Patient Details

• linkId: 5b224753-9365-44e3-823b-9c17e7394005

In progress

• linkId: CD-in-progress-32
• Enable When: todo

Complete

• linkId: CD-complete-32
• Enable When: todo

Important: The patient record will not be updated with information entered here. Information intended for the patient record should be entered there first.

• linkId: RecordUpdate-Patient

Name

• linkId: 17596726-34cf-4133-9960-7081e1d63558

Preferred pronouns

• linkId: 540b1034-7c9a-4aba-a9ef-afb77d445a58
• Answers: Personal Pronouns

Gender identity

Identifies as male gender Identifies as female gender Identifies as nonbinary gender Unknown Asked But Declined

• linkId: f669a4fe-4818-429a-8847-d20da88d2bb3
• Answers: Gender Identity Response

Administrative gender Male Female Other Unknown

• Flags:
• linkId: 418e4a02-de77-48a0-a92a-fe8fcc52b1aa
• Answers: AdministrativeGender

Sex assigned at birth Female Indeterminate sex Intersex Male

• linkId: 56ef44bb-3d1d-4972-aad1-834b69185d61
• Answers: Biological Sex

Date of birth

• linkId: 90ad8f16-16e4-4438-a7aa-b3189f510da2

Age

• linkId: e2a16e4d-2765-4b61-b286-82cfc6356b30

Aboriginal and/or Torres Strait Islander status Aboriginal but not Torres Strait Islander origin Torres Strait Islander but not Aboriginal origin Both Aboriginal and Torres Strait Islander origin

• linkId: 8acde9f8-7a91-4f0c-9216-38531ec984ef
• Answers: #AboriginalTorresStraitIslander

Parents/primary carer/s mother father grandparent not applicable

• linkId: c8852db9-efe9-4102-96db-cef3a8be0a5f
• Answers: #PrimaryCarerParentGrandparent

Other family

• linkId: 7089c48e-4216-4089-a548-034cd585e4da

details

• linkId: 70c45932-99dc-42a3-9650-4683892a0892

Other

• linkId: 42b1f5e0-bf4a-47d9-86a4-f2fe946ac01f

details

• linkId: dcbd3a54-9b68-4486-bf30-f6f1723bc39c

Parents/primary carer/s details

• linkId: 06737e46-e880-4037-9a2c-bcd278cd70ba

Name of parent/primary carer

• linkId: cc20ce96-af06-4cd7-aa9b-c2601a6169ad

Relationship to child

• linkId: 372d79bb-9d0b-42d2-a98c-cbe332bd3745

Home address

• linkId: f1262ade-843c-4eba-a86d-51a9c97d134b

No fixed address

• linkId: 311d83bb-f22e-4f60-9b50-b6e38dd2059b
• Definition: Address.extension:noFixedAddress

Address

• linkId: 4e0dc185-f83e-4027-b7a8-ecb543d42c6d
• Enable When: todo

Street address

• linkId: 2fee2d51-7828-4178-b8c1-35edd32ba338
• Definition: Address.line

City

• linkId: ddb65ed1-f4b2-4730-af2a-2f98bc73c76f
• Definition: Address.city

State ??

• linkId: d9a1236c-8d6e-4f20-a12a-9d5de5a1d0f6
• Definition: Address.state
• Answers: https://healthterminologies.gov.au/fhir/ValueSet/australian-states-territories-2

