US Core Implementation Guide
9.0.0 - STU 9 US

US Core Implementation Guide - Downloaded Version 9.0.0 See the Directory of published versions

## : Questionnaire PRAPARE Example - XML Representation

Page standards status: Informative

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    <Questionnaire xmlns="http://hl7.org/fhir">
      <id value="prapare-example"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire"/>
      </meta>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Questionnaire prapare-example</b></p><a name="prapare-example"> </a><a name="hcprapare-example"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="http://hl7.org/fhir/uv/sdc/STU4/StructureDefinition-sdc-questionnaire.html">SDC Base Questionnaire</a></p></div><b>Structure</b><table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Cardinality</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description &amp; Constraints</a><span style="float: right"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="." style="background-color: white; background-color: inherit" title="QuestionnaireRoot" class="hierarchy"/> PRAPAREExample</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">http://hl7.org/fhir/us/core/Questionnaire/prapare-example#9.0.0</td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)" id="item./93025-5" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="group" class="hierarchy"/> /93025-5</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)" id="item./93043-8" class="hierarchy"><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-group.png" alt="." style="background-color: white; background-color: inherit" title="group" class="hierarchy"/> /93043-8</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Personal characteristics</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)" id="item./93043-8/56051-6" class="hierarchy"><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_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"/> /93043-8/56051-6</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Hispanic or Latino</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./93043-8/56051-6">3 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)" id="item./93043-8/32624-9" class="hierarchy"><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_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"/> /93043-8/32624-9</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Race</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./93043-8/32624-9">8 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)" id="item./93043-8/93035-4" class="hierarchy"><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_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"/> /93043-8/93035-4</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./93043-8/93035-4">3 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)" id="item./93043-8/93034-7" class="hierarchy"><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_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"/> /93043-8/93034-7</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Discharged from the U.S. Armed Forces</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./93043-8/93034-7">3 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0100.png)" id="item./93043-8/54899-0" class="hierarchy"><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_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"/> /93043-8/54899-0</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Preferred language</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./93043-8/54899-0">3 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)" id="item./93042-0" class="hierarchy"><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-group.png" alt="." style="background-color: white; background-color: inherit" title="group" class="hierarchy"/> /93042-0</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Family and home</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)" id="item./93042-0/63512-8" class="hierarchy"><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_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: #F7F7F7; background-color: inherit" title="integer" class="hierarchy"/> /93042-0/63512-8</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How many people are living or staying at this address [#]</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer">integer</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0111.png)" id="item./93042-0/71802-3" class="hierarchy"><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_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"/> /93042-0/71802-3</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Housing status</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./93042-0/71802-3">3 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01100.png)" id="item./93042-0/71802-3-help" class="hierarchy"><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_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-display.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="display" class="hierarchy"/> /93042-0/71802-3-help</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Describes patients living arrangement</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)" id="item./93042-0/93033-9" class="hierarchy"><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_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"/> /93042-0/93033-9</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Are you worried about losing your housing [PRAPARE]</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./93042-0/93033-9">3 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0100.png)" id="item./93042-0/56799-0" class="hierarchy"><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_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"/> /93042-0/56799-0</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Address</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)" id="item./93041-2" class="hierarchy"><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-group.png" alt="." style="background-color: white; background-color: inherit" title="group" class="hierarchy"/> /93041-2</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Money and resources</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)" id="item./93041-2/82589-3" class="hierarchy"><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_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"/> /93041-2/82589-3</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Highest level of educ</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./93041-2/82589-3">4 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)" id="item./93041-2/67875-5" class="hierarchy"><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_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"/> /93041-2/67875-5</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Employment status current</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./93041-2/67875-5">5 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)" id="item./93041-2/76437-3" class="hierarchy"><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_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"/> /93041-2/76437-3</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Primary insurance</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./93041-2/76437-3">7 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)" id="item./93041-2/63586-2" class="hierarchy"><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_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"/> /93041-2/63586-2</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal">decimal</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)" id="item./93041-2/93031-3" class="hierarchy"><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_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"/> /93041-2/93031-3</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./93041-2/93031-3">8 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0100.png)" id="item./93041-2/93030-5" class="hierarchy"><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_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: white; background-color: inherit" title="coding" class="hierarchy"/> /93041-2/93030-5</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./93041-2/93030-5">4 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)" id="item./93040-4" class="hierarchy"><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-group.