{
  "resourceType": "Questionnaire",
  "id": "dr-garvey-chilopora",
  "text": {
    "status": "extensions",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Questionnaire dr-garvey-chilopora</b></p><a name=\"dr-garvey-chilopora\"> </a><a name=\"hcdr-garvey-chilopora\"> </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\"/> </td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Questionnaire template representing a provider (HIC)-specific eReferral form for Dr. Chilopora.</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"></td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Questionnaire</td><td style=\"\" class=\"hierarchy xhtCellBorder1\"></td><td style=\"\" class=\"hierarchy xhtCellBorder1\">http://ontariohealth.ca/fhir/eforms/Questionnaire/dr-garvey-chilopora#1.2.0</td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01.png)\" id=\"item.questionnaire\" 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: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> questionnaire</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">null</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>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck010.png)\" id=\"item.item47143865\" 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: white; 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\">questionnaire / </span>item47143865</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">* Indicates a required field</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>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck011.png)\" id=\"item.section47163071\" 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-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\">questionnaire / </span>section47163071</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Patient Information</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>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck0110.png)\" id=\"item.item29578021\" 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_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\">questionnaire / section47163071 / </span>item29578021</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">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-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck0110.png)\" id=\"item.item67890802\" 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_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\">questionnaire / section47163071 / </span>item67890802</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">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-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck0100.png)\" id=\"item.item84833268\" 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_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: white; 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\">questionnaire / section47163071 / </span>item84833268</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">null</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\"><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\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck011.png)\" id=\"item.section2763158\" 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-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\">questionnaire / </span>section2763158</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Referral Information</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>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck0110.png)\" id=\"item.item48807357\" 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_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\">questionnaire / section2763158 / </span>item48807357</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Reason for Referral:</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">1..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>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck0111.png)\" id=\"item.section42000384\" 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_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\">questionnaire / section2763158 / </span>section42000384</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Pregnancy History</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>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01110.png)\" id=\"item.item67762889\" 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_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-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\">questionnaire / section2763158 / section42000384 / </span>item67762889</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Total number of pregnancies:</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">1..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\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01110.png)\" id=\"item.item91252875\" 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_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-integer.png\" alt=\"\" style=\"background-color: #F7F7F7; 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\">questionnaire / section2763158 / section42000384 / </span>item91252875</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Number of vaginal deliveries:</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\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01110.png)\" id=\"item.item47328769\" 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_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-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\">questionnaire / section2763158 / section42000384 / </span>item47328769</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Number of C-sections:</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\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01110.png)\" id=\"item.item36834119\" 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_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-integer.png\" alt=\"\" style=\"background-color: #F7F7F7; 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\">questionnaire / section2763158 / section42000384 / </span>item36834119</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Number of miscarriages/pregnancy losses/ectopic pregnancies:</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\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01100.png)\" id=\"item.item29828101\" 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_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-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\">questionnaire / section2763158 / section42000384 / </span>item29828101</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Number of abortions/pregnancy terminations:</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\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck0111.png)\" id=\"item.section41623208\" 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_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\">questionnaire / section2763158 / </span>section41623208</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Menstrual History</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>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01110.png)\" id=\"item.item68062550\" 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_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-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\">questionnaire / section2763158 / section41623208 / </span>item68062550</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Date of Last Menstrual Period:</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>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01110.png)\" id=\"item.item35661442\" 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_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-integer.png\" alt=\"\" style=\"background-color: #F7F7F7; 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\">questionnaire / section2763158 / section41623208 / </span>item35661442</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Number of days between periods:</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\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01110.png)\" id=\"item.item34464904\" 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_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-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\">questionnaire / section2763158 / section41623208 / </span>item34464904</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Number of days period lasts:</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\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01110.png)\" id=\"item.item12983596\" 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_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-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\">questionnaire / section2763158 / section41623208 / </span>item12983596</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Are patient's periods painful:</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.item12983596\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01110.png)\" id=\"item.item93188178\" 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_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-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\">questionnaire / section2763158 / section41623208 / </span>item93188178</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Are patient's periods heavy:</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.item93188178\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01100.png)\" id=\"item.item9542494\" 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_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-integer.png\" alt=\"\" style=\"background-color: #F7F7F7; 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\">questionnaire / section2763158 / section41623208 / </span>item9542494</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Number of pads/tampons used on the heaviest day of period:</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\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck0111.png)\" id=\"item.section87236956\" 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_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: 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\">questionnaire / section2763158 / </span>section87236956</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Gynecologic History</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>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01111.png)\" id=\"item.section90671878\" 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_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-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\">questionnaire / section2763158 / section87236956 / </span>section90671878</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">null</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>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck011110.png)\" id=\"item.item5390108\" 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_vline.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-display.png\" alt=\"\" style=\"background-color: white; 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\">questionnaire / section2763158 / section87236956 / section90671878 / </span>item5390108</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Select all that apply: *</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>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck011110.png)\" id=\"item.item27527635\" 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_vline.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-boolean.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section2763158 / section87236956 / section90671878 / </span>item27527635</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">None</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck011101.png)\" id=\"item.section95740632\" 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_vline.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-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\">questionnaire / section2763158 / section87236956 / section90671878 / </span>section95740632</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">null</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\">Enable When: <span><a href=\"#item.item27527635\">item27527635</a> != true</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck0111010.png)\" id=\"item.item97846576\" 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_vline.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_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-boolean.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section2763158 / section87236956 / section90671878 / section95740632 / </span>item97846576</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Abnormal pap tests</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck0111010.png)\" id=\"item.item76524094\" 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_vline.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_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-boolean.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section2763158 / section87236956 / section90671878 / section95740632 / </span>item76524094</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Fibroids</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck0111010.png)\" id=\"item.item62031353\" 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_vline.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_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-boolean.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section2763158 / section87236956 / section90671878 / section95740632 / </span>item62031353</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Endometriosis</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck0111010.png)\" id=\"item.item78555427\" 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_vline.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_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-boolean.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section2763158 / section87236956 / section90671878 / section95740632 / </span>item78555427</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Ovarian cysts</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck0111010.png)\" id=\"item.item86136829\" 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_vline.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_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-boolean.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section2763158 / section87236956 / section90671878 / section95740632 / </span>item86136829</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Sexually transmitted infection(s)</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck0111000.png)\" id=\"item.item50977523\" 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_vline.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_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\"/> <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\">questionnaire / section2763158 / section87236956 / section90671878 / section95740632 / </span>item50977523</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Specify:</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.item86136829\">item86136829</a> = true</span><br/>Options: <a href=\"#opt-item.item50977523\">6 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01110.png)\" id=\"item.item127317\" 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_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-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\">questionnaire / section2763158 / section87236956 / </span>item127317</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Date of last pap test:</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">1..