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Created the ICT Screening (Old) Form with it's concepts
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{ | ||
"name": "ICT Screening", | ||
"version": "1.0", | ||
"published": true, | ||
"retired": false, | ||
"encounter": "ICT Screening", | ||
"pages": [ | ||
{ | ||
"label": "ICT SCREENING (OLD)", | ||
"sections": [ | ||
{ | ||
"label": "ICT REGISTRATION SCREENING", | ||
"isExpanded": "true", | ||
"questions": [ | ||
{ | ||
"label": "Is the client eligible for partner and family based ICT?", | ||
"type": "obs", | ||
"required": false, | ||
"id": "eligibleForIct", | ||
"questionOptions": { | ||
"rendering": "radio", | ||
"concept": "15063af6-4d52-4f58-94a3-c151048d9c57", | ||
"conceptMappings": [], | ||
"answers": [ | ||
{ | ||
"concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", | ||
"label": "Yes" | ||
}, | ||
{ | ||
"concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", | ||
"label": "No" | ||
} | ||
] | ||
} | ||
}, | ||
{ | ||
"label": "Maternal HIV status", | ||
"type": "obs", | ||
"required": false, | ||
"id": "maternalHivStatus", | ||
"questionOptions": { | ||
"rendering": "select", | ||
"concept": "3535f4d1-bf1e-47d5-822d-60c1da143cad", | ||
"conceptMappings": [], | ||
"answers": [ | ||
{ | ||
"concept": "703AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", | ||
"label": "Known Positive" | ||
}, | ||
{ | ||
"concept": "5e4fc757-0b14-49ae-b3b7-419666f41e15", | ||
"label": "Negative" | ||
}, | ||
{ | ||
"concept": "1067AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", | ||
"label": "Unknown status & alive" | ||
}, | ||
{ | ||
"concept": "160432AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", | ||
"label": "Dead" | ||
} | ||
] | ||
} | ||
}, | ||
{ | ||
"label": "Marital status", | ||
"type": "obs", | ||
"required": false, | ||
"id": "maritalStatus", | ||
"questionOptions": { | ||
"rendering": "select", | ||
"concept": "2feaa615-f6af-41db-91c1-301def421146", | ||
"answers": [ | ||
{ | ||
"concept": "5555AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", | ||
"label": "Married" | ||
}, | ||
{ | ||
"concept": "1057AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", | ||
"label": "Single" | ||
}, | ||
{ | ||
"concept": "1056AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", | ||
"label": "Separated" | ||
}, | ||
{ | ||
"concept": "1058AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", | ||
"label": "Divorced" | ||
}, | ||
{ | ||
"concept": "1059AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", | ||
"label": "Widow/Widower" | ||
}, | ||
{ | ||
"concept": "1060AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", | ||
"label": "Living together" | ||
} | ||
] | ||
}, | ||
"validators": [] | ||
}, | ||
{ | ||
"label": "Number of contacts elicited?", | ||
"type": "obs", | ||
"required": false, | ||
"id": "contactsElicited", | ||
"questionOptions": { | ||
"rendering": "text", | ||
"concept": "cb018c94-17f1-4065-98c0-af892e5f7a36", | ||
"conceptMappings": [], | ||
"answers": [] | ||
} | ||
}, | ||
{ | ||
"label": "Did the index case agree to be interviewed?", | ||
"type": "obs", | ||
"required": false, | ||
"id": "agreeInterviewed", | ||
"questionOptions": { | ||
"rendering": "radio", | ||
"concept": "4dd6e628-fcc9-4629-92b8-192751c3de9c", | ||
"conceptMappings": [], | ||
"answers": [ | ||
{ | ||
"concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", | ||
"label": "Yes" | ||
}, | ||
{ | ||
"concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", | ||
"label": "No" | ||
} | ||
] | ||
} | ||
}, | ||
{ | ||
"label": "Reason for not being interviewed", | ||
"type": "obs", | ||
"required": false, | ||
"id": "reasonNotBeingInterviewed", | ||
"hide": { | ||
"hideWhenExpression": "agreeInterviewed !== '1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" | ||
}, | ||
"questionOptions": { | ||
"rendering": "radio", | ||
"concept": "a4c912a5-bb4d-4250-ab4c-35a7d3020587", | ||