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="group" class="hierarchy"/> /93040-4</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Social and emotional health</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)" id="item./93040-4/93029-7" class="hierarchy"><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_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"/> /93040-4/93029-7</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How often do you see or talk to people that you care about and feel close to [PRAPARE]</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./93040-4/93029-7">5 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0100.png)" id="item./93040-4/93038-8" class="hierarchy"><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_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"/> /93040-4/93038-8</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Stress is when someone feels tense, nervous, anxious or can't sleep at night because their mind is troubled. How stressed are you?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./93040-4/93038-8">6 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck001.png)" id="item./93039-6" class="hierarchy"><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-group.png" alt="." style="background-color: white; background-color: inherit" title="group" class="hierarchy"/> /93039-6</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Optional additional questions</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)" id="item./93039-6/93028-9" class="hierarchy"><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_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-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> /93039-6/93028-9</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./93039-6/93028-9">3 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)" id="item./93039-6/93027-1" class="hierarchy"><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_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-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> /93039-6/93027-1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Are you a refugee</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./93039-6/93027-1">3 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)" id="item./93039-6/93026-3" class="hierarchy"><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_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-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> /93039-6/93026-3</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel physically and emotionally safe where you currently live [PRAPARE]</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./93039-6/93026-3">4 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0000.png)" id="item./93039-6/76501-6" class="hierarchy"><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_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-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> /93039-6/76501-6</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Within the last year, have you been afraid of your partner or ex-partner</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./93039-6/76501-6">2 options</a></td></tr>
    <tr><td colspan="5" class="hierarchy"><br/><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name="opt-item./93043-8/56051-6"> </a><p><b>Answer options for /93043-8/56051-6 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA33-6 (&quot;Yes&quot;)</li><li style="font-size: 11px">http://loinc.org#LA32-8 (&quot;No&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30122-8 (&quot;I choose not to answer this question&quot;)</li></ul><a name="opt-item./93043-8/32624-9"> </a><p><b>Answer options for /93043-8/32624-9 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA6156-9 (&quot;Asian&quot;)</li><li style="font-size: 11px">http://loinc.org#LA14045-1 (&quot;Native Hawaiian&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30187-1 (&quot;Pacific Islander&quot;)</li><li style="font-size: 11px">http://loinc.org#LA14042-8 (&quot;Black/African American&quot;)</li><li style="font-size: 11px">http://loinc.org#LA4457-3 (&quot;White&quot;)</li><li style="font-size: 11px">http://loinc.org#LA4-4 (&quot;American Indian/Alaskan Native&quot;)</li><li style="font-size: 11px">http://loinc.org#LA46-8 (&quot;Other&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30122-8 (&quot;I choose not to answer this question&quot;)</li></ul><a name="opt-item./93043-8/93035-4"> </a><p><b>Answer options for /93043-8/93035-4 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA33-6 (&quot;Yes&quot;)</li><li style="font-size: 11px">http://loinc.org#LA32-8 (&quot;No&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30122-8 (&quot;I choose not to answer this question&quot;)</li></ul><a name="opt-item./93043-8/93034-7"> </a><p><b>Answer options for /93043-8/93034-7 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA33-6 (&quot;Yes&quot;)</li><li style="font-size: 11px">http://loinc.org#LA32-8 (&quot;No&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30122-8 (&quot;I choose not to answer this question&quot;)</li></ul><a name="opt-item./93043-8/54899-0"> </a><p><b>Answer options for /93043-8/54899-0 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA43-5 (&quot;English&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30188-9 (&quot;Language other than English&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30122-8 (&quot;I choose not to answer this question&quot;)</li></ul><a name="opt-item./93042-0/71802-3"> </a><p><b>Answer options for /93042-0/71802-3 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA30189-7 (&quot;I have housing&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30190-5 (&quot;I do not have housing (staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, or in a park)&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30122-8 (&quot;I choose not to answer this question&quot;)</li></ul><a name="opt-item./93042-0/93033-9"> </a><p><b>Answer options for /93042-0/93033-9 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA33-6 (&quot;Yes&quot;)</li><li style="font-size: 11px">http://loinc.org#LA32-8 (&quot;No&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30122-8 (&quot;I choose not to answer this question&quot;)</li></ul><a