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>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01110.png)\" id=\"item.item54300787\" 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_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-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\">questionnaire / section2763158 / section87236956 / </span>item54300787</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Patient is sexually active:</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.item54300787\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01110.png)\" id=\"item.item96682694\" 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_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-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\">questionnaire / section2763158 / section87236956 / </span>item96682694</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">With:</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.item54300787\">item54300787</a> = Yes (expandedYes-NoIndicator#Y)</span><br/>Options: <a href=\"#opt-item.item96682694\">3 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01100.png)\" id=\"item.item86913170\" 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_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-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\">questionnaire / section2763158 / section87236956 / </span>item86913170</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Form of birth control used:</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.item54300787\">item54300787</a> = Yes (expandedYes-NoIndicator#Y)</span><br/>Options: <a href=\"#opt-item.item86913170\">10 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck0100.png)\" id=\"item.item95005032\" 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_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\"/> <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\">questionnaire / section2763158 / </span>item95005032</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">null</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\"><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\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck011.png)\" id=\"item.section4572141\" 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-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\">questionnaire / </span>section4572141</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Medical History</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>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck0110.png)\" id=\"item.prob\" 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_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\">questionnaire / section4572141 / </span>prob</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">null</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>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck0101.png)\" id=\"item.section61677093\" 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_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: 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\">questionnaire / section4572141 / </span>section61677093</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">null</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>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item4613718\" 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_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-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\">questionnaire / section4572141 / section61677093 / </span>item4613718</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Select all that apply:</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>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item16667176\" 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_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-boolean.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section4572141 / section61677093 / </span>item16667176</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item18948376\" 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_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-boolean.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section4572141 / section61677093 / </span>item18948376</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item35434575\" 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_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-boolean.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section4572141 / section61677093 / </span>item35434575</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Blood clots in lungs/legs</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item69273958\" 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_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-boolean.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section4572141 / section61677093 / </span>item69273958</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Migraine headaches</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item47066864\" 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_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-boolean.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section4572141 / section61677093 / </span>item47066864</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Liver disease/hepatitis</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item75358255\" 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_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-boolean.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section4572141 / section61677093 / </span>item75358255</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Osteoporosis</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item41631847\" 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_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-boolean.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section4572141 / section61677093 / </span>item41631847</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Infertility</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item18292760\" 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_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-boolean.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section4572141 / section61677093 / </span>item18292760</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Cancer</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item66877002\" 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_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-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\">questionnaire / section4572141 / section61677093 / </span>item66877002</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Type(s):</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">1..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.item18292760\">item18292760</a> = true</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item77134898\" 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_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-boolean.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section4572141 / section61677093 / </span>item77134898</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item880791\" 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_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-boolean.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section4572141 / section61677093 / </span>item880791</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Asthma</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item72238932\" 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_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-boolean.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section4572141 / section61677093 / </span>item72238932</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Anxiety/ Depression</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item37884318\" 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_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-boolean.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section4572141 / section61677093 / </span>item37884318</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Incontinence (urine/stool)</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item41904126\" 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_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-boolean.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section4572141 / section61677093 / </span>item41904126</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Constipation</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item51470870\" 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_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-boolean.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section4572141 / section61677093 / </span>item51470870</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Frequent bladder infections</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item15815594\" 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_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-boolean.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section4572141 / section61677093 / </span>item15815594</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Other</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01000.png)\" id=\"item.item78475900\" 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_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-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\">questionnaire / section4572141 / section61677093 / </span>item78475900</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Specify:</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">1..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.item15815594\">item15815594</a> = true</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck011.png)\" id=\"item.i_nmedications_n\" 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-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\">questionnaire / </span>i_nmedications_n</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">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>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck0100.png)\" id=\"item.rx\" 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_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: 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\">questionnaire / i_nmedications_n / </span>rx</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">null</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>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck011.png)\" id=\"item.allergies\" 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-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\">questionnaire / </span>allergies</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">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>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck0100.png)\" id=\"item.allg\" 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_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: 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\">questionnaire / allergies / </span>allg</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">null</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>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck011.png)\" id=\"item.i_npast_medical_histo\" 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-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\">questionnaire / </span>i_npast_medical_histo</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Past Medical History</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>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck0100.png)\" id=\"item.pmhx\" 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_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: 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\">questionnaire / i_npast_medical_histo / </span>pmhx</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">null</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>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck011.png)\" id=\"item.section68506771\" 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-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\">questionnaire / </span>section68506771</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Family History</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>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck0110.png)\" id=\"item.fhx\" 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_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\">questionnaire / section68506771 / </span>fhx</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">null</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>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck0101.png)\" id=\"item.section48519309\" 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_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\">questionnaire / section68506771 / </span>section48519309</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">null</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>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item33610974\" 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_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-display.png\" alt=\"\" style=\"background-color: white; 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\">questionnaire / section68506771 / section48519309 / </span>item33610974</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Select all that apply:</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>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item65894204\" 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_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-boolean.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section68506771 / section48519309 / </span>item65894204</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item82516489\" 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_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-boolean.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section68506771 / section48519309 / </span>item82516489</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Heart Disease/Stroke</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item30885585\" 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_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-boolean.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section68506771 / section48519309 / </span>item30885585</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item4088333\" 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_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-boolean.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section68506771 / section48519309 / </span>item4088333</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Bad reaction to anesthetic</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item37784990\" 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_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-boolean.