Questionnaire-Consent

Sourcecsiro.fhir.au.smartforms#current:Smart Forms (v4.0.1)
resourceTypeQuestionnaire
idConsent
canonicalhttp://www.health.gov.au/assessments/mbs/715/Consent
version0.1.0
statusdraft
publisherAEHRC CSIRO
nameConsent
titleAboriginal and Torres Strait Islander Health Check - Consent
date2022-05-24
experimentalfalse
descriptionConsent sub-questionnaire for Aboriginal and Torres Strait Islander Health Check.
copyrightCSIRO © 2022+; Licensed under Apache License, Version 2.0
jurisdictionsau
Usages(none)

Consent

  • linkId: 1016f79d-9756-4daf-b6ee-29add134b34f

In progress

  • linkId: CD-in-progress-30
  • Enable When: todo

Complete

  • linkId: CD-complete-30
  • Enable When: todo

Consent given after discussion of process and benefits of a health check

  • linkId: d1e1ab3d-1c6c-430b-8ae7-af56b8f0af55
  • Answers: #YesNoNA

Consent given by parent/primary carer after discussion of process and benefits of a health check

  • linkId: 7fa8bc57-f3f9-4ddc-bf9b-12a9b9885dbd
  • Answers: #YesNoNA

Parent/primary caregiver present

  • linkId: 80a6a405-49a4-44fb-bff3-212902096b95

Parent/primary caregiver is present for health check?

  • linkId: c72933c7-349f-4fef-94ff-c424c69da6f3
  • Answers: #YesNoNA

Relationship to child

  • linkId: b7d116f9-0425-4cf1-8cde-fbf4dfaee550
  • Enable When: todo

Consent for sharing of information

  • linkId: d8c88bff-75ea-476f-8f83-e9b72fc9e1a0

Consent given for sharing of information with relevant healthcare providers?

  • linkId: 057483ce-f265-46df-a1c5-7a18d492c1ba
  • Answers: #YesNoNA

Who/details

  • linkId: 43517c44-5cd2-4d9a-9f18-d6bf8124f4ae
  • Enable When: todo

Date *

  • linkId: 84162f36-f4af-4509-b178-ef2a3849d0b6

Doctor

  • linkId: 0f92eb2d-4629-4215-96f8-46722a2efa73

Nurse

  • linkId: 8b94a129-3aab-4d13-bb6d-7a748f5c41e5

Aboriginal and/or Torres Strait Islander Health Worker / Health Practitioner

  • linkId: 2a517291-e2f1-4f66-ad1f-ae5b091d2f8a

Location of health check

Location of health check

Mark section as complete

  • linkId: MarkComplete-30

Produced 08 Sep 2023