name="opt-item./93041-2/82589-3"> </a><p><b>Answer options for /93041-2/82589-3 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA30191-3 (&quot;Less than high school degree&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30192-1 (&quot;High school diploma or GED&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30193-9 (&quot;More than high school&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30122-8 (&quot;I choose not to answer this question&quot;)</li></ul><a name="opt-item./93041-2/67875-5"> </a><p><b>Answer options for /93041-2/67875-5 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA17956-6 (&quot;Unemployed&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30138-4 (&quot;Part-time or temporary work&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30136-8 (&quot;Full-time work&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30137-6 (&quot;Otherwise unemployed but not seeking work (ex: student, retired, disabled, unpaid primary care giver)&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30122-8 (&quot;I choose not to answer this question&quot;)</li></ul><a name="opt-item./93041-2/76437-3"> </a><p><b>Answer options for /93041-2/76437-3 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA30194-7 (&quot;None/uninsured&quot;)</li><li style="font-size: 11px">http://loinc.org#LA17849-3 (&quot;Medicaid&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30195-4 (&quot;CHIP Medicaid&quot;)</li><li style="font-size: 11px">http://loinc.org#LA15652-3 (&quot;Medicare&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30196-2 (&quot;Other public insurance (not CHIP)&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30197-0 (&quot;Other public insurance (CHIP)&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6350-8 (&quot;Private insurance&quot;)</li></ul><a name="opt-item./93041-2/93031-3"> </a><p><b>Answer options for /93041-2/93031-3 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA30125-1 (&quot;Food&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30126-9 (&quot;Clothing&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30124-4 (&quot;Utilities&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30127-7 (&quot;Child care&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30128-5 (&quot;Medicine or Any Health Care (Medical, Dental, Mental Health, Vision)&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30129-3 (&quot;Phone&quot;)</li><li style="font-size: 11px">http://loinc.org#LA46-8 (&quot;Other&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30122-8 (&quot;I choose not to answer this question&quot;)</li></ul><a name="opt-item./93041-2/93030-5"> </a><p><b>Answer options for /93041-2/93030-5 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA30133-5 (&quot;Yes, it has kept me from medical appointments or from getting my medications&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30134-3 (&quot;Yes, it has kept me from non-medical meetings, appointments, work, or from getting things that I need&quot;)</li><li style="font-size: 11px">http://loinc.org#LA32-8 (&quot;No&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30257-2 (&quot;Patient unable to respond&quot;)</li></ul><a name="opt-item./93040-4/93029-7"> </a><p><b>Answer options for /93040-4/93029-7 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA27722-0 (&quot;Less than once a week&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30130-1 (&quot;1 or 2 times a week&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30131-9 (&quot;3 to 5 times a week&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30132-7 (&quot;5 or more times a week&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30122-8 (&quot;I choose not to answer this question&quot;)</li></ul><a name="opt-item./93040-4/93038-8"> </a><p><b>Answer options for /93040-4/93038-8 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA6568-5 (&quot;Not at all&quot;)</li><li style="font-size: 11px">http://loinc.org#LA13863-8 (&quot;A little bit&quot;)</li><li style="font-size: 11px">http://loinc.org#LA13909-9 (&quot;Somewhat&quot;)</li><li style="font-size: 11px">http://loinc.org#LA13902-4 (&quot;Quite a bit&quot;)</li><li style="font-size: 11px">http://loinc.org#LA13914-9 (&quot;Very much&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30122-8 (&quot;I choose not to answer this question&quot;)</li></ul><a name="opt-item./93039-6/93028-9"> </a><p><b>Answer options for /93039-6/93028-9 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA33-6 (&quot;Yes&quot;)</li><li style="font-size: 11px">http://loinc.org#LA32-8 (&quot;No&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30122-8 (&quot;I choose not to answer this question&quot;)</li></ul><a name="opt-item./93039-6/93027-1"> </a><p><b>Answer options for /93039-6/93027-1 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA33-6 (&quot;Yes&quot;)</li><li style="font-size: 11px">http://loinc.org#LA32-8 (&quot;No&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30122-8 (&quot;I choose not to answer this question&quot;)</li></ul><a name="opt-item./93039-6/93026-3"> </a><p><b>Answer options for /93039-6/93026-3 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA33-6 (&quot;Yes&quot;)</li><li style="font-size: 11px">http://loinc.org#LA32-8 (&quot;No&quot;)</li><li style="font-size: 11px">http://loinc.org#LA14072-5 (&quot;Unsure&quot;)</li><li style="font-size: 11px">http://loinc.org#LA30122-8 (&quot;I choose not to answer this question&quot;)</li></ul><a name="opt-item./93039-6/76501-6"> </a><p><b>Answer options for /93039-6/76501-6 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA33-6 (&quot;Yes&quot;)</li><li style="font-size: 11px">http://loinc.org#LA32-8 (&quot;No&quot;)</li></ul></div>
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            <answerOption>
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              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA30126-9"/>
                <display value="Clothing"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA30124-4"/>
                <display value="Utilities"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA30127-7"/>
                <display value="Child care"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA30128-5"/>
                <display
                         value="Medicine or Any Health Care (Medical, Dental, Mental Health, Vision)"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA30129-3"/>
                <display value="Phone"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA46-8"/>
                <display value="Other"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA30122-8"/>
                <display value="I choose not to answer this question"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="/93041-2/93030-5"/>
            <code>
              <system value="http://loinc.org"/>
              <code value="93030-5"/>
              <display
                       value="Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"/>
            </code>
            <text
                  value="Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"/>
            <type value="choice"/>
            <required value="false"/>
            <repeats value="true"/>
            <answerOption>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix">
                <valueString value="A"/>
              </extension>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA30133-5"/>