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section68506771 / section48519309 / </span>item37784990</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Breast Cancer</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item53504294\" 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_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-boolean.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section68506771 / section48519309 / </span>item53504294</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Uterine Cancer</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item4801402\" 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_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-boolean.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section68506771 / section48519309 / </span>item4801402</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Ovarian Cancer</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item75842905\" 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_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-boolean.png\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section68506771 / section48519309 / </span>item75842905</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Colon/Bowel Cancer</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item22994219\" 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_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-boolean.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" 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\">questionnaire / section68506771 / section48519309 / </span>item22994219</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Other Cancer(s)</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-boolean\">boolean</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01000.png)\" id=\"item.item29254997\" 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_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-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\">questionnaire / section68506771 / section48519309 / </span>item29254997</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Specify:</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">1..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.item22994219\">item22994219</a> = true</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck011.png)\" id=\"item.i_nsocial_history_n\" 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-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\">questionnaire / </span>i_nsocial_history_n</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Social History</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>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck0110.png)\" id=\"item.soc\" 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_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\">questionnaire / i_nsocial_history_n / </span>soc</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">null</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>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck0101.png)\" id=\"item.section64573544\" 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_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\">questionnaire / i_nsocial_history_n / </span>section64573544</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">null</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>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item57834583\" 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_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-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\">questionnaire / i_nsocial_history_n / section64573544 / </span>item57834583</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Smoker:</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.item57834583\">3 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item10529961\" 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_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\">questionnaire / i_nsocial_history_n / section64573544 / </span>item10529961</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Number of 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-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.item57834583\">item57834583</a> = Yes (dr-garvey-chilopora_item57834583#Yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item44127211\" 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_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\">questionnaire / i_nsocial_history_n / section64573544 / </span>item44127211</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Number of cigarettes 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-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.item57834583\">item57834583</a> = Yes (dr-garvey-chilopora_item57834583#Yes)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item41506070\" 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_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\">questionnaire / i_nsocial_history_n / section64573544 / </span>item41506070</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Quit 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-string\">string</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.item57834583\">item57834583</a> = Ex-Smoker (dr-garvey-chilopora_item57834583#Ex-Smoker)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item151992\" 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_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-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\">questionnaire / i_nsocial_history_n / section64573544 / </span>item151992</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Consumes alcohol:</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.item151992\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item94627251\" 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_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\">questionnaire / i_nsocial_history_n / section64573544 / </span>item94627251</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Number of drinks per week on average:</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.item151992\">item151992</a> = Yes (expandedYes-NoIndicator#Y)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item93764222\" 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_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-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\">questionnaire / i_nsocial_history_n / section64573544 / </span>item93764222</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Uses recreational and/or street drugs:</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.item93764222\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item74607677\" 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_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-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\">questionnaire / i_nsocial_history_n / section64573544 / </span>item74607677</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Specify:</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.item93764222\">item93764222</a> = Yes (expandedYes-NoIndicator#Y)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck01010.png)\" id=\"item.item33664919\" 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_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-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\">questionnaire / i_nsocial_history_n / section64573544 / </span>item33664919</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Consumes caffeine:</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.item33664919\">2 options</a></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck01000.png)\" id=\"item.item45718527\" 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_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-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\">questionnaire / i_nsocial_history_n / section64573544 / </span>item45718527</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Number of cups of coffee/tea/cola 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-text\">text</a></td><td style=\"\" class=\"hierarchy xhtCellBorder1\"/><td style=\"\" class=\"hierarchy xhtCellBorder1\">Enable When: <span><a href=\"#item.item33664919\">item33664919</a> = Yes (expandedYes-NoIndicator#Y)</span></td></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck001.png)\" id=\"item.section98896179\" 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-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\">questionnaire / </span>section98896179</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Export Analytics</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\"><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\"/></tr>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck0010.png)\" id=\"item.referralService\" 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_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\">questionnaire / section98896179 / </span>referralService</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">GYNECOLOGY</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>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck0010.png)\" id=\"item.referralDescription\" 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_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: white; 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\">questionnaire / section98896179 / </span>referralDescription</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Gynecology Consult</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>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck0010.png)\" id=\"item.ax_reasonForReferral\" 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_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\">questionnaire / section98896179 / </span>ax_reasonForReferral</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Gynecology Consult</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>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck0010.png)\" id=\"item.ax_bodySite\" 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_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: white; 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\">questionnaire / section98896179 / </span>ax_bodySite</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Reproductive System</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>\r\n<tr class=\"xhtRowBorder1 xhtRowOdd\"><td style=\"background-image: url(tbl_bck0010.png)\" id=\"item.ax_v_bp\" 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_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\">questionnaire / section98896179 / </span>ax_v_bp</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">Dr. Chilopora eReferral Form [FINAL MAY 2022]; 2022.05.25</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>\r\n<tr class=\"xhtRowBorder1 xhtRowEven\"><td style=\"background-image: url(tbl_bck0000.png)\" id=\"item.ax_diagnosis\" 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_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-display.png\" alt=\"\" style=\"background-color: white; 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\">questionnaire / section98896179 / </span>ax_diagnosis</td><td style=\"\" class=\"hierarchy xhtCellBorder1\">null</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>\r\n<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.item12983596\"> </a><p><b>Answer options for item12983596 </b></p><ul><li style=\"font-size: 11px\">http://terminology.hl7.org/CodeSystem/v2-0532#Y (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">http://terminology.hl7.org/CodeSystem/v2-0532#N (&quot;No&quot;)</li></ul><a name=\"opt-item.item93188178\"> </a><p><b>Answer options for item93188178 </b></p><ul><li style=\"font-size: 11px\">http://terminology.hl7.org/CodeSystem/v2-0532#Y (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">http://terminology.hl7.org/CodeSystem/v2-0532#N (&quot;No&quot;)</li></ul><a name=\"opt-item.item50977523\"> </a><p><b>Answer options for item50977523 </b></p><ul><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item50977523#Gonorrhea (&quot;Gonorrhea&quot;)</li><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item50977523#Chlamydia (&quot;Chlamydia&quot;)</li><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item50977523#Herpes (&quot;Herpes&quot;)</li><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item50977523#Genital warts (&quot;Genital warts&quot;)</li><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item50977523#Syphilis (&quot;Syphilis&quot;)</li><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item50977523#Other (&quot;Other&quot;)</li></ul><a name=\"opt-item.item54300787\"> </a><p><b>Answer options for item54300787 </b></p><ul><li style=\"font-size: 11px\">http://terminology.hl7.org/CodeSystem/v2-0532#Y (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">http://terminology.hl7.org/CodeSystem/v2-0532#N (&quot;No&quot;)</li></ul><a name=\"opt-item.item96682694\"> </a><p><b>Answer options for item96682694 </b></p><ul><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item96682694#Men (&quot;Men&quot;)</li><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item96682694#Women (&quot;Women&quot;)</li><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item96682694#Both (&quot;Both&quot;)</li></ul><a name=\"opt-item.item86913170\"> </a><p><b>Answer options for item86913170 </b></p><ul><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item86913170#Birth Control pill / patch / ring (&quot;Birth Control pill / patch / ring&quot;)</li><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item86913170#Condoms (&quot;Condoms&quot;)</li><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item86913170#IUD (hormone) (&quot;IUD (hormone)&quot;)</li><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item86913170#IUD (copper) (&quot;IUD (copper)&quot;)</li><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item86913170#Pull-out/withdrawal (&quot;Pull-out/withdrawal&quot;)</li><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item86913170#Calendar / Natural Family Planning (&quot;Calendar / Natural Family Planning&quot;)</li><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item86913170#Partner had vasectomy (&quot;Partner had vasectomy&quot;)</li><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item86913170#Permanent tubal sugery (&quot;Permanent tubal sugery&quot;)</li><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item86913170#Subdermal implant (&quot;Subdermal implant&quot;)</li><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item86913170#None (&quot;None&quot;)</li></ul><a name=\"opt-item.item57834583\"> </a><p><b>Answer options for item57834583 </b></p><ul><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item57834583#No (&quot;No&quot;)</li><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item57834583#Yes (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">http://example.org/CodeSystem/dr-garvey-chilopora_item57834583#Ex-Smoker (&quot;Ex-Smoker&quot;)</li></ul><a name=\"opt-item.item151992\"> </a><p><b>Answer options for item151992 </b></p><ul><li style=\"font-size: 11px\">http://terminology.hl7.org/CodeSystem/v2-0532#Y (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">http://terminology.hl7.org/CodeSystem/v2-0532#N (&quot;No&quot;)</li></ul><a name=\"opt-item.item93764222\"> </a><p><b>Answer options for item93764222 </b></p><ul><li style=\"font-size: 11px\">http://terminology.hl7.org/CodeSystem/v2-0532#Y (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">http://terminology.hl7.org/CodeSystem/v2-0532#N (&quot;No&quot;)</li></ul><a name=\"opt-item.item33664919\"> </a><p><b>Answer options for item33664919 </b></p><ul><li style=\"font-size: 11px\">http://terminology.hl7.org/CodeSystem/v2-0532#Y (&quot;Yes&quot;)</li><li style=\"font-size: 11px\">http://terminology.hl7.org/CodeSystem/v2-0532#N (&quot;No&quot;)</li></ul><h2>Contained Resources</h2><hr/>\n  <table class=\"narrative-table\">\n    <tbody>\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"metadata\"> </a>Metadata</th>\n\n\n</tr>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Experimental</th>\n\n\n\n<td class=\"content-container\">true</td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Description</th>\n\n\n\n<td class=\"content-container\">HTML with embedded [FHIRPath Liquid](https://confluence.hl7.org/spaces/FHIR/pages/66938964/FHIR+Liquid+Profile) that is intended to be executed against QuestionnaireResponses based on this Questionnaire.</td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Type</th>\n\n\n\n<td class=\"content-container\">\n    <a href=\"CodeSystem-library-types.html\">http://ontariohealth.ca/fhir/eforms/CodeSystem/library-types</a>#qr-narrative-liquid\n\n\n</td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"parameters\"> </a>Parameters</th>\n\n\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Parameter</th>\n\n\n\n<td class=\"content-container\">None</td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Library Content</th>\n\n\n</tr>\n  \n    \n    <tr>\n      <th scope=\"row\" class=\"row-header\">text/htmlContent</th>\n      <td>\n        <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code>Encoded data </code></pre>\n      </td>\n    </tr>\n    \n  \n\n\n\n<tr>\n  <th colspan=\"2\" scope=\"row\" class=\"row-header\">Generated using version 0.5.6 of the sample-content-ig Liquid templates</th>\n</tr>\n\n    </tbody>\n  </table>\n</div>"
