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KazeemHamzatKazeemHamzat
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Feature-IOPS-2415-YoungPersonAssentForm/ROD-Version-1-Questionnaire`s (#56)
* Add Young Person Questionnaire Add Young Person Questionnaire and the PDF Version * Rename uestionnaire-RoD-YoungPersonAssentForm Rename uestionnaire-RoD-YoungPersonAssentForm * Delete Questionnaire-TestOrderForm-YoungPersonAssentForm-Example Delete Questionnaire-TestOrderForm-YoungPersonAssentForm-Example * Add QResponse Resource Add QResponse Resource * Changing all Data type to valueCoding Changing all Data type on Qnnaire to valueCoding * Change Qnnaire Response types to valueBoolean Change Qnnaire Response types to valueBoolean * Update Questionnaire-RoD-YoungPersonAssentForm-Example.json Removing Constraint on W2C * Removed HL7 Contact Removed HL7 Contact
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‎Questionnaire/Questionnaire-RoD-YoungPersonAssentForm-Example.json‎

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{
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"resourceType": "Questionnaire",
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"id": "Questionnaire-RoD-YoungPersonAssentForm-Example",
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"url": "https://fhir.nhs.uk/Questionnaire/Questionnaire-RoD-YoungPersonAssentForm-Example",
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"version": "0.1.0",
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"name": "QuestionnaireRoDYoungPersonAssentFormExample",
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"title": "National Genomic Research Library Young Person Assent Form (ages 6 – 15)",
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"status": "draft",
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"subjectType": [
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"Patient"
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],
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"date": "2024-01-18T09:00:00Z",
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"publisher": "NHS England",
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"contact": [
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{
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"name": "NHS England",
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"telecom": [
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{
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"system": "email",
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"value": "interoperabilityteam@nhs.net",
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"use": "work",
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"rank": 1
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}
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]
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}
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],
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"description": "This questionnaire is to be used to document the patient consent for young person(ages 6 – 15) before undergoing Genomic testing and their choice of participation in the National Genomic Research Library programme",
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"purpose": "Young Person Assent Form (ages 6 – 15) Regarding Genomic Testing",
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"item": [
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{
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"type": "display",
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"linkId": "declaration",
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"text": "Feel free to ask any questions before answering the questions below."
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},
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{
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"linkId": "patientDetails",
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"text": "Patient Details",
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"type": "group",
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"item": [
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{
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"linkId": "givenName",
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"text": "First Name",
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"type": "string",
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"required": true
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},
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{
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"linkId": "familyName",
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"text": "Last Name",
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"type": "string",
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"required": true
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},
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{
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"linkId": "nhs_Number",
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"text": "NHS number (or postcode if not not known)",
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"type": "string",
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"required": true
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},
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{
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"linkId": "birthDate",
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"text": "Date of Birth",
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"type": "date",
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"required": true
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}
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]
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},
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{
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"item": [
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{
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"type": "boolean",
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"linkId": "consentQuestion1",
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"text": "1. Have you read information or has someone explained the research to you?",
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"required": true
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},
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{
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"type": "boolean",
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"linkId": "consentQuestion2",
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"text": "2. Have you asked all the questions you want?",
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"required": true
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},
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{
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"type": "boolean",
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"linkId": "consentQuestion3",
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"text": "3. Have you had your questions answered in a way you understand?",
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"required": true
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},
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{
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"type": "boolean",
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"linkId": "consentQuestion4",
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"text": "4. Do you understand it’s OK to say you don’t want to take part – but that your parent(s), or guardian who look after you, will make the final choice?",
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"required": true
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},
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{
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"type": "boolean",
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"linkId": "consentQuestion5",
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"text": "5. Are you happy to take part?",
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"required": true
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}
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],
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"type": "group",
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"linkId": "declarationResponse",
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"text": "Please indicate your choices below by ticking the appropriate box:",
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"readOnly": true
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},
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{
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"item": [
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{
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"type": "display",
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"linkId": "NonWillingToConsent1",
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"text": "• Don’t sign your name on this form"
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},
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{
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"type": "display",
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"linkId": "NonWillingToConsent2",
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"text": "• Tell your parents and healthcare team how you feel, so they know"
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}
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],
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"type": "group",
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"linkId": "guidanceNonWillingToConsent",
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"text": "If ANY of your answers are ‘NO’, or you don’t want to take part:"
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},
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{
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"item": [
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{
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"type": "display",
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"linkId": "WillingToConsent",
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"text": "• Please write your name, signature, and today’s date here:"
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}
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],
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"type": "group",
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"linkId": "guidanceWillingToConsent",
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"text": "If ALL of your answers are ‘YES’:"
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},
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{
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"type": "boolean",
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"linkId": "isRemoteConsentTrue",
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"text": "Assent obtained remotely, no participant signature",
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"required": true
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},
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{
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"item": [
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{
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"type": "string",
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"linkId": "patientNamecombined",
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"text": "Patient Name",
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"required": true
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},
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{
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"type": "string",
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"linkId": "patientSignature",
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"text": "Signature",
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"required": true
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},
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{
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"type": "dateTime",
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"linkId": "datePatientCompletedForm",
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"text": "Date",
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"required": true
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}
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],
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"type": "group",
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"linkId": "patientValidation",
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"text": "Patient Validation",
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"enableWhen": [
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{
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"question": "consentQuestion1",
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"operator": "=",
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"answerBoolean": true
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},
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{
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"question": "consentQuestion2",
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"operator": "=",
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"answerBoolean": true
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},
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{
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"question": "consentQuestion3",
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"operator": "=",
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"answerBoolean": true
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},
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{
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"question": "consentQuestion4",
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"operator": "=",
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"answerBoolean": true
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},
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{
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"question": "consentQuestion5",
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"operator": "=",
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"answerBoolean": true
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},
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{
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"question": "isRemoteConsentTrue",
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"operator": "=",
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"answerBoolean": false
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}
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],
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"enableBehavior": "all"
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}
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]
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}

‎QuestionnaireResponse/QuestionnaireResponse-RoD-YoungPersonAssentForm-Example.json‎

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{
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"resourceType": "QuestionnaireResponse",
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"id": "QuestionnaireResponse-RoD-YoungPersonAssentForm-Example",
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"questionnaire": "https://fhir.nhs.uk/Questionnaire/Questionnaire-RoD-YoungPersonAssentForm-Example",
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"status": "completed",
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"basedOn": [
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{
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"reference": "urn:uuid:a40c7ddc-2897-4e3c-bae6-88500e080229"
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}
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],
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"subject": {
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"identifier": {
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"system": "https://fhir.nhs.uk/Id/nhs-number",
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"value": "9449307539"
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},
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"display": "A Patient"
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},
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"authored": "2024-01-25",
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"author": {
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"type": "PractitionerRole",
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"identifier": {
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"system": "https://fhir.nhs.uk/Id/sds-role-profile-id",
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"value": "999999999999"
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}
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},
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"source": {
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"type": "PractitionerRole",
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"identifier": {
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"system": "https://fhir.nhs.uk/Id/sds-role-profile-id",
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"value": "999999999999"
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}
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},
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"item": [
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{
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"linkId": "patientDetails",
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"text": "Patient Details",
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"item": [
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{
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"linkId": "givenName",
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"text": "First Name",
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"answer": [
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{
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"valueString": "Phoebe"
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}
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]
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},
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{
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"linkId": "familyName",
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"text": "Last Name",
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"answer": [
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{
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"valueString": "Smitham"
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}
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]
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},
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{
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"linkId": "nhs_Number",
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"text": "NHS number (or postcode if not not known)",
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"answer": [
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{
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"valueString": "9449307539"
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}
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]
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},
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{
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"linkId": "birthDate",
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"text": "Date of Birth",
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"answer": [
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{
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"valueDate": "2013-09-27"
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}
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]
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}
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]
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},
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{
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"linkId": "declarationResponse",
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"text": "Please indicate your choices below by ticking the appropriate box:",
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"item": [
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{
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"linkId": "consentQuestion1",
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"text": "1. Have you read information or has someone explained the research to you?",
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"answer": [
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{
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"valueBoolean": true
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}
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]
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},
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{
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"linkId": "consentQuestion2",
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"text": "2. Have you asked all the questions you want?",
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"answer": [
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{
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"valueBoolean": true
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}
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]
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},
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{
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"linkId": "consentQuestion3",
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"text": "3. Have you had your questions answered in a way you understand?",
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"answer": [
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{
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"valueBoolean": true
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}
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]
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},
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{
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"linkId": "consentQuestion4",
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"text": "4. Do you understand it’s OK to say you don’t want to take part – but that your parent(s), or guardian who look after you, will make the final choice?",
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"answer": [
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{
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"valueBoolean": true
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}
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]
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},
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{
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"linkId": "consentQuestion5",
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"text": "5. Are you happy to take part?",
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"answer": [
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{
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"valueBoolean": false
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}
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]
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}
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]
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},
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{
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"linkId": "isRemoteConsentTrue",
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"text": "Assent obtained remotely, no participant signature",
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"answer": [
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{
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"valueBoolean": true
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}
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]
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}
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]
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}

‎documents/nhs-genomic-medicine-service-genomic-consultee-declaration-1.pdf‎

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‎documents/nhs-genomic-medicine-service-young-persons-assent-form.pdf‎

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