                <display
                         value="Yes, it has kept me from medical appointments or from getting my medications"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix">
                <valueString value="B"/>
              </extension>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA30134-3"/>
                <display
                         value="Yes, it has kept me from non-medical meetings, appointments, work, or from getting things that I need"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix">
                <valueString value="C"/>
              </extension>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix">
                <valueString value="X"/>
              </extension>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA30257-2"/>
                <display value="Patient unable to respond"/>
              </valueCoding>
            </answerOption>
          </item>
        </item>
        <item>
          <linkId value="/93040-4"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="93040-4"/>
            <display value="Social and emotional health [PRAPARE]"/>
          </code>
          <text value="Social and emotional health"/>
          <type value="group"/>
          <required value="false"/>
          <item>
            <linkId value="/93040-4/93029-7"/>
            <code>
              <system value="http://loinc.org"/>
              <code value="93029-7"/>
              <display
                       value="How often do you see or talk to people that you care about and feel close to [PRAPARE]"/>
            </code>
            <text
                  value="How often do you see or talk to people that you care about and feel close to [PRAPARE]"/>
            <type value="choice"/>
            <required value="false"/>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA27722-0"/>
                <display value="Less than once a week"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA30130-1"/>
                <display value="1 or 2 times a week"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA30131-9"/>
                <display value="3 to 5 times a week"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA30132-7"/>
                <display value="5 or more times a week"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA30122-8"/>
                <display value="I choose not to answer this question"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="/93040-4/93038-8"/>
            <code>
              <system value="http://loinc.org"/>
              <code value="93038-8"/>
              <display value="Stress level"/>
            </code>
            <text
                  value="Stress is when someone feels tense, nervous, anxious or can't sleep at night because their mind is troubled. How stressed are you?"/>
            <type value="choice"/>
            <required value="false"/>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA6568-5"/>
                <display value="Not at all"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA13863-8"/>
                <display value="A little bit"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA13909-9"/>
                <display value="Somewhat"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA13902-4"/>
                <display value="Quite a bit"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA13914-9"/>
                <display value="Very much"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA30122-8"/>
                <display value="I choose not to answer this question"/>
              </valueCoding>
            </answerOption>
          </item>
        </item>
        <item>
          <linkId value="/93039-6"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="93039-6"/>
            <display value="Optional additional questions [PRAPARE]"/>
          </code>
          <text value="Optional additional questions"/>
          <type value="group"/>
          <required value="false"/>
          <item>
            <linkId value="/93039-6/93028-9"/>
            <code>
              <system value="http://loinc.org"/>
              <code value="93028-9"/>
              <display
                       value="Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"/>
            </code>
            <text
                  value="Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"/>
            <type value="choice"/>
            <required value="false"/>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA33-6"/>
                <display value="Yes"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA30122-8"/>
                <display value="I choose not to answer this question"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="/93039-6/93027-1"/>
            <code>
              <system value="http://loinc.org"/>
              <code value="93027-1"/>
              <display value="Are you a refugee"/>
            </code>
            <text value="Are you a refugee"/>
            <type value="choice"/>
            <required value="false"/>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA33-6"/>
                <display value="Yes"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA30122-8"/>
                <display value="I choose not to answer this question"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="/93039-6/93026-3"/>
            <code>
              <system value="http://loinc.org"/>
              <code value="93026-3"/>
              <display
                       value="Do you feel physically and emotionally safe where you currently live [PRAPARE]"/>
            </code>
            <text
                  value="Do you feel physically and emotionally safe where you currently live [PRAPARE]"/>
            <type value="choice"/>
            <required value="false"/>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA33-6"/>
                <display value="Yes"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA14072-5"/>
                <display value="Unsure"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA30122-8"/>
                <display value="I choose not to answer this question"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="/93039-6/76501-6"/>
            <code>
              <system value="http://loinc.org"/>
              <code value="76501-6"/>
              <display
                       value="Within the last year, have you been afraid of your partner or ex-partner"/>
            </code>
            <text
                  value="Within the last year, have you been afraid of your partner or ex-partner"/>
            <type value="choice"/>
            <required value="false"/>
            <answerOption>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix">
                <valueString value="1"/>
              </extension>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
                <valueDecimal value="1"/>
              </extension>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA33-6"/>
                <display value="Yes"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix">
                <valueString value="0"/>
              </extension>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
                <valueDecimal value="0"/>
              </extension>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answerOption>
          </item>
        </item>
      </item>
    </Questionnaire>