  },
  "contained": [
    {
      "resourceType": "Library",
      "id": "liquid",
      "status": "active",
      "experimental": true,
      "type": {
        "coding": [
          {
            "system": "http://ontariohealth.ca/fhir/eforms/CodeSystem/library-types",
            "code": "qr-narrative-liquid"
          }
        ]
      },
      "description": "HTML with embedded [FHIRPath Liquid](https://confluence.hl7.org/spaces/FHIR/pages/66938964/FHIR+Liquid+Profile) that is intended to be executed against QuestionnaireResponses based on this Questionnaire.",
      "content": [
        {
          "contentType": "text/html",
          "data": "<div>{% capture childItems %}{% if QuestionnaireResponse.item.where(linkId = 'questionnaire').exists() %}{% for currentItem in QuestionnaireResponse.item.where(linkId = 'questionnaire') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'section47163071').exists() %}Patient Information<br/> {% for currentItem in currentItem.item.where(linkId = 'section47163071') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item29578021' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item29578021' and answer.exists()) %}{% if currentItem.answer.exists() %}Height (cm): {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item67890802' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item67890802' and answer.exists()) %}{% if currentItem.answer.exists() %}Weight (kg): {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}<br/><span/>{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section2763158').exists() %}<span style="font-weight:bold;text-decoration:underline;">Referral Information<br/></span> {% for currentItem in currentItem.item.where(linkId = 'section2763158') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item48807357' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item48807357' and answer.exists()) %}{% if currentItem.answer.exists() %}Reason for Referral: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section42000384').exists() %}<span style="font-weight:bold;">Pregnancy History<br/></span> {% for currentItem in currentItem.item.where(linkId = 'section42000384') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item67762889' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item67762889' and answer.exists()) %}{% if currentItem.answer.exists() %}Total number of pregnancies: {% for answer in currentItem.answer %}{{ answer.value.ofType(integer) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item91252875' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item91252875' and answer.exists()) %}{% if currentItem.answer.exists() %}Number of vaginal deliveries: {% for answer in currentItem.answer %}{{ answer.value.ofType(integer) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item47328769' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item47328769' and answer.exists()) %}{% if currentItem.answer.exists() %}Number of C-sections: {% for answer in currentItem.answer %}{{ answer.value.ofType(integer) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item36834119' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item36834119' and answer.exists()) %}{% if currentItem.answer.exists() %}Number of miscarriages/pregnancy losses/ectopic pregnancies: {% for answer in currentItem.answer %}{{ answer.value.ofType(integer) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item29828101' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item29828101' and answer.exists()) %}{% if currentItem.answer.exists() %}Number of abortions/pregnancy terminations: {% for answer in currentItem.answer %}{{ answer.value.ofType(integer) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section41623208').exists() %}<span style="font-weight:bold;">Menstrual History<br/></span> {% for currentItem in currentItem.item.where(linkId = 'section41623208') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item68062550' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item68062550' and answer.exists()) %}{% if currentItem.answer.exists() %}<span/> {% for answer in currentItem.answer %}{{ answer.value.ofType(date) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item35661442' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item35661442' and answer.exists()) %}{% if currentItem.answer.exists() %}Number of days between periods: {% for answer in currentItem.answer %}{{ answer.value.ofType(integer) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item34464904' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item34464904' and answer.exists()) %}{% if currentItem.answer.exists() %}Number of days period lasts: {% for answer in currentItem.answer %}{{ answer.value.ofType(integer) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item12983596' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item12983596' and answer.exists()) %}{% if currentItem.answer.exists() %}Are patient's periods painful: <span style="font-weight:bold;color:#AA0000;">{% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}</span>{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item93188178' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item93188178' and answer.exists()) %}{% if currentItem.answer.exists() %}Are patient's periods heavy: <span style="font-weight:bold;color:#AA0000;">{% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}</span>{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item9542494' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item9542494' and answer.exists()) %}{% if currentItem.answer.exists() %}Number of pads/tampons used on the heaviest day of period: {% for answer in currentItem.answer %}{{ answer.value.ofType(integer) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section87236956').exists() %}<span style="font-weight:bold;">Gynecologic History<br/></span> {% for currentItem in currentItem.item.where(linkId = 'section87236956') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'section90671878').exists() %}{% for currentItem in currentItem.item.where(linkId = 'section90671878') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item27527635' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item27527635' and answer.exists(value.ofType(boolean)=true)) %}None{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section95740632').exists() %}{% for currentItem in currentItem.item.where(linkId = 'section95740632') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item97846576' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item97846576' and answer.exists(value.ofType(boolean)=true)) %}<span style="font-weight:bold;color:#AA0000;">Abnormal pap tests</span>{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item76524094' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item76524094' and answer.exists(value.ofType(boolean)=true)) %}<span style="font-weight:bold;color:#AA0000;">Fibroids</span>{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item62031353' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item62031353' and answer.exists(value.ofType(boolean)=true)) %}<span style="font-weight:bold;color:#AA0000;">Endometriosis</span>{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item78555427' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item78555427' and answer.exists(value.ofType(boolean)=true)) %}<span style="font-weight:bold;color:#AA0000;">Ovarian cysts</span>{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item86136829' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item86136829' and answer.exists(value.ofType(boolean)=true)) %}<span style="font-weight:bold;color:#AA0000;">Sexually transmitted infection(s)</span>{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item50977523' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item50977523' and answer.exists()) %}{% if currentItem.answer.exists() %}{% capture answer %}{% for answer in currentItem.answer %}{% if answer.value.code = 'Gonorrhea' %}Gonorrhea{% endif %}{% if answer.value.code = 'Chlamydia' %}Chlamydia{% endif %}{% if answer.value.code = 'Herpes' %}Herpes{% endif %}{% if answer.value.code = 'Genital warts' %}Genital warts{% endif %}{% if answer.value.code = 'Syphilis' %}Syphilis{% endif %}{% if answer.value.code = 'Other' %}Other{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endcapture %}{{answer}}{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item127317' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item127317' and answer.exists()) %}{% if currentItem.answer.exists() %}Date of last pap test: {% for answer in currentItem.answer %}{{ answer.value.ofType(date) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item54300787' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item54300787' and answer.exists()) %}{% if currentItem.answer.exists() %}Patient is sexually active: {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item96682694' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item96682694' and answer.exists()) %}{% if currentItem.answer.exists() %}With: {% for answer in currentItem.answer %}{% if answer.value.code = 'Men' %}Men{% endif %}{% if answer.value.code = 'Women' %}Women{% endif %}{% if answer.value.code = 'Both' %}Both{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item86913170' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item86913170' and answer.exists()) %}{% if currentItem.answer.exists() %}Form of birth control used: {% for answer in currentItem.answer %}{% if answer.value.code = 'Birth Control pill / patch / ring' %}Birth Control pill / patch / ring{% endif %}{% if answer.value.code = 'Condoms' %}Condoms{% endif %}{% if answer.value.code = 'IUD (hormone)' %}IUD (hormone){% endif %}{% if answer.value.code = 'IUD (copper)' %}IUD (copper){% endif %}{% if answer.value.code = 'Pull-out/withdrawal' %}Pull-out/withdrawal{% endif %}{% if answer.value.code = 'Calendar / Natural Family Planning' %}Calendar / Natural Family Planning{% endif %}{% if answer.value.code = 'Partner had vasectomy' %}Partner had vasectomy{% endif %}{% if answer.value.code = 'Permanent tubal sugery' %}Permanent tubal sugery{% endif %}{% if answer.value.code = 'Subdermal implant' %}Subdermal implant{% endif %}{% if answer.value.code = 'None' %}None{% endif %}{% if forloop.last.not() %}{% if forloop.nextitem %}; {% else %}; {% endif %}{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}<br/><span/>{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section4572141').exists() %}<span style="font-weight:bold;text-decoration:underline;">Medical History<br/></span> {% for currentItem in currentItem.item.where(linkId = 'section4572141') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'prob' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'prob' and answer.exists()) %}{% if currentItem.answer.exists() %} {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section61677093').exists() %}{% for currentItem in currentItem.item.where(linkId = 'section61677093') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item16667176' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item16667176' and answer.exists(value.ofType(boolean)=true)) %}High blood pressure{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item18948376' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item18948376' and answer.exists(value.ofType(boolean)=true)) %}Diabetes{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item35434575' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item35434575' and answer.exists(value.ofType(boolean)=true)) %}Blood clots in lungs/legs{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item69273958' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item69273958' and answer.exists(value.ofType(boolean)=true)) %}Migraine headaches{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item47066864' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item47066864' and answer.exists(value.ofType(boolean)=true)) %}Liver disease/hepatitis{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item75358255' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item75358255' and answer.exists(value.ofType(boolean)=true)) %}Osteoporosis{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item41631847' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item41631847' and answer.exists(value.ofType(boolean)=true)) %}Infertility{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item18292760' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item18292760' and answer.exists(value.ofType(boolean)=true)) %}Cancer{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item66877002' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item66877002' and answer.exists()) %}{% if currentItem.answer.exists() %}Type(s): <span style="font-weight:bold;color:#AA0000;">{% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}</span>{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item77134898' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item77134898' and answer.exists(value.ofType(boolean)=true)) %}Thyroid problems{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item880791' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item880791' and answer.exists(value.ofType(boolean)=true)) %}Asthma{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item72238932' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item72238932' and answer.exists(value.ofType(boolean)=true)) %}Anxiety/ Depression{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item37884318' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item37884318' and