Postcode

• linkId: 3f61a1ea-1c74-4f52-8519-432ce861a74f
• Definition: Address.postalCode

Home phone

• linkId: 9541f0b0-f5ba-4fe7-a8e9-ad003cef897b

Mobile phone

• linkId: 4037a02b-4a85-40e0-9be6-5b17df1aac56

Emergency contact

• linkId: c22390d3-1be6-4fd1-b775-6443b7239a6b

Name

• linkId: d7f2dd75-20c8-480f-8c22-71d604ebee8d

Relationship to child

• linkId: aa35d559-f45b-4d35-9453-dd02e4a790f3

Relationship to patient

• linkId: 27099697-d6d1-42c0-bb0a-5e9ff7372a96

Phone

• linkId: 626e3723-6310-4b99-81c1-525676b027c8

Medicare number

• linkId: df1475ea-bf7e-4bf0-a69f-7f9608c3ed3c

Number

• linkId: eb2a59ed-9632-4df1-b5b1-1e85c3b4b7cf

Reference number

• linkId: d6253253-a124-494e-a1d8-7ce02c69ec11

Expiry

• linkId: c520e213-5313-42c3-860a-d30206620290

Pensioner Card Number

• linkId: c1e4e967-c0aa-4280-b5d4-ab1f375ed9ac
• Max Length: 10

Health Care Card Number

• linkId: a7e97574-3cea-4dfa-bef2-2665e7748364
• Max Length: 10

Registered for Closing the Gap PBS Co-payment Measure (CTG) Yes No N/A

• linkId: 83814495-3a81-43f4-88df-42186cce516a
• Answers: #YesNoNA

Child has a birth certificate Yes No N/A

• linkId: e63547c6-1623-412f-963f-5f1ebf23563f
• Answers: #YesNoNA

My Aged Care

• linkId: a8143230-b30d-4b85-9805-5f2f73f2dffa

Registered for My Aged Care Yes No N/A

• linkId: 7165c072-e3d8-4564-9d1d-d17f6807787c
• Answers: #YesNoNA

My Aged Care Number

• linkId: 04e50521-dc85-4744-b7ab-6f8682aacb11
• Enable When: todo

National Disability Insurance Scheme

• linkId: 2bfe50cb-7913-4f31-bce2-763c17ff8b1a

Registered for NDIS Yes No N/A

• linkId: 924b4500-53ac-4c4e-831b-7ab5569ff981
• Answers: #YesNoNA

NDIS Number

• linkId: 7379a0fd-d95b-4ecb-a781-9f43d1394f10
• Enable When: todo

Children

• linkId: 9bc882bc-e989-4600-9587-8089fb757641

Do you have children? Yes No N/A

• linkId: e90b436b-2751-4e07-a40c-adfe951b6528
• Answers: #YesNoNA

Number of children

• linkId: 241f5fca-f61a-49bd-8972-52613c0e6d15
• Enable When: todo

Number of children in your care

• linkId: 74ce4c60-31d6-4e78-9056-579937379451
• Enable When: todo

Someone's carer

• linkId: 2b5ae784-4341-4172-875d-1698cc8069f0

Are you responsible for caring for someone else? Yes No N/A

• linkId: a08271f1-194b-4fe9-91f9-4f3398858eb0
• Answers: #YesNoNA

Details

• linkId: 4c14b158-3ae4-4994-8446-76e02640702c
• Enable When: todo

Your carer

• linkId: 6c80c675-1320-4ca3-ae3f-51ad173da741

Do you have a carer? Yes No N/A

• linkId: d05558fb-a3cc-4bd6-b803-b672b36b9c51
• Answers: #YesNoNA

Details

• linkId: b9991e7e-ce03-465d-b4b0-5a1725b24e02
• Enable When: todo

Providers

• linkId: 3494631c-6b56-46dc-abf7-a17bfc1d025f

Are name and contact details of other key providers (eg case workers, support services) up to date? Yes No N/A

• linkId: 41210be5-d441-4c44-b9c2-8dd94a44cbb4
• Answers: #YesNoNA

Details

• linkId: 6733d6ec-5b6b-4ee2-a21e-0e9474c2b22b

Advance care planning

• linkId: 38f81a73-447f-4ecd-a8eb-6eccd9dee050

Enduring Power of Attorney

• linkId: c023ef16-b554-4ed9-8993-1331e5f5a3b4

Enduring Power of Attorney Yes No N/A

• linkId: 036eace9-ea83-46ec-9d01-f2093f710816
• Answers: #YesNoNA

Discussed today

• linkId: 83518215-7151-4365-b745-d7464bbb9528

Advance Health Directive

• linkId: c4f68251-26af-462f-879a-a69b449066ff

Advance Health Directive Yes No N/A

• linkId: b0632039-c12b-4748-9e94-52073590c0ba
• Answers: #YesNoNA

Discussed today

• linkId: c4bc2d84-e411-488d-9c0d-761f0377a026

Mark section as complete

• linkId: MarkComplete-32