{
    "resourceType": "QuestionnaireResponse",
    "id": "QuestionnaireResponse-RoD-PheobeSmithamYPAForm-Example",
    "questionnaire": "https://fhir.nhs.uk/Questionnaire/Questionnaire-RoD-YoungPersonAssentForm-Example",
    "status": "completed",
    "basedOn":  [
        {
            "reference": "ServiceRequest/ServiceRequest-WGSTestOrderForm-TrioTestingProband-Example"
        }
    ],
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449307539"
        },
        "display": "A Patient"
    },
    "authored": "2024-01-25",
    "author": {
        "type": "PractitionerRole",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/sds-role-profile-id",
            "value": "999999999999"
        }
    },
    "source": {
        "type": "PractitionerRole",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/sds-role-profile-id",
            "value": "999999999999"
        }
    },
    "item":  [
        {
            "linkId": "patientDetails",
            "text": "Patient Details",
            "item":  [
                {
                    "linkId": "givenName",
                    "text": "First Name",
                    "answer":  [
                        {
                            "valueString": "Phoebe"
                        }
                    ]
                },
                {
                    "linkId": "familyName",
                    "text": "Last Name",
                    "answer":  [
                        {
                            "valueString": "Smitham"
                        }
                    ]
                },
                {
                    "linkId": "nhs_Number",
                    "text": "NHS number (or postcode if not not known)",
                    "answer":  [
                        {
                            "valueString": "9449307539"
                        }
                    ]
                },
                {
                    "linkId": "birthDate",
                    "text": "Date of Birth",
                    "answer":  [
                        {
                            "valueDate": "2013-09-27"
                        }
                    ]
                }
            ]
        },
        {
            "linkId": "declarationResponse",
            "text": "Please indicate your choices below by ticking the appropriate box:",
            "item":  [
                {
                    "linkId": "consentQuestion1",
                    "text": "1. Have you read information or has someone explained the research to you?",
                    "answer":  [
                        {
                            "valueBoolean": true
                        }
                    ]
                },
                {
                    "linkId": "consentQuestion2",
                    "text": "2. Have you asked all the questions you want?",
                    "answer":  [
                        {
                            "valueBoolean": true
                        }
                    ]
                },
                {
                    "linkId": "consentQuestion3",
                    "text": "3. Have you had your questions answered in a way you understand?",
                    "answer":  [
                        {
                            "valueBoolean": true
                        }
                    ]
                },
                {
                    "linkId": "consentQuestion4",
                    "text": "4. Do you understand it’s OK to say you don’t want to take part – but that your parent(s), or guardian who look after you, will make the final choice?",
                    "answer":  [
                        {
                            "valueBoolean": true
                        }
                    ]
                },
                {
                    "linkId": "consentQuestion5",
                    "text": "5. Are you happy to take part?",
                    "answer":  [
                        {
                            "valueBoolean": true
                        }
                    ]
                }
            ]
        },
        {
            "linkId": "isRemoteConsentTrue",
            "text": "Assent obtained remotely, no participant signature",
            "answer":  [
                {
                    "valueBoolean": true
                }
            ]
        }
    ]
}

<QuestionnaireResponse xmlns="http://hl7.org/fhir">
    <id value="QuestionnaireResponse-RoD-PheobeSmithamYPAForm-Example" />
    <basedOn>
        <reference value="ServiceRequest/ServiceRequest-WGSTestOrderForm-TrioTestingProband-Example" />
    </basedOn>
    <questionnaire value="https://fhir.nhs.uk/Questionnaire/Questionnaire-RoD-YoungPersonAssentForm-Example" />
    <status value="completed" />
    <subject>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9449307539" />
        </identifier>
        <display value="A Patient" />
    </subject>
    <authored value="2024-01-25" />
    <author>
        <type value="PractitionerRole" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/sds-role-profile-id" />
            <value value="999999999999" />
        </identifier>
    </author>
    <source>
        <type value="PractitionerRole" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/sds-role-profile-id" />
            <value value="999999999999" />
        </identifier>
    </source>
    <item>
        <linkId value="patientDetails" />
        <text value="Patient Details" />
        <item>
            <linkId value="givenName" />
            <text value="First Name" />
            <answer>
                <valueString value="Phoebe" />
            </answer>
        </item>
        <item>
            <linkId value="familyName" />
            <text value="Last Name" />
            <answer>
                <valueString value="Smitham" />
            </answer>
        </item>
        <item>
            <linkId value="nhs_Number" />
            <text value="NHS number (or postcode if not not known)" />
            <answer>
                <valueString value="9449307539" />
            </answer>
        </item>
        <item>
            <linkId value="birthDate" />
            <text value="Date of Birth" />
            <answer>
                <valueDate value="2013-09-27" />
            </answer>
        </item>
    </item>
    <item>
        <linkId value="declarationResponse" />
        <text value="Please indicate your choices below by ticking the appropriate box:" />
        <item>
            <linkId value="consentQuestion1" />
            <text value="1. Have you read information or has someone explained the research to you?" />
            <answer>
                <valueBoolean value="true" />
            </answer>
        </item>
        <item>
            <linkId value="consentQuestion2" />
            <text value="2. Have you asked all the questions you want?" />
            <answer>
                <valueBoolean value="true" />
            </answer>
        </item>
        <item>
            <linkId value="consentQuestion3" />
            <text value="3. Have you had your questions answered in a way you understand?" />
            <answer>
                <valueBoolean value="true" />
            </answer>
        </item>
        <item>
            <linkId value="consentQuestion4" />
            <text value="4. Do you understand it’s OK to say you don’t want to take part – but that your parent(s), or guardian who look after you, will make the final choice?" />
            <answer>
                <valueBoolean value="true" />
            </answer>
        </item>
        <item>
            <linkId value="consentQuestion5" />
            <text value="5. Are you happy to take part?" />
            <answer>
                <valueBoolean value="true" />
            </answer>
        </item>
    </item>
    <item>
        <linkId value="isRemoteConsentTrue" />
        <text value="Assent obtained remotely, no participant signature" />
        <answer>
            <valueBoolean value="true" />
        </answer>
    </item>
</QuestionnaireResponse>

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