answer.exists(value.ofType(boolean)=true)) %}Incontinence (urine/stool){% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item41904126' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item41904126' and answer.exists(value.ofType(boolean)=true)) %}Constipation{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item51470870' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item51470870' and answer.exists(value.ofType(boolean)=true)) %}Frequent bladder infections{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item78475900' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item78475900' and answer.exists()) %}{% if currentItem.answer.exists() %}{% capture answer %}{% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endcapture %}Other: {{answer}}{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'i_nmedications_n').exists() %}<span style="font-weight:bold;text-decoration:underline;">Medications<br/></span> {% for currentItem in currentItem.item.where(linkId = 'i_nmedications_n') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'rx' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'rx' and answer.exists()) %}{% if currentItem.answer.exists() %} {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'allergies').exists() %}<span style="font-weight:bold;">Allergies<br/></span> {% for currentItem in currentItem.item.where(linkId = 'allergies') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'allg' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'allg' and answer.exists()) %}{% if currentItem.answer.exists() %} <span style="font-weight:bold;color:#AA0000;">{% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}</span>{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'i_npast_medical_histo').exists() %}<span style="font-weight:bold;">Past Medical History<br/></span> {% for currentItem in currentItem.item.where(linkId = 'i_npast_medical_histo') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'pmhx' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'pmhx' and answer.exists()) %}{% if currentItem.answer.exists() %} {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section68506771').exists() %}<span style="font-weight:bold;">Family History<br/></span> {% for currentItem in currentItem.item.where(linkId = 'section68506771') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'fhx' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'fhx' and answer.exists()) %}{% if currentItem.answer.exists() %} {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section48519309').exists() %}{% for currentItem in currentItem.item.where(linkId = 'section48519309') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item65894204' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item65894204' and answer.exists(value.ofType(boolean)=true)) %}High blood pressure{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item82516489' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item82516489' and answer.exists(value.ofType(boolean)=true)) %}Heart Disease/Stroke{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item30885585' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item30885585' and answer.exists(value.ofType(boolean)=true)) %}Diabetes{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item4088333' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item4088333' and answer.exists(value.ofType(boolean)=true)) %}Bad reaction to anesthetic{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item37784990' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item37784990' and answer.exists(value.ofType(boolean)=true)) %}Breast Cancer{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item53504294' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item53504294' and answer.exists(value.ofType(boolean)=true)) %}Uterine Cancer{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item4801402' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item4801402' and answer.exists(value.ofType(boolean)=true)) %}Ovarian Cancer{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item75842905' and answer.exists(value.ofType(boolean)=true)).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item75842905' and answer.exists(value.ofType(boolean)=true)) %}Colon/Bowel Cancer{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item29254997' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item29254997' and answer.exists()) %}{% if currentItem.answer.exists() %}{% capture answer %}{% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endcapture %}Other Cancer(s): {{answer}}{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'i_nsocial_history_n').exists() %}<span style="font-weight:bold;">Social History<br/></span> {% for currentItem in currentItem.item.where(linkId = 'i_nsocial_history_n') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'soc' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'soc' and answer.exists()) %}{% if currentItem.answer.exists() %} {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'section64573544').exists() %}{% for currentItem in currentItem.item.where(linkId = 'section64573544') %}{% capture childItems %}{% if currentItem.item.where(linkId = 'item57834583' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item57834583' and answer.exists()) %}{% if currentItem.answer.exists() %}Smoker: {% for answer in currentItem.answer %}{% if answer.value.code = 'No' %}No{% endif %}{% if answer.value.code = 'Yes' %}Yes{% endif %}{% if answer.value.code = 'Ex-Smoker' %}Ex-Smoker{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item10529961' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item10529961' and answer.exists()) %}{% if currentItem.answer.exists() %}Number of years: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item44127211' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item44127211' and answer.exists()) %}{% if currentItem.answer.exists() %}Number of cigarettes per day: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item41506070' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item41506070' and answer.exists()) %}{% if currentItem.answer.exists() %}Quit date: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item151992' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item151992' and answer.exists()) %}{% if currentItem.answer.exists() %}Consumes alcohol: {% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item94627251' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item94627251' and answer.exists()) %}{% if currentItem.answer.exists() %}Number of drinks per week on average: {% for answer in currentItem.answer %}{{ answer.value.extension('').extension('').value.ofType(string) }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item93764222' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item93764222' and answer.exists()) %}{% if currentItem.answer.exists() %}Uses recreational and/or street drugs: <span style="font-weight:bold;color:#A6A900;">{% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}</span>{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item74607677' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item74607677' and answer.exists()) %}{% if currentItem.answer.exists() %}Specify: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item33664919' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item33664919' and answer.exists()) %}{% if currentItem.answer.exists() %}Consumes caffeine: <span style="font-weight:bold;color:#A6A900;">{% for answer in currentItem.answer %}{% if answer.value.code = 'Y' %}Yes{% endif %}{% if answer.value.code = 'N' %}No{% endif %}{% endfor %}</span>{% endif %}{% endfor %}$SEP${% endif %}{% if currentItem.item.where(linkId = 'item45718527' and answer.exists()).exists() %}{% for currentItem in currentItem.item.where(linkId = 'item45718527' and answer.exists()) %}{% if currentItem.answer.exists() %}Number of cups of coffee/tea/cola per day: {% for answer in currentItem.answer %}{{ answer.value }}{% endfor %}{% endif %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}{% endfor %}$SEP${% endif %}{% endcapture %}{% assign itemList = childItems || remove_last: '$SEP$' || split: '$SEP$' %}{% for listItem in itemList %}{{ listItem }}{% if forloop.last.not() %}{% if forloop.nextitem %}<br/>{% else %}<br/>{% endif %}{% endif %}{% endfor %}</div>"
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm",
      "valueCoding": {
        "system": "http://hl7.org/fhir/version-algorithm",
        "code": "semver"
      }
    },
    {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-entryMode",
      "valueCode": "random"
    },
    {
      "extension": [
        {
          "url": "name",
          "valueCoding": {
            "system": "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext",
            "code": "patient"
          }
        },
        {
          "url": "type",
          "valueCode": "Patient"
        }
      ],
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/variable",
      "valueExpression": {
        "name": "query-ptLatestVal.ht",
        "language": "application/x-fhir-query",
        "expression": "Observation?patient={{%patient.id}}&code=http%3A//loinc.org|8302-2&status=final,ammended&_sort=-date&_count=1"
      }
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/variable",
      "valueExpression": {
        "name": "var-ptLatestVal.ht",
        "language": "text/fhirpath",
        "expression": "%`query-ptLatestVal.ht`.entry.resource.ofType(Observation).first().value.where(code='cm').value.toString()"
      }
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/variable",
      "valueExpression": {
        "name": "query-ips",
        "language": "application/x-fhir-query",
        "expression": "Bundle?composition.patient={{%patient.id}}&composition.code=http%3A//loinc.org|60591-5&composition.status=final,ammended&_sort=-composition.date&_count=1"
      }
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/variable",
      "valueExpression": {
        "name": "var-ptCpp.soc",
        "language": "text/fhirpath",
        "expression": "%`query-ips`.entry.resource.first().section.where(code.coding.exists(code='http%3A//loinc.org' and code='29762-2')).text.div"
      }
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/variable",
      "valueExpression": {
        "name": "query-ptLatestVal.wt",
        "language": "application/x-fhir-query",
        "expression": "Observation?patient={{%patient.id}}&code=http%3A//loinc.org|29463-7&status=final,ammended&_sort=-date&_count=1"
      }
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/variable",
      "valueExpression": {
        "name": "var-ptLatestVal.wt",
        "language": "text/fhirpath",
        "expression": "%`query-ptLatestVal.wt`.entry.resource.ofType(Observation).first().value.where(code='kg').value.toString()"
      }
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/variable",
      "valueExpression": {
        "name": "var-ptCpp.allg",
        "language": "text/fhirpath",
        "expression": "%`query-ips`.entry.resource.first().section.where(code.coding.exists(code='http%3A//loinc.org' and code='48765-2')).text.div"
      }
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/variable",
      "valueExpression": {
        "name": "var-ptCpp.pmhx",
        "language": "text/fhirpath",
        "expression": "%`query-ips`.entry.resource.first().section.where(code.coding.exists(code='http%3A//loinc.org' and code='47519-4')).text.div"
      }
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/variable",
      "valueExpression": {
        "name": "var-ptCpp.prob",
        "language": "text/fhirpath",
        "expression": "%`query-ips`.entry.resource.first().section.where(code.coding.exists(code='http%3A//loinc.org' and code='11450-4')).text.div"
      }
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/variable",
      "valueExpression": {
        "name": "var-ptCpp.rx",
        "language": "text/fhirpath",
        "expression": "%`query-ips`.entry.resource.first().section.where(code.coding.exists(code='http%3A//loinc.org' and code='46264-8')).text.div"
      }
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/variable",
      "valueExpression": {
        "name": "query-ptCpp.fhx",
        "language": "application/x-fhir-query",
        "expression": "Observation?patient={{%patient.id}}&code=http%3A//loinc.org|10157-6&status=final,ammended&_sort=-date&_count=1"
      }
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/variable",
      "valueExpression": {
        "name": "var-ptCpp.fhx",
        "language": "text/fhirpath",
        "expression": "%`query-ptCpp.fhx`.entry.resource.ofType(Observation).first().value"
      }
    },
    {
      "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/sdc-responseRenderingLiquid",
      "valueReference": {
        "reference": "#liquid"
      }
    }
  ],
  "url": "http://ontariohealth.ca/fhir/eforms/Questionnaire/dr-garvey-chilopora",
  "version": "1.2.0",
  "title": "Dr. Chilopora eReferral Form [FINAL MAY 2022]",
  "status": "active",
  "experimental": true,
  "subjectType": [
    "Patient"
  ],
  "publisher": "Ontario Health",
  "description": "Questionnaire template representing a provider (HIC)-specific eReferral form for Dr. Chilopora.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "CA"
        }
      ]
    }
  ],
  "item": [
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
          "valueString": "background-color:grey;border-style:solid;"
        },
        {
          "extension": [
            {
              "url": "style",
              "valueString": "font-weight:bold;text-decoration:underline;"
            }
          ],
          "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/group-note-info"
        }
      ],
      "linkId": "questionnaire",
      "type": "group",
      "item": [
        {
          "linkId": "item47143865",
          "text": "* Indicates a required field",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                "valueString": "font-weight:bold;"
              }
            ]
          },
          "type": "display"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            },
            {
              "extension": [
                {
                  "url": "listSeparator",
                  "_valueString": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "<br/>"
                      }
                    ]
                  }
                }
              ],
              "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/group-note-info"
            }
          ],
          "linkId": "section47163071",
          "text": "Patient Information",
          "type": "group",
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%`var-ptLatestVal.ht`"
                  }
                },
                {
                  "extension": [
                    {
                      "url": "text",
                      "valueString": "Height (cm):"
                    }
                  ],
                  "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info"
                }
              ],
              "linkId": "item29578021",
              "text": "Height (cm):",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "Height (cm):<br/>"
                  }
                ]
              },
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%`var-ptLatestVal.wt`"
                  }
                },
                {
                  "extension": [
                    {
                      "url": "text",
                      "valueString": "Weight (kg): "
                    }
                  ],
