WHO SMART Guidelines - HIV
1.0.0 - release

This page is part of the WHO SMART Guidelines - HIV (v1.0.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Questionnaire: Provide information to referral facility

Branch:
LinkIDTextCardinalityTypeFlagsDescription & Constraintsdoco
.. Questionnaire for provide information to referral facilityQuestionnairehttp://smart.who.int/hiv/Questionnaire/HIV.I6ProvideInformationToReferralFacility#1.0.0
... HIV.I.DE2Reason for referral1..1choiceValue Set: #HIV.I.DE2
... HIV.I.DE8Referral for other general services (specify)0..1string
... HIV.I.DE9Any treatment given before referral?1..1boolean
... HIV.I.DE10Date of scheduled referral appointment1..1dateTime
... HIV.I.DE11Location of scheduled referral appointment1..1string
... HIV.I.DE12Date referral was made1..1dateTime
... HIV.I.DE13Provider who made referral1..1string
... HIV.I.DE14Provider's facility1..1string
... HIV.I.DE15Provider's telephone number1..1integer
... HIV.I.DE16Referral notes1..1string
... HIV.I.DE17Client history summary1..1string

doco Documentation for this format