"conceptMappings": [], | ||
"answers": [ | ||
{ | ||
"concept": "afe90395-0720-4515-929b-6796e45a11ae", | ||
"label": "Refused" | ||
}, | ||
{ | ||
"concept": "160432AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", | ||
"label": "Dead" | ||
}, | ||
{ | ||
"concept": "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", | ||
"label": "Other" | ||
} | ||
] | ||
} | ||
}, | ||
{ | ||
"label": "Date index case interviewed", | ||
"type": "obs", | ||
"required": false, | ||
"id": "dateIcInterviewed", | ||
"hide": { | ||
"hideWhenExpression": "agreeInterviewed !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" | ||
}, | ||
"questionOptions": { | ||
"rendering": "date", | ||
"concept": "5fff58c8-705d-4e4a-954e-41e7441c659d" | ||
} | ||
}, | ||
{ | ||
"label": "Is the index case interviewed for partner service?", | ||
"type": "obs", | ||
"required": false, | ||
"id": "icInterviewedForService", | ||
"questionOptions": { | ||
"rendering": "radio", | ||
"concept": "75a0a101-a094-4c7d-a4c7-255fb0094440", | ||
"conceptMappings": [], | ||
"answers": [ | ||
{ | ||
"concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", | ||
"label": "Yes" | ||
}, | ||
{ | ||
"concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", | ||
"label": "No" | ||
} | ||
] | ||
} | ||
}, | ||
{ | ||
"label": "Date interview offered for index case", | ||
"type": "obs", | ||
"required": false, | ||
"id": "dateIcInterviewOffered", | ||
"hide": { | ||
"hideWhenExpression": "icInterviewedForService !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" | ||
}, | ||
"questionOptions": { | ||
"rendering": "date", | ||
"concept": "93f85b06-9bd2-4789-a3d6-8fbfb3075429" | ||
} | ||
}, | ||
{ | ||
"label": "Number of sexual partners in the past 12 month", | ||
"type": "obs", | ||
"required": false, | ||
"questionOptions": { | ||
"rendering": "number", | ||
"concept": "75dfe54f-30f1-404c-8523-eda893d51468", | ||
"max": 200, | ||
"min": 0, | ||
"showDate": "" | ||
}, | ||
"id": "12month" | ||
}, | ||
{ | ||
"label": "Number of sexual partners in the past 24 month", | ||
"type": "obs", | ||
"required": false, | ||
"questionOptions": { | ||
"rendering": "number", | ||
"concept": "59ca144e-569b-4d8e-b83c-24c47af6b683", | ||
"max": 200, | ||
"min": 0, | ||
"showDate": "" | ||
}, | ||
"id": "24month" | ||
}, | ||
{ | ||
"label": "Is index client willing to provide names of partners", | ||
"type": "obs", | ||
"required": false, | ||
"id": "willingToProvideNames", | ||
"questionOptions": { | ||
"rendering": "radio", | ||
"concept": "0e7e5389-0966-40f7-9e97-ae059b9f2ce7", | ||
"conceptMappings": [], | ||
"answers": [ | ||
{ | ||
"concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", | ||
"label": "Yes" | ||
}, | ||
{ | ||
"concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", | ||
"label": "No" | ||
} | ||
] | ||
} | ||
}, | ||
{ | ||
"label": "Reason for not willing to provide the names of partners", | ||
"type": "obs", | ||
"required": false, | ||
"id": "notWillingToProvideNames", | ||
"hide": { | ||
"hideWhenExpression": "willingToProvideNames !== '1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" | ||
}, | ||
"questionOptions": { | ||
"rendering": "text", | ||
"concept": "e637d9c3-49a1-4a00-8bbf-ace9f12a9b7e" | ||
} | ||
}, | ||
{ | ||
"label": "Next visit date", | ||
"type": "obs", | ||
"questionOptions": { | ||
"rendering": "date", | ||
"concept": "c596f199-4d76-4eca-b3c4-ffa631c0aee9", | ||
"weeksList": "" | ||
}, | ||
"readonly": "false", | ||
"id": "nextVisitDate" | ||
} | ||
] | ||
} | ||
] | ||
} | ||
], | ||
"availableIntents": [ | ||
{ | ||
"intent": "*", | ||
"display": "default_intent" | ||
} | ||
], | ||
"processor": "EncounterFormProcessor", | ||
"uuid": "ecefb340-0162-47b2-aec4-3db9b7bdc5e8", | ||
"referencedForms": [], | ||
"encounterType": "43a8ef4f-473e-4778-9c90-7b7f05014499", | ||
"allowUnspecifiedAll": true | ||
} |
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