                  "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info"
                }
              ],
              "linkId": "item67890802",
              "text": "Weight (kg):",
              "_text": {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                    "valueString": "Weight (kg): <br/>"
                  }
                ]
              },
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                  "valueBoolean": true
                },
                {
                  "extension": [
                    {
                      "url": "text",
                      "valueString": "#blank_line#"
                    }
                  ],
                  "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/display-note-info"
                }
              ],
              "linkId": "item84833268",
              "type": "display"
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            },
            {
              "extension": [
                {
                  "url": "style",
                  "valueString": "font-weight:bold;text-decoration:underline;"
                },
                {
                  "url": "listSeparator",
                  "_valueString": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "<br/>"
                      }
                    ]
                  }
                }
              ],
              "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/group-note-info"
            }
          ],
          "linkId": "section2763158",
          "text": "Referral Information",
          "type": "group",
          "item": [
            {
              "linkId": "item48807357",
              "text": "Reason for Referral:",
              "type": "text",
              "required": true
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                  "valueString": "background-color:white;border-style:solid;"
                },
                {
                  "extension": [
                    {
                      "url": "style",
                      "valueString": "font-weight:bold;"
                    },
                    {
                      "url": "listSeparator",
                      "_valueString": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          }
                        ]
                      }
                    }
                  ],
                  "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/group-note-info"
                }
              ],
              "linkId": "section42000384",
              "text": "Pregnancy History",
              "type": "group",
              "item": [
                {
                  "linkId": "item67762889",
                  "text": "Total number of pregnancies:",
                  "type": "integer",
                  "required": true
                },
                {
                  "linkId": "item91252875",
                  "text": "Number of vaginal deliveries:",
                  "type": "integer"
                },
                {
                  "linkId": "item47328769",
                  "text": "Number of C-sections:",
                  "type": "integer"
                },
                {
                  "linkId": "item36834119",
                  "text": "Number of miscarriages/pregnancy losses/ectopic pregnancies:",
                  "type": "integer"
                },
                {
                  "linkId": "item29828101",
                  "text": "Number of abortions/pregnancy terminations:",
                  "type": "integer"
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                  "valueString": "background-color:white;border-style:solid;"
                },
                {
                  "extension": [
                    {
                      "url": "style",
                      "valueString": "font-weight:bold;"
                    },
                    {
                      "url": "listSeparator",
                      "_valueString": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          }
                        ]
                      }
                    }
                  ],
                  "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/group-note-info"
                }
              ],
              "linkId": "section41623208",
              "text": "Menstrual History",
              "type": "group",
              "item": [
                {
                  "extension": [
                    {
                      "extension": [
                        {
                          "url": "text",
                          "_valueString": {
                            "extension": [
                              {
                                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                                "valueString": "<span/>"
                              }
                            ]
                          }
                        }
                      ],
                      "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info"
                    }
                  ],
                  "linkId": "item68062550",
                  "text": "Date of Last Menstrual Period:",
                  "_text": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "Date of Last Menstrual Period:<br/>"
                      }
                    ]
                  },
                  "type": "date"
                },
                {
                  "extension": [
                    {
                      "extension": [
                        {
                          "url": "text",
                          "valueString": "Number of days between periods:"
                        }
                      ],
                      "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info"
                    }
                  ],
                  "linkId": "item35661442",
                  "text": "Number of days between periods:",
                  "_text": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "Number of days between periods:<br/>"
                      }
                    ]
                  },
                  "type": "integer"
                },
                {
                  "extension": [
                    {
                      "extension": [
                        {
                          "url": "text",
                          "valueString": "Number of days period lasts:"
                        }
                      ],
                      "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info"
                    }
                  ],
                  "linkId": "item34464904",
                  "text": "Number of days period lasts:",
                  "_text": {
                    "extension": [
                      {
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                  "linkId": "item12983596",
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                      "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info"
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                  ],
                  "linkId": "item93188178",
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                },
                {
                  "linkId": "item9542494",
                  "text": "Number of pads/tampons used on the heaviest day of period:",
                  "type": "integer"
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              ]
            },
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                  "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
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              "linkId": "section87236956",
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                          "url": "key",
                          "valueId": "item5390108"
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                          "valueCode": "error"
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                          "url": "human",
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                      "linkId": "item5390108",
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                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
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                          "valueCodeableConcept": {
                            "coding": [
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                          "extension": [
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                                  "url": "answerStyle",
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                              "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info"
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                          ],
                          "linkId": "item97846576",
                          "text": "Abnormal pap tests",
                          "type": "boolean"
                        },
                        {
                          "extension": [
                            {
                              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                              "valueCodeableConcept": {
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                              "extension": [
                                {
                                  "url": "answerStyle",
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                              "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info"
                            }
                          ],
                          "linkId": "item76524094",
                          "text": "Fibroids",
                          "type": "boolean"
                        },
                        {
                          "extension": [
                            {
                              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                              "valueCodeableConcept": {
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                                  "url": "answerStyle",
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                              "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info"
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                          "linkId": "item62031353",
                          "text": "Endometriosis",
                          "type": "boolean"
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                              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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                              "extension": [
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                                  "url": "answerStyle",
                                  "valueString": "font-weight:bold;color:#AA0000;"
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                              "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info"
                            }
                          ],
                          "linkId": "item78555427",
                          "text": "Ovarian cysts",
                          "type": "boolean"
                        },
                        {
                          "extension": [
                            {
                              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                              "valueCodeableConcept": {
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                                    "system": "http://hl7.org/fhir/questionnaire-item-control",
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                            },
                            {
                              "extension": [
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                                  "url": "answerStyle",
                                  "valueString": "font-weight:bold;color:#AA0000;"
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                              "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info"
                            }
                          ],
                          "linkId": "item86136829",
                          "text": "Sexually transmitted infection(s)",
                          "type": "boolean"
                        },
                        {
                          "extension": [
                            {
                              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                              "valueCodeableConcept": {
                                "coding": [
                                  {
                                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                                    "code": "drop-down"
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                            },
                            {
                              "extension": [
                                {
                                  "url": "text",
                                  "valueString": "{{answer}}"
                                }
                              ],
                              "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info"
                            }
                          ],
                          "linkId": "item50977523",
                          "text": "Specify:",
                          "type": "choice",
                          "enableWhen": [
                            {
                              "question": "item86136829",
                              "operator": "=",
                              "answerBoolean": true
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                          "enableBehavior": "all",
                          "repeats": true,
                          "answerOption": [
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                              "valueCoding": {
                                "extension": [
                                  {
                                    "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                                    "valueDecimal": 1
                                  }
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                                "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item50977523",
                                "code": "Gonorrhea",
                                "display": "Gonorrhea"
                              }
                            },
                            {
                              "valueCoding": {
                                "extension": [
                                  {
                                    "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                                    "valueDecimal": 2
                                  }
                                ],
                                "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item50977523",
                                "code": "Chlamydia",
                                "display": "Chlamydia"
                              }
                            },
                            {
                              "valueCoding": {
                                "extension": [
                                  {
                                    "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                                    "valueDecimal": 3
