This page is part of the ICVP (v0.3.0: Releases Draft) 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
Example Questionnaire: DVC Model Questionnaire
Branch:| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  | Questionnaire | http://smart.who.int/icvp/Questionnaire/pPreQual#0.3.0 | ||
  name | Full Name of the client | 1..1 | string | |
 dob | Date of Birth | 1..1 | date | |
 sex | Sex | 0..1 | choice | Value Set: hl7VS-administrativeSex |
| nationality | Nationality | 0..1 | choice | Value Set: Country |
| nid | National Identification Document | 0..1 | string | |
 guardian | Parent or Guardian Details | 0..1 | group | |
  guardianName | Name of Parent or Guardian | 0..1 | string | |
| vaccineDetails | Vaccine Certificate Details | 1..* | group | |
| productID | Vaccine or Prophylaxis ID | 1..1 | choice | Value Set: WHO PreQualificaiton Vaccine Product Ids |
| date | Date of Vaccination | 1..1 | date | |
| clinicianName | Name of supervising clinician | 0..1 | string | |
| issuer | Relevant authoring reponsible for issuing the certificate, or for overseeing the administration center | 0..1 | string | |
| batchNo.text | Batch Number | 1..1 | string | |
| validityPeriod | Certificate Validity Period | 0..1 | group | |
 startDate | From | 0..1 | date | |
| endDate | To | 0..1 | date | |
 attachment | Upload Paper Form image or PDF | 0..1 | attachment | |
| Documentation for this format | ||||