1.7.1 - release

SHINNYHRSN - Local Development build (v1.7.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## : SHINNYNYSHRSNQuestionnaire - XML Representation

Active as of 2025-12-09

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    <Questionnaire xmlns="http://hl7.org/fhir">
      <id value="SHINNYNYSHRSNQuestionnaire"/>
      <meta>
        <lastUpdated value="2024-01-01T00:00:00Z"/>
        <profile
                 value="http://test.shinny.org/us/ny/hrsn/StructureDefinition/shinny-questionnaire"/>
      </meta>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Questionnaire SHINNYNYSHRSNQuestionnaire</b></p><a name="SHINNYNYSHRSNQuestionnaire"> </a><a name="hcSHINNYNYSHRSNQuestionnaire"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Last updated: 2024-01-01 00:00:00+0000</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-shinny-questionnaire.html">SHINNY Questionnaire Profile</a></p></div><b>Structure</b><table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><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 style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><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, " alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><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="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">http://test.shinny.org/us/ny/hrsn/Questionnaire/SHINNYNYSHRSNQuestionnaire#1.7.1</td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)" id="item.nys-hrsn-questionnaire" class="hierarchy"><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"/> nys-hrsn-questionnaire</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">NYS Accountable Health Communities (AHC) Health-Related Social Needs Screening (HRSN) tool</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck001.png)" id="item.96777-8" class="hierarchy"><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"/> 96777-8</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Accountable health communities (AHC) health-related social needs screening (HRSN) tool</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)" id="item.71802-3" class="hierarchy"><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-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> 71802-3</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">What is your living situation today?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.71802-3">3 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)" id="item.96778-6" class="hierarchy"><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-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> 96778-6</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Think about the place you live. Do you have problems with any of the following?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.96778-6">8 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)" id="item.96779-4" class="hierarchy"><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-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> 96779-4</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">In the past 12 months has the electric, gas, oil, or water company threatened to shut off services in your home?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.96779-4">3 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)" id="item.88122-7" class="hierarchy"><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-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> 88122-7</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Within the past 12 months, you worried that your food would run out before you got money to buy more.</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.88122-7">3 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)" id="item.88123-5" class="hierarchy"><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-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> 88123-5</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Within the past 12 months, the food you bought just didn't last and you didn't have money to get more.</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.88123-5">3 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)" id="item.93030-5" class="hierarchy"><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-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> 93030-5</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">In the past 12 months, has lack of reliable transportation kept you from medical appointments, meetings, work or from getting things needed for daily living?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.93030-5">2 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)" id="item.96780-2" class="hierarchy"><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-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> 96780-2</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you want help finding or keeping work or a job?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.96780-2">3 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)" id="item.96782-8" class="hierarchy"><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-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> 96782-8</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you want help with school or training? For example, starting or completing job training or getting a high school diploma, GED or equivalent.</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.96782-8">2 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)" id="item.95618-5" class="hierarchy"><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-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> 95618-5</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How often does anyone, including family and friends, physically hurt you?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.95618-5">5 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)" id="item.95617-7" class="hierarchy"><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-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> 95617-7</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How often does anyone, including family and friends, insult or talk down to you?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.95617-7">5 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)" id="item.95616-9" class="hierarchy"><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-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> 95616-9</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How often does anyone, including family and friends, threaten you with harm?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.95616-9">5 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0000.png)" id="item.95615-1" class="hierarchy"><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-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> 95615-1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How often does anyone, including family and friends, scream or curse at you?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.95615-1">5 options</a></td></tr>