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                                ],
                                "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item50977523",
                                "code": "Herpes",
                                "display": "Herpes"
                              }
                            },
                            {
                              "valueCoding": {
                                "extension": [
                                  {
                                    "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                                    "valueDecimal": 4
                                  }
                                ],
                                "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item50977523",
                                "code": "Genital warts",
                                "display": "Genital warts"
                              }
                            },
                            {
                              "valueCoding": {
                                "extension": [
                                  {
                                    "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                                    "valueDecimal": 5
                                  }
                                ],
                                "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item50977523",
                                "code": "Syphilis",
                                "display": "Syphilis"
                              }
                            },
                            {
                              "valueCoding": {
                                "extension": [
                                  {
                                    "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                                    "valueDecimal": 0
                                  }
                                ],
                                "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item50977523",
                                "code": "Other",
                                "display": "Other"
                              }
                            }
                          ]
                        }
                      ]
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "extension": [
                        {
                          "url": "text",
                          "valueString": "Date of last pap test:"
                        }
                      ],
                      "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info"
                    }
                  ],
                  "linkId": "item127317",
                  "text": "Date of last pap test:",
                  "_text": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "Date of last pap test:<br/>"
                      }
                    ]
                  },
                  "type": "date",
                  "required": true
                },
                {
                  "linkId": "item54300787",
                  "text": "Patient is sexually active:",
                  "type": "choice",
                  "answerOption": [
                    {
                      "valueCoding": {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
                        "code": "Y",
                        "display": "Yes"
                      }
                    },
                    {
                      "valueCoding": {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
                        "code": "N",
                        "display": "No"
                      }
                    }
                  ]
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                {
                  "extension": [
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                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://ontariohealth.ca/fhir/eforms/CodeSystem/item-controls",
                            "code": "push-button"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item96682694",
                  "text": "With:",
                  "type": "choice",
                  "enableWhen": [
                    {
                      "question": "item54300787",
                      "operator": "=",
                      "answerCoding": {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
                        "code": "Y",
                        "display": "Yes"
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                  ],
                  "enableBehavior": "all",
                  "repeats": false,
                  "answerOption": [
                    {
                      "valueCoding": {
                        "extension": [
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                            "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                            "valueDecimal": 1
                          }
                        ],
                        "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item96682694",
                        "code": "Men",
                        "display": "Men"
                      }
                    },
                    {
                      "valueCoding": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                            "valueDecimal": 2
                          }
                        ],
                        "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item96682694",
                        "code": "Women",
                        "display": "Women"
                      }
                    },
                    {
                      "valueCoding": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                            "valueDecimal": 3
                          }
                        ],
                        "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item96682694",
                        "code": "Both",
                        "display": "Both"
                      }
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "drop-down"
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                        ]
                      }
                    }
                  ],
                  "linkId": "item86913170",
                  "text": "Form of birth control used:",
                  "type": "choice",
                  "enableWhen": [
                    {
                      "question": "item54300787",
                      "operator": "=",
                      "answerCoding": {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
                        "code": "Y",
                        "display": "Yes"
                      }
                    }
                  ],
                  "enableBehavior": "all",
                  "repeats": true,
                  "answerOption": [
                    {
                      "valueCoding": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                            "valueDecimal": 1
                          }
                        ],
                        "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item86913170",
                        "code": "Birth Control pill / patch / ring",
                        "display": "Birth Control pill / patch / ring"
                      }
                    },
                    {
                      "valueCoding": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                            "valueDecimal": 2
                          }
                        ],
                        "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item86913170",
                        "code": "Condoms",
                        "display": "Condoms"
                      }
                    },
                    {
                      "valueCoding": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                            "valueDecimal": 3
                          }
                        ],
                        "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item86913170",
                        "code": "IUD (hormone)",
                        "display": "IUD (hormone)"
                      }
                    },
                    {
                      "valueCoding": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                            "valueDecimal": 4
                          }
                        ],
                        "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item86913170",
                        "code": "IUD (copper)",
                        "display": "IUD (copper)"
                      }
                    },
                    {
                      "valueCoding": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                            "valueDecimal": 5
                          }
                        ],
                        "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item86913170",
                        "code": "Pull-out/withdrawal",
                        "display": "Pull-out/withdrawal"
                      }
                    },
                    {
                      "valueCoding": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                            "valueDecimal": 0
                          }
                        ],
                        "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item86913170",
                        "code": "Calendar / Natural Family Planning",
                        "display": "Calendar / Natural Family Planning"
                      }
                    },
                    {
                      "valueCoding": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                            "valueDecimal": 0
                          }
                        ],
                        "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item86913170",
                        "code": "Partner had vasectomy",
                        "display": "Partner had vasectomy"
                      }
                    },
                    {
                      "valueCoding": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                            "valueDecimal": 0
                          }
                        ],
                        "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item86913170",
                        "code": "Permanent tubal sugery",
                        "display": "Permanent tubal sugery"
                      }
                    },
                    {
                      "valueCoding": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                            "valueDecimal": 0
                          }
                        ],
                        "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item86913170",
                        "code": "Subdermal implant",
                        "display": "Subdermal implant"
                      }
                    },
                    {
                      "valueCoding": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                            "valueDecimal": 0
                          }
                        ],
                        "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item86913170",
                        "code": "None",
                        "display": "None"
                      }
                    }
                  ]
                }
              ]
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
                  "valueBoolean": true
                },
                {
                  "extension": [
                    {
                      "url": "text",
                      "valueString": "#blank_line#"
                    }
                  ],
                  "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/display-note-info"
                }
              ],
              "linkId": "item95005032",
              "type": "display"
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            },
            {
              "extension": [
                {
                  "url": "style",
                  "valueString": "font-weight:bold;text-decoration:underline;"
                },
                {
                  "url": "lastSeparator",
                  "_valueString": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "<br/>"
                      }
                    ]
                  }
                },
                {
                  "url": "listSeparator",
                  "_valueString": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "<br/>"
                      }
                    ]
                  }
                }
              ],
              "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/group-note-info"
            }
          ],
          "linkId": "section4572141",
          "text": "Medical History",
          "type": "group",
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "item.where(linkId='prob').answer.exists()"
                  }
                },
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%`var-ptCpp.prob`"
                  }
                }
              ],
              "linkId": "prob",
              "type": "text",
              "enableBehavior": "all"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
                  "valueExpression": {
                    "description": "prob.r == ''",
                    "language": "text/fhirpath",
                    "expression": "%resource.repeat(item).where(linkId='prob').answer.empty()"
                  }
                }
              ],
              "linkId": "section61677093",
              "type": "group",
              "item": [
                {
                  "linkId": "item4613718",
                  "text": "Select all that apply:",
                  "_text": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                        "valueString": "font-style:italic;"
                      }
                    ]
                  },
                  "type": "display"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item16667176",
                  "text": "High blood pressure",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item18948376",
                  "text": "Diabetes",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item35434575",
                  "text": "Blood clots in lungs/legs",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item69273958",
                  "text": "Migraine headaches",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item47066864",
                  "text": "Liver disease/hepatitis",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item75358255",
                  "text": "Osteoporosis",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item41631847",
                  "text": "Infertility",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item18292760",
                  "text": "Cancer",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "extension": [
                        {
                          "url": "answerStyle",
                          "valueString": "font-weight:bold;color:#AA0000;"
                        }
                      ],
                      "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info"
                    }
                  ],
                  "linkId": "item66877002",
                  "text": "Type(s):",
                  "type": "text",
                  "enableWhen": [
                    {
                      "question": "item18292760",
                      "operator": "=",
                      "answerBoolean": true
                    }
                  ],
                  "enableBehavior": "all",
                  "required": true
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item77134898",
                  "text": "Thyroid problems",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item880791",
                  "text": "Asthma",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item72238932",
                  "text": "Anxiety/ Depression",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item37884318",
                  "text": "Incontinence (urine/stool)",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item41904126",
                  "text": "Constipation",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item51470870",
                  "text": "Frequent bladder infections",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    },
                    {
                      "extension": [
                        {
                          "url": "enableWhenExpression",
                          "valueExpression": {
                            "description": "false",
                            "language": "text/fhirpath",
                            "expression": "false"
                          }
                        }
                      ],
                      "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info"
                    }
                  ],
                  "linkId": "item15815594",
                  "text": "Other",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "extension": [
                        {
                          "url": "text",
                          "valueString": "Other: {{answer}}"
                        }
                      ],
                      "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info"
                    }
                  ],
                  "linkId": "item78475900",
                  "text": "Specify:",
                  "type": "text",
                  "enableWhen": [
                    {
                      "question": "item15815594",
                      "operator": "=",
                      "answerBoolean": true
                    }
                  ],
                  "enableBehavior": "all",
                  "required": true
                }
              ]
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            },
            {
              "extension": [
                {
                  "url": "style",
                  "valueString": "font-weight:bold;text-decoration:underline;"
                }
              ],
              "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/group-note-info"
            }
          ],
          "linkId": "i_nmedications_n",
          "text": "Medications",
          "type": "group",
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%`var-ptCpp.rx`"
                  }
                }
              ],
              "linkId": "rx",
              "type": "text"
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            },
            {
              "extension": [
                {
                  "url": "style",
                  "valueString": "font-weight:bold;"
                },
                {
                  "url": "answerStyle",
                  "valueString": "font-weight:bold;color:#AA0000;"
                }
              ],
              "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/group-note-info"
            }
          ],
          "linkId": "allergies",
          "text": "Allergies",
          "type": "group",
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%`var-ptCpp.allg`"
                  }
                }
              ],
              "linkId": "allg",
              "type": "text"
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            },
            {
              "extension": [
                {
                  "url": "style",
                  "valueString": "font-weight:bold;"
                }
              ],
              "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/group-note-info"
            }
          ],
          "linkId": "i_npast_medical_histo",
          "text": "Past Medical History",
          "type": "group",
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%`var-ptCpp.pmhx`"
                  }
                }
              ],
              "linkId": "pmhx",
              "type": "text"
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            },
            {
              "extension": [
                {
                  "url": "style",
                  "valueString": "font-weight:bold;"
                },
                {
                  "url": "lastSeparator",
                  "_valueString": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                        "valueString": "<br/>"
                      }
                    ]
                  }
                },
                {
                  "url": "groupItems",
                  "valueBoolean": false
                }
              ],
              "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/group-note-info"
            }
          ],
          "linkId": "section68506771",
          "text": "Family History",
          "type": "group",
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "item.where(linkId='fhx').answer.exists()"
                  }
                },
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%`var-ptCpp.fhx`"
                  }
                }
              ],
              "linkId": "fhx",
              "type": "text",
              "enableBehavior": "all"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
                  "valueExpression": {
                    "description": "fhx.r == ''",
                    "language": "text/fhirpath",
                    "expression": "%resource.repeat(item).where(linkId='fhx').answer.empty()"
                  }
                }
              ],
              "linkId": "section48519309",
              "type": "group",
              "item": [
                {
                  "linkId": "item33610974",
                  "text": "Select all that apply:",
                  "_text": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
                        "valueString": "font-style:italic;"
                      }
                    ]
                  },
                  "type": "display"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item65894204",
                  "text": "High blood pressure",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item82516489",
                  "text": "Heart Disease/Stroke",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item30885585",
                  "text": "Diabetes",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item4088333",
                  "text": "Bad reaction to anesthetic",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item37784990",
                  "text": "Breast Cancer",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item53504294",
                  "text": "Uterine Cancer",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item4801402",
                  "text": "Ovarian Cancer",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item75842905",
                  "text": "Colon/Bowel Cancer",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://hl7.org/fhir/questionnaire-item-control",
                            "code": "check-box"
                          }
                        ]
                      }
                    },
                    {
                      "extension": [
                        {
                          "url": "enableWhenExpression",
                          "valueExpression": {
                            "description": "false",
                            "language": "text/fhirpath",
                            "expression": "false"
                          }
                        }
                      ],
                      "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info"
                    }
                  ],
                  "linkId": "item22994219",
                  "text": "Other Cancer(s)",
                  "type": "boolean"
                },
                {
                  "extension": [
                    {
                      "extension": [
                        {
                          "url": "text",
                          "valueString": "Other Cancer(s): {{answer}}"
                        }
                      ],
                      "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info"
                    }
                  ],
                  "linkId": "item29254997",
                  "text": "Specify:",
                  "type": "text",
                  "enableWhen": [
                    {
                      "question": "item22994219",
                      "operator": "=",
                      "answerBoolean": true
                    }
                  ],
                  "enableBehavior": "all",
                  "required": true
                }
              ]
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
              "valueString": "background-color:white;border-style:solid;"
            },
            {
              "extension": [
                {
                  "url": "style",
                  "valueString": "font-weight:bold;"
                }
              ],
              "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/group-note-info"
            }
          ],
          "linkId": "i_nsocial_history_n",
          "text": "Social History",
          "type": "group",
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "item.where(linkId='soc').answer.exists()"
                  }
                },
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/fhirpath",
                    "expression": "%`var-ptCpp.soc`"
                  }
                }
              ],
              "linkId": "soc",
              "type": "text",
              "enableBehavior": "all"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
                  "valueExpression": {
                    "description": "soc.r == ''",
                    "language": "text/fhirpath",
                    "expression": "%resource.repeat(item).where(linkId='soc').answer.empty()"
                  }
                },
                {
                  "extension": [
                    {
                      "url": "style",
                      "valueString": "font-weight:bold;text-decoration:underline;"
                    },
                    {
                      "url": "lastSeparator",
                      "_valueString": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                            "valueString": "<br/>"
                          }
                        ]
                      }
                    }
                  ],
                  "url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/group-note-info"
                }
              ],
              "linkId": "section64573544",
              "type": "group",
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://ontariohealth.ca/fhir/eforms/CodeSystem/item-controls",
                            "code": "push-button"
                          }
                        ]
                      }
                    }
                  ],
                  "linkId": "item57834583",
                  "text": "Smoker:",
                  "type": "choice",
                  "repeats": false,
                  "answerOption": [
                    {
                      "valueCoding": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                            "valueDecimal": 1
                          }
                        ],
                        "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item57834583",
                        "code": "No",
                        "display": "No"
                      }
                    },
                    {
                      "valueCoding": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                            "valueDecimal": 2
                          }
                        ],
                        "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item57834583",
                        "code": "Yes",
                        "display": "Yes"
                      }
                    },
                    {
                      "valueCoding": {
                        "extension": [
                          {
                            "url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
                            "valueDecimal": 3
                          }
                        ],
                        "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item57834583",
                        "code": "Ex-Smoker",
                        "display": "Ex-Smoker"
                      }
                    }
                  ]
                },
                {
                  "linkId": "item10529961",
                  "text": "Number of years:",
                  "type": "string",
                  "enableWhen": [
                    {
                      "question": "item57834583",
                      "operator": "=",
                      "answerCoding": {
                        "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item57834583",
                        "code": "Yes",
                        "display": "Yes"
                      }
                    }
                  ],
                  "enableBehavior": "all"
                },
                {
                  "linkId": "item44127211",
                  "text": "Number of cigarettes per day:",
                  "type": "string",
                  "enableWhen": [
                    {
                      "question": "item57834583",
                      "operator": "=",
                      "answerCoding": {
                        "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item57834583",
                        "code": "Yes",
                        "display": "Yes"
                      }
                    }
                  ],
                  "enableBehavior": "all"
                },
                {
                  "linkId": "item41506070",
                  "text": "Quit date:",
                  "type": "string",
                  "enableWhen": [
                    {
                      "question": "item57834583",
                      "operator": "=",
                      "answerCoding": {
                        "system": "http://example.org/CodeSystem/dr-garvey-chilopora_item57834583",
                        "code": "Ex-Smoker",
                        "display": "Ex-Smoker"
                      }
                    }
                  ],
                  "enableBehavior": "all"
                },
                {
                  "linkId": "item151992",
                  "text": "Consumes alcohol:",
                  "type": "choice",
                  "answerOption": [
                    {
                      "valueCoding": {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
                        "code": "Y",
                        "display": "Yes"
                      }
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                    {
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