>Answer options for AllergiesOrReactions </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.PreviousSurgeryOrAdmission"> </a><p><b>Answer options for PreviousSurgeryOrAdmission </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.ProblemsUnderAnaesthetic"> </a><p><b>Answer options for ProblemsUnderAnaesthetic </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.RelativeProblemsUnderAnaesthetic"> </a><p><b>Answer options for RelativeProblemsUnderAnaesthetic </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.AttendedPreAnaesthesiaAssessment"> </a><p><b>Answer options for AttendedPreAnaesthesiaAssessment </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.RequirePhysicalSupportOrAids"> </a><p><b>Answer options for RequirePhysicalSupportOrAids </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.LiveAlone"> </a><p><b>Answer options for LiveAlone </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.ProblemsWithDailyActivities"> </a><p><b>Answer options for ProblemsWithDailyActivities </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.WhoWillTakeYouHome"> </a><p><b>Answer options for WhoWillTakeYouHome </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.SomeoneToStayOvernight"> </a><p><b>Answer options for SomeoneToStayOvernight </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.UsingCommunitySupportServices"> </a><p><b>Answer options for UsingCommunitySupportServices </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul><a name="opt-item.SpeakUnderstandEnglish"> </a><p><b>Answer options for SpeakUnderstandEnglish </b></p><ul><li style="font-size: 11px">null#yes (&quot;Yes&quot;)</li><li style="font-size: 11px">null#no (&quot;No&quot;)</li></ul></div>
  </text>
  <url
       value="https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/RespiratoryAdultHealthQuestionnaire"/>
  <identifier>
    <use value="official"/>
    <value value="RespiratoryAdultHealthQuestionnaire"/>
  </identifier>
  <version value="1.0.0"/>
  <name value="RespiratoryAdultHealthQuestionnaire"/>
  <title value="Adult Health Questionnaire for EBUS">
    <extension url="http://hl7.org/fhir/StructureDefinition/rendering-xhtml">
      <valueString
                   value="&lt;div&gt;&lt;h1 style=&quot;margin:0 0 12px 0;font-size:30px;line-height:1.2;color:#007d8a;font-weight:700;&quot;&gt;Adult Health Questionnaire for EBUS&lt;/h1&gt;&lt;div style=&quot;margin:0 0 18px 0;padding:12px 16px;background-color:#f0f9fa;border-left:4px solid #007d8a;border-radius:4px;&quot;&gt;&lt;p style=&quot;margin:0 0 4px 0;font-size:18px;line-height:1.4;color:#005f68;font-weight:700;&quot;&gt;Proposed surgery / procedure: Endobronchial Ultrasound (EBUS)&lt;/p&gt;&lt;p style=&quot;margin:0;font-size:15px;line-height:1.5;color:#5f6b76;&quot;&gt;Please complete this questionnaire before your procedure. The information helps the Respiratory Service and the anaesthetic team assess your health and plan your care safely.&lt;/p&gt;&lt;/div&gt;&lt;/div&gt;"/>
    </extension>
  </title>
  <status value="active"/>
  <subjectType value="Patient"/>
  <date value="2026-10-19T00:00:00.000Z"/>
  <publisher value="Te Whatu Ora"/>
  <contact>
    <name value="Te Whatu Ora"/>
    <telecom>
      <system value="url"/>
      <value value="https://www.tewhatuora.govt.nz/"/>
    </telecom>
  </contact>
  <contact>
    <name value="Te Whatu Ora Integration Team"/>
    <telecom>
      <system value="email"/>
      <value value="integration@tewhatuora.govt.nz"/>
      <use value="work"/>
    </telecom>
  </contact>
  <description
               value="Questions about respiratory procedure health assessment"/>
  <useContext>
    <code>
      <system
              value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
      <code value="focus"/>
      <display value="Clinical Focus"/>
    </code>
    <valueCodeableConcept>
      <text value="M65 Respiratory Medicine"/>
    </valueCodeableConcept>
  </useContext>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="NZ"/>
      <display value="New Zealand"/>
    </coding>
  </jurisdiction>
  <purpose value="Respiratory procedure health assessment"/>
  <item>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-hidden">
      <valueBoolean value="true"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-claims-extract">
      <valueString value="specialtyCode"/>
    </extension>
    <linkId value="meta-specialty-code"/>
    <text value="Specialty Code"/>
    <type value="string"/>
    <required value="false"/>
    <initial>
      <valueString value="M65"/>
    </initial>
  </item>
  <item>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-hidden">
      <valueBoolean value="true"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-claims-extract">
      <valueString value="specialtyName"/>
    </extension>
    <linkId value="meta-specialty-name"/>
    <text value="Specialty Name"/>
    <type value="string"/>
    <required value="false"/>
    <initial>
      <valueString value="Respiratory Medicine"/>
    </initial>
  </item>
  <item>
    <linkId value="Section0PatientID"/>
    <text value="Patient ID"/>
    <type value="group"/>
    <item>
      <linkId value="Surname"/>
      <text value="Surname"/>
      <type value="string"/>
      <required value="false"/>
    </item>
    <item>
      <linkId value="FirstNames"/>
      <text value="First Names"/>
      <type value="string"/>
      <required value="false"/>
    </item>
    <item>
      <linkId value="NHI"/>
      <text value="NHI"/>
      <type value="string"/>
      <required value="false"/>
    </item>
    <item>
      <linkId value="DateOfBirth"/>
      <text value="Date of Birth"/>
      <type value="date"/>
      <required value="false"/>
    </item>
    <item>
      <linkId value="Sex"/>
      <text value="Sex"/>
      <type value="string"/>
      <required value="false"/>
    </item>
  </item>
  <item>
    <linkId value="Section1PatientDetails"/>
    <text value="Section 1 – Patient details"/>
    <type value="group"/>
    <item>
      <linkId value="TodaysDate"/>
      <text value="Today's date"/>
      <type value="date"/>
      <required value="false"/>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/minValue">
        <valueInteger value="0"/>
      </extension>
      <linkId value="Height"/>
      <text value="Your height (cm)"/>
      <type value="decimal"/>
      <required value="false"/>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/minValue">
        <valueInteger value="0"/>
      </extension>
      <linkId value="Weight"/>
      <text value="Your weight (kg)"/>
      <type value="decimal"/>
      <required value="false"/>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/minValue">
        <valueInteger value="0"/>
      </extension>
      <linkId value="BMI"/>
      <text value="BMI"/>
      <type value="decimal"/>
      <required value="false"/>
    </item>
    <item>
      <linkId value="ProposedProcedure"/>
      <text value="Proposed surgery / procedure"/>
      <type value="string"/>
      <required value="false"/>
      <initial>
        <valueString value="Endobronchial Ultrasound (EBUS)"/>
      </initial>
    </item>
    <item>
      <linkId value="ContactDetailsGroup"/>
      <text
            value="If a phone call is required for further information relating to this questionnaire, please provide details on how we can contact you."/>
      <type value="group"/>
      <item>
        <linkId value="ContactHomePhone"/>
        <text value="Home phone"/>
        <type value="string"/>
        <required value="false"/>
      </item>
      <item>
        <linkId value="ContactWorkPhone"/>
        <text value="Work phone"/>
        <type value="string"/>
        <required value="false"/>
      </item>
      <item>
        <linkId value="ContactMobilePhone"/>
        <text value="Mobile phone"/>
        <type value="string"/>
        <required value="false"/>
      </item>
      <item>
        <linkId value="ContactEmail"/>
        <text value="Email"/>
        <type value="string"/>
        <required value="false"/>
      </item>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="HappyToLeaveMessage"/>
      <text value="Are you happy for us to leave a message?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="MessageWithPerson"/>
      <text value="With a person?"/>
      <type value="choice"/>
      <enableWhen>
        <question value="HappyToLeaveMessage"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="MessageWithPersonName"/>
      <text value="If yes, please give person's name"/>
      <type value="string"/>
      <enableWhen>
        <question value="HappyToLeaveMessage"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <enableWhen>
        <question value="MessageWithPerson"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <enableBehavior value="all"/>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="MessageOnAnswerPhone"/>
      <text value="On answer phone?"/>
      <type value="choice"/>
      <enableWhen>
        <question value="HappyToLeaveMessage"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="BestTimeToCall"/>
      <text
            value="When is the best time for you to receive telephone calls from staff?"/>
      <type value="string"/>
      <required value="false"/>
    </item>
  </item>
  <item>
    <linkId value="Section2DHBUseOnly"/>
    <text value="Section 2 – Capital and Coast DHB use only"/>
    <type value="group"/>
    <item>
      <linkId value="AssessorName"/>
      <text value="Name"/>
      <type value="string"/>
      <required value="false"/>
    </item>
    <item>
      <linkId value="AssessorPosition"/>
      <text value="Position"/>
      <type value="string"/>
      <required value="false"/>
    </item>
    <item>
      <linkId value="AssessmentDate"/>
      <text value="Date"/>
      <type value="date"/>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="check-box"/>
            <display value="Check-box"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="PreAnaesthesiaRequirements"/>
      <text value="Pre-anaesthesia Requirements"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="true"/>
      <answerOption>
        <valueCoding>
          <code value="nurse-telephone-call"/>
          <display value="Nurse telephone call"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="routine"/>
          <display value="Routine"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="complex"/>
          <display value="Complex"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="high-risk"/>
          <display value="High risk"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="paediatric-specialist"/>
          <display value="Paediatric specialist"/>
        </valueCoding>
      </answerOption>
    </item>
  </item>
  <item>
    <linkId value="Section3MedicalConditions"/>
    <text value="Section 3 – Medical conditions"/>
    <type value="group"/>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="HighBloodPressure"/>
      <text value="1. High blood pressure?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="HighBloodPressureBPAtClinic"/>
      <text value="BP at clinic"/>
      <type value="string"/>
      <enableWhen>
        <question value="HighBloodPressure"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="HeartConditions"/>
      <text
            value="2. Heart conditions (e.g. heart murmur, valve disease, chest pain or discomfort, angina, palpitations or irregular heart beat)?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="HeartConditionsComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="text"/>
      <enableWhen>
        <question value="HeartConditions"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="HeartLungSurgery"/>
      <text value="3. Heart/Lung surgery?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="HeartLungSurgeryComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="string"/>
      <enableWhen>
        <question value="HeartLungSurgery"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="ICDorPacemaker"/>
      <text value="4. Implanted cardiac defibrillator (ICD) or Pacemaker?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="ICDorPacemakerLastChecked"/>
      <text value="When was it last checked?"/>
      <type value="string"/>
      <enableWhen>
        <question value="ICDorPacemaker"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="ShortnessOfBreathAtNight"/>
      <text value="5. Shortness of breath at night?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="ShortnessOfBreathAtNightComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="string"/>
      <enableWhen>
        <question value="ShortnessOfBreathAtNight"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="BlackoutsOrFainting"/>
      <text value="6. Blackouts or fainting?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="BlackoutsOrFaintingCircumstances"/>
      <text value="Under what circumstances?"/>
      <type value="string"/>
      <enableWhen>
        <question value="BlackoutsOrFainting"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="SwollenAnkles"/>
      <text value="7. Swollen ankles?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="SwollenAnklesComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="string"/>
      <enableWhen>
        <question value="SwollenAnkles"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="BreathingDifficulties"/>
      <text
            value="8. Breathing difficulties (e.g. asthma, emphysema, C.O.R.D., bronchitis)?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="BreathingDifficultiesComment"/>
      <text
            value="(Please bring peak flow recordings with you if available)"/>
      <type value="string"/>
      <enableWhen>
        <question value="BreathingDifficulties"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="SteroidsForBreathing"/>
      <text
            value="9. Have you taken steroids for your breathing difficulty in the past 5 years?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="SteroidsForBreathingLastCourse"/>
      <text value="When was the last course?"/>
      <type value="string"/>
      <enableWhen>
        <question value="SteroidsForBreathing"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="SleepApnoea"/>
      <text
            value="10. Sleep apnoea (or have you been told you stop breathing while asleep)?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="SleepApnoeaComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="text"/>
      <enableWhen>
        <question value="SleepApnoea"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="KidneyCondition"/>
      <text value="11. Kidney (Renal) condition?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="KidneyConditionComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="string"/>
      <enableWhen>
        <question value="KidneyCondition"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="Diabetes"/>
      <text value="12. Diabetes?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="DiabetesType"/>
      <text value="Please tick which type"/>
      <type value="choice"/>
      <enableWhen>
        <question value="Diabetes"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="type-1"/>
          <display value="Type 1"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="type-2"/>
          <display value="Type 2"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="check-box"/>
            <display value="Check-box"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="DiabetesManagement"/>
      <text value="Do you currently use (please tick):"/>
      <type value="choice"/>
      <enableWhen>
        <question value="Diabetes"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
      <repeats value="true"/>
      <answerOption>
        <valueCoding>
          <code value="insulin"/>
          <display value="Insulin"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="tablets"/>
          <display value="Tablets"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="diet-control"/>
          <display value="Diet control"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="Stroke"/>
      <text value="13. Stroke (Cerebrovascular accident or CVA)?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="StrokeComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="text"/>
      <enableWhen>
        <question value="Stroke"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="SuddenLossVisionSpeechMovement"/>
      <text value="14. Sudden loss of vision, speech or movement?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="SuddenLossVisionSpeechMovementComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="string"/>
      <enableWhen>
        <question value="SuddenLossVisionSpeechMovement"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="BloodClotsOrBleedingDisorder"/>
      <text
            value="15. Blood clots in lungs or legs or a bleeding disorder (PE, DVT, thrombosis)?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="BloodClotsOrBleedingDisorderComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="text"/>
      <enableWhen>
        <question value="BloodClotsOrBleedingDisorder"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="HeartburnRefluxHiatusHernia"/>
      <text value="16. Heartburn/reflux of acid/hiatus hernia?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="HeartburnRefluxHiatusHerniaComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="string"/>
      <enableWhen>
        <question value="HeartburnRefluxHiatusHernia"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="ThyroidProblems"/>
      <text value="17. Thyroid problems?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="ThyroidProblemsComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="string"/>
      <enableWhen>
        <question value="ThyroidProblems"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="Dementia"/>
      <text value="18. Dementia? (e.g. Alzheimer's, forgetfulness)"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="DementiaComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="text"/>
      <enableWhen>
        <question value="Dementia"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="Epilepsy"/>
      <text value="19. Epilepsy?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="EpilepsySeizureFrequency"/>
      <text value="How often do you have seizures?"/>
      <type value="string"/>
      <enableWhen>
        <question value="Epilepsy"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <linkId value="EpilepsyLastSeizure"/>
      <text value="When was your last seizure?"/>
      <type value="string"/>
      <enableWhen>
        <question value="Epilepsy"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="Arthritis"/>
      <text value="20. Arthritis?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="ArthritisComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="string"/>
      <enableWhen>
        <question value="Arthritis"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="JointReplacementOrMetalware"/>
      <text value="21. Joint replacement or orthopaedic metalware?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="JointReplacementOrMetalwareType"/>
      <text value="What type?"/>
      <type value="string"/>
      <enableWhen>
        <question value="JointReplacementOrMetalware"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="MuscleOrNeurologicalDisease"/>
      <text
            value="22. Muscle or Neurological disease (e.g. MS, Parkinson's, Muscular dystrophy)?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="MuscleOrNeurologicalDiseaseComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="text"/>
      <enableWhen>
        <question value="MuscleOrNeurologicalDisease"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="JawOrNeckProblems"/>
      <text value="23. Jaw or neck problems?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="JawOrNeckProblemsComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="string"/>
      <enableWhen>
        <question value="JawOrNeckProblems"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="HepatitisOrLiverCondition"/>
      <text value="24. Hepatitis A, B, C, jaundice or liver condition?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="HepatitisOrLiverConditionComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="string"/>
      <enableWhen>
        <question value="HepatitisOrLiverCondition"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="TransmittableDisease"/>
      <text
            value="25. Transmittable disease (such as MRSA, 'golden staph', boils, skin or other infection, septicaemia, HIV, VRSA)?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="TransmittableDiseaseComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="text"/>
      <enableWhen>
        <question value="TransmittableDisease"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="Tuberculosis"/>
      <text value="26. Tuberculosis (TB)?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="TuberculosisTreatment"/>
      <text value="Have you had or are you on treatment for this?"/>
      <type value="string"/>
      <enableWhen>
        <question value="Tuberculosis"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="FamilyConditions"/>
      <text
            value="27. Are there any conditions that run in your family? (e.g. malignant hyperthermia, thalassaemia, muscular dystrophy)?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="FamilyConditionsComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="text"/>
      <enableWhen>
        <question value="FamilyConditions"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="Anaemia"/>
      <text value="28. Anaemia?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="AnaemiaComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="string"/>
      <enableWhen>
        <question value="Anaemia"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="PreviousBloodTransfusion"/>
      <text value="29. Previous blood transfusion?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="PreviousBloodTransfusionComment"/>
      <text value="When was the last?"/>
      <type value="string"/>
      <enableWhen>
        <question value="PreviousBloodTransfusion"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="BloodTransfusionRefusal"/>
      <text
            value="30. Do you have any reasons which might stop you from accepting a blood transfusion?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="BloodTransfusionRefusalComment"/>
      <text value="What was the reason?"/>
      <type value="text"/>
      <enableWhen>
        <question value="BloodTransfusionRefusal"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="Phobias"/>
      <text value="31. Phobias (e.g. claustrophobia, anxiety attacks)?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="PhobiasComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="text"/>
      <enableWhen>
        <question value="Phobias"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="TravelledOverseas"/>
      <text value="32. Travelled overseas in the last 6 months?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="TravelledOverseasHospitalised"/>
      <text value="Were you hospitalised?"/>
      <type value="string"/>
      <enableWhen>
        <question value="TravelledOverseas"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
      <repeats value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="VisualOrHearingImpairment"/>
      <text value="33. A visual or hearing impairment?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="VisualOrHearingImpairmentComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="string"/>
      <enableWhen>
        <question value="VisualOrHearingImpairment"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="CurrentPainProblems"/>
      <text value="34. Do you have any current pain problems?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="CurrentPainProblemsLocation"/>
      <text value="What is the location of the pain?"/>
      <type value="string"/>
      <enableWhen>
        <question value="CurrentPainProblems"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="text-box"/>
            <display value="Text Box"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="OtherRelevantMedicalCondition"/>
      <text
            value="35. Is there any other relevant medical condition that you need to tell us about?"/>
      <type value="text"/>
      <required value="false"/>
    </item>
  </item>
  <item>
    <linkId value="Section4HealthProfessionals"/>
    <text value="Section 4 – Health professionals"/>
    <type value="group"/>
    <item>
      <linkId value="HealthProfessionalsGroup"/>
      <text
            value="List the name(s) of the hospital/clinic/doctors/surgeons/nurses you see."/>
      <type value="group"/>
      <repeats value="true"/>
      <item>
        <linkId value="HealthProfessionalName"/>
        <text value="Doctor's name"/>
        <type value="string"/>
        <required value="false"/>
      </item>
      <item>
        <linkId value="HealthProfessionalReason"/>
        <text value="Reason you see this doctor"/>
        <type value="string"/>
        <required value="false"/>
      </item>
      <item>
        <linkId value="HealthProfessionalLastVisit"/>
        <text value="Date of last visit"/>
        <type value="date"/>
        <required value="false"/>
      </item>
    </item>
  </item>
  <item>
    <linkId value="Section5FitnessAndLifestyle"/>
    <text value="Section 5 – Fitness and lifestyle"/>
    <type value="group"/>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="StairsWithoutStoppingNow"/>
      <text
            value="1. What can you do without stopping or getting breathless?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="10-stairs"/>
          <display value="10 stairs"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="20-stairs"/>
          <display value="20 stairs"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="30-stairs"/>
          <display value="30 stairs"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="40-stairs"/>
          <display value="40 stairs"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="ManageAroundHouse"/>
      <text value="2. Can you manage around the house?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="ChangedInLast6Months"/>
      <text value="3. Has this changed in the last 6 months?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="StairsWithoutStopping6MonthsAgo"/>
      <text
            value="If yes, what could you do without stopping or getting breathless 6 months ago?"/>
      <type value="choice"/>
      <enableWhen>
        <question value="ChangedInLast6Months"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="10-stairs"/>
          <display value="10 stairs"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="20-stairs"/>
          <display value="20 stairs"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="30-stairs"/>
          <display value="30 stairs"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="40-stairs"/>
          <display value="40 stairs"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="text-box"/>
            <display value="Text Box"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="WhatStopsWalking"/>
      <text
            value="4. What stops or restricts you from walking now? (e.g. getting breathless, pain in joints, pain in calf muscles)"/>
      <type value="text"/>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="DoYouSmoke"/>
      <text value="5. Do you smoke?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/minValue">
        <valueInteger value="0"/>
      </extension>
      <linkId value="SmokeHowManyPerDay"/>
      <text value="How many per day?"/>
      <type value="integer"/>
      <enableWhen>
        <question value="DoYouSmoke"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="EverSmoked"/>
      <text value="6. Have you ever smoked?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="WhenDidYouStopSmoking"/>
      <text value="If so, when did you stop?"/>
      <type value="string"/>
      <enableWhen>
        <question value="EverSmoked"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
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        </valueCodeableConcept>
      </extension>
      <linkId value="DrinkAlcoholRegularly"/>
      <text value="7. Do you drink alcohol regularly?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
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      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="AlcoholHowMuchPerWeek"/>
      <text value="How much per week?"/>
      <type value="string"/>
      <enableWhen>
        <question value="DrinkAlcoholRegularly"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
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      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
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            <code value="radio-button"/>
            <display value="Radio Button"/>
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        </valueCodeableConcept>
      </extension>
      <linkId value="PregnantOrMayBePregnant"/>
      <text value="8. Are you or do you think you may be pregnant?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/minValue">
        <valueInteger value="0"/>
      </extension>
      <linkId value="PregnancyWeeks"/>
      <text value="If yes – how many weeks?"/>
      <type value="integer"/>
      <enableWhen>
        <question value="PregnantOrMayBePregnant"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
  </item>
  <item>
    <linkId value="Section6Allergies"/>
    <text value="Section 6 – Allergies"/>
    <type value="group"/>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
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        </valueCodeableConcept>
      </extension>
      <linkId value="AllergiesOrReactions"/>
      <text
            value="1. Allergies or reactions to medicines (sticking plasters, food, paint, latex / rubber products or x-ray dye)?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
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    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="text-box"/>
            <display value="Text Box"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="AllergiesDescription"/>
      <text value="Please describe what happens to you:"/>
      <type value="text"/>
      <enableWhen>
        <question value="AllergiesOrReactions"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
  </item>
  <item>
    <linkId value="Section7Medications"/>
    <text value="Section 7 – Medications"/>
    <type value="group"/>
    <item>
      <linkId value="MedicationsGroup"/>
      <text value="Medication / Therapy"/>
      <type value="group"/>
      <repeats value="true"/>
      <item>
        <linkId value="MedicationName"/>
        <text value="Name of Medication/Therapy"/>
        <type value="string"/>
        <required value="false"/>
      </item>
      <item>
        <linkId value="MedicationHowMuch"/>
        <text value="How much?"/>
        <type value="string"/>
        <required value="false"/>
      </item>
      <item>
        <linkId value="MedicationHowOften"/>
        <text value="How often each day? (Breakfast, lunch, tea)"/>
        <type value="string"/>
        <required value="false"/>
      </item>
    </item>
  </item>
  <item>
    <linkId value="Section8PreviousSurgeryAnaesthesia"/>
    <text value="Section 8 – Previous surgery / anaesthesia"/>
    <type value="group"/>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
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        </valueCodeableConcept>
      </extension>
      <linkId value="PreviousSurgeryOrAdmission"/>
      <text
            value="1. Have you ever had surgery or been admitted to hospital before? (Including day surgery)"/>
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      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="PreviousSurgeryGroup"/>
      <text value="If yes, when, what for and what hospital was that in?"/>
      <type value="group"/>
      <enableWhen>
        <question value="PreviousSurgeryOrAdmission"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
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      <repeats value="true"/>
      <item>
        <linkId value="PreviousSurgeryOperationIllness"/>
        <text value="Operation / Illness"/>
        <type value="string"/>
        <required value="false"/>
      </item>
      <item>
        <linkId value="PreviousSurgeryYear"/>
        <text value="Year"/>
        <type value="string"/>
        <required value="false"/>
      </item>
      <item>
        <linkId value="PreviousSurgeryHospital"/>
        <text value="Hospital"/>
        <type value="string"/>
        <required value="false"/>
      </item>
    </item>
  </item>
  <item>
    <linkId value="Section9AnaesthesiaRelatedIssues"/>
    <text value="Section 9 – Anaesthesia related issues"/>
    <type value="group"/>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="ProblemsUnderAnaesthetic"/>
      <text value="1. Have you had any problems while under an anaesthetic?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="ProblemsUnderAnaestheticComment"/>
      <text
            value="(e.g. slow to wake, nausea and vomiting, post surgery confusion, agitation)"/>
      <type value="string"/>
      <enableWhen>
        <question value="ProblemsUnderAnaesthetic"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
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      <required value="false"/>
    </item>
    <item>
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                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="RelativeProblemsUnderAnaesthetic"/>
      <text
            value="2. Has any blood relative had problems while under an anaesthetic?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="RelativeProblemsUnderAnaestheticComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="string"/>
      <enableWhen>
        <question value="RelativeProblemsUnderAnaesthetic"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="AttendedPreAnaesthesiaAssessment"/>
      <text
            value="3. Have you attended a pre-anaesthesia assessment before?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="AttendedPreAnaesthesiaAssessmentLastTime"/>
      <text value="When was the last time?"/>
      <type value="string"/>
      <enableWhen>
        <question value="AttendedPreAnaesthesiaAssessment"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
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      </enableWhen>
      <required value="false"/>
    </item>
  </item>
  <item>
    <linkId value="Section10DischargePlanning"/>
    <text value="Section 10 – Discharge planning"/>
    <type value="group"/>
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      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
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        </valueCodeableConcept>
      </extension>
      <linkId value="RequirePhysicalSupportOrAids"/>
      <text value="1. Do you require any physical support or aids?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="RequirePhysicalSupportOrAidsDetails"/>
      <text value="If so what?"/>
      <type value="string"/>
      <enableWhen>
        <question value="RequirePhysicalSupportOrAids"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="LiveAlone"/>
      <text value="2. Do you live alone?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="LiveAloneComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="string"/>
      <enableWhen>
        <question value="LiveAlone"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="radio-button"/>
            <display value="Radio Button"/>
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        </valueCodeableConcept>
      </extension>
      <linkId value="ProblemsWithDailyActivities"/>
      <text value="3. Do you have any problems with daily activities?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="ProblemsWithDailyActivitiesComment"/>
      <text value="(e.g. showering, bathing, dressing)"/>
      <type value="string"/>
      <enableWhen>
        <question value="ProblemsWithDailyActivities"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
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            <code value="radio-button"/>
            <display value="Radio Button"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="WhoWillTakeYouHome"/>
      <text value="4. Who will be taking you home?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
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    <item>
      <linkId value="WhoWillTakeYouHomeComment"/>
      <text value="If yes, or not certain, please comment"/>
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      <enableWhen>
        <question value="WhoWillTakeYouHome"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
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      </enableWhen>
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    <item>
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                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
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            <code value="radio-button"/>
            <display value="Radio Button"/>
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        </valueCodeableConcept>
      </extension>
      <linkId value="SomeoneToStayOvernight"/>
      <text
            value="5. Do you have someone to stay overnight with you when you get home?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
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    <item>
      <linkId value="SomeoneToStayOvernightComment"/>
      <text value="If yes, or not certain, please comment"/>
      <type value="text"/>
      <enableWhen>
        <question value="SomeoneToStayOvernight"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
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      </enableWhen>
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    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
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            <code value="radio-button"/>
            <display value="Radio Button"/>
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        </valueCodeableConcept>
      </extension>
      <linkId value="UsingCommunitySupportServices"/>
      <text
            value="6. Are you currently using any community support services?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
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    <item>
      <linkId value="CommunitySupportServicesList"/>
      <text value="If so please list:"/>
      <type value="string"/>
      <enableWhen>
        <question value="UsingCommunitySupportServices"/>
        <operator value="="/>
        <answerCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
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            <code value="radio-button"/>
            <display value="Radio Button"/>
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        </valueCodeableConcept>
      </extension>
      <linkId value="SpeakUnderstandEnglish"/>
      <text value="7. Do you speak and understand English?"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <answerOption>
        <valueCoding>
          <code value="yes"/>
          <display value="Yes"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <code value="no"/>
          <display value="No"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="FirstLanguage"/>
      <text value="If not, what is your first language?"/>
      <type value="string"/>
      <enableWhen>
        <question value="SpeakUnderstandEnglish"/>
        <operator value="="/>
        <answerCoding>
          <code value="no"/>
          <display value="No"/>
        </answerCoding>
      </enableWhen>
      <required value="false"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="text-box"/>
            <display value="Text Box"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="AnythingToDiscuss"/>
      <text
            value="8. Is there anything in particular you would like to discuss?"/>
      <type value="text"/>
      <required value="false"/>
    </item>
  </item>
  <item>
    <linkId value="Section11PatientDeclaration"/>
    <text value="Section 11 – Patient declaration"/>
    <type value="group"/>
    <item>
      <linkId value="DeclarationStatement"/>
      <text
            value="The above health information is a true and accurate account of my health status."/>
      <type value="display"/>
    </item>
    <item>
      <linkId value="PatientSignature"/>
      <text value="Patient's signature"/>
      <type value="string"/>
      <required value="false"/>
    </item>
    <item>
      <linkId value="DeclarationDate"/>
      <text value="Date"/>
      <type value="date"/>
      <required value="false"/>
    </item>
  </item>
</Questionnaire>