    <tr><td colspan="5" class="hierarchy"><br/><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64, " 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.71802-3"> </a><p><b>Answer options for 71802-3 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA31993-1 (&quot;I have a steady place to live&quot;)</li><li style="font-size: 11px">http://loinc.org#LA31994-9 (&quot;I have a place to live today, but I am worried about losing it in the future&quot;)</li><li style="font-size: 11px">http://loinc.org#LA31995-6 (&quot;I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park)&quot;)</li></ul><a name="opt-item.96778-6"> </a><p><b>Answer options for 96778-6 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA31996-4 (&quot;Pests such as bugs, ants, or mice&quot;)</li><li style="font-size: 11px">http://loinc.org#LA28580-1 (&quot;Mold&quot;)</li><li style="font-size: 11px">http://loinc.org#LA31997-2 (&quot;Lead paint or pipes&quot;)</li><li style="font-size: 11px">http://loinc.org#LA31998-0 (&quot;Lack of heat&quot;)</li><li style="font-size: 11px">http://loinc.org#LA31999-8 (&quot;Oven or stove not working&quot;)</li><li style="font-size: 11px">http://loinc.org#LA32000-4 (&quot;Smoke detectors missing or not working&quot;)</li><li style="font-size: 11px">http://loinc.org#LA32001-2 (&quot;Water leaks&quot;)</li><li style="font-size: 11px">http://loinc.org#LA9-3 (&quot;None of the above&quot;)</li></ul><a name="opt-item.96779-4"> </a><p><b>Answer options for 96779-4 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA33-6 (&quot;Yes&quot;)</li><li style="font-size: 11px">http://loinc.org#LA32-8 (&quot;No&quot;)</li><li style="font-size: 11px">http://loinc.org#LA32002-0 (&quot;Already shut off&quot;)</li></ul><a name="opt-item.88122-7"> </a><p><b>Answer options for 88122-7 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA28397-0 (&quot;Often true&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6729-3 (&quot;Sometimes true&quot;)</li><li style="font-size: 11px">http://loinc.org#LA28398-8 (&quot;Never true&quot;)</li></ul><a name="opt-item.88123-5"> </a><p><b>Answer options for 88123-5 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA28397-0 (&quot;Often true&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6729-3 (&quot;Sometimes true&quot;)</li><li style="font-size: 11px">http://loinc.org#LA28398-8 (&quot;Never true&quot;)</li></ul><a name="opt-item.93030-5"> </a><p><b>Answer options for 93030-5 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA33-6 (&quot;Yes&quot;)</li><li style="font-size: 11px">http://loinc.org#LA32-8 (&quot;No&quot;)</li></ul><a name="opt-item.96780-2"> </a><p><b>Answer options for 96780-2 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA31981-6 (&quot;Yes, help finding work&quot;)</li><li style="font-size: 11px">http://loinc.org#LA31982-4 (&quot;Yes, help keeping work&quot;)</li><li style="font-size: 11px">http://loinc.org#LA31983-2 (&quot;I do not need or want help&quot;)</li></ul><a name="opt-item.96782-8"> </a><p><b>Answer options for 96782-8 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA33-6 (&quot;Yes&quot;)</li><li style="font-size: 11px">http://loinc.org#LA32-8 (&quot;No&quot;)</li></ul><a name="opt-item.95618-5"> </a><p><b>Answer options for 95618-5 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA6270-8 (&quot;Never&quot;)</li><li style="font-size: 11px">http://loinc.org#LA10066-1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">http://loinc.org#LA10082-8 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">http://loinc.org#LA16644-9 (&quot;Fairly often&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6482-9 (&quot;Frequently&quot;)</li></ul><a name="opt-item.95617-7"> </a><p><b>Answer options for 95617-7 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA6270-8 (&quot;Never&quot;)</li><li style="font-size: 11px">http://loinc.org#LA10066-1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">http://loinc.org#LA10082-8 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">http://loinc.org#LA16644-9 (&quot;Fairly often&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6482-9 (&quot;Frequently&quot;)</li></ul><a name="opt-item.95616-9"> </a><p><b>Answer options for 95616-9 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA6270-8 (&quot;Never&quot;)</li><li style="font-size: 11px">http://loinc.org#LA10066-1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">http://loinc.org#LA10082-8 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">http://loinc.org#LA16644-9 (&quot;Fairly often&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6482-9 (&quot;Frequently&quot;)</li></ul><a name="opt-item.95615-1"> </a><p><b>Answer options for 95615-1 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA6270-8 (&quot;Never&quot;)</li><li style="font-size: 11px">http://loinc.org#LA10066-1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">http://loinc.org#LA10082-8 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">http://loinc.org#LA16644-9 (&quot;Fairly often&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6482-9 (&quot;Frequently&quot;)</li></ul></div>
      </text>
      <url
           value="http://test.shinny.org/us/ny/hrsn/Questionnaire/SHINNYNYSHRSNQuestionnaire"/>
      <version value="1.7.1"/>
      <status value="active"/>
      <date value="2025-12-09T09:01:49-05:00"/>
      <publisher value="shinny"/>
      <contact>
        <name value="shinny"/>
        <telecom>
          <system value="url"/>
          <value value="https://test.shinny.org/us/ny/hrsn.index.html"/>
        </telecom>
      </contact>
      <item>
        <linkId value="nys-hrsn-questionnaire"/>
        <code>
          <system
                  value="http://test.shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires"/>
          <code value="nys-hrsn-questionnaire"/>
          <display value="NYS HRSN Questionnaire"/>
        </code>
        <text
              value="NYS Accountable Health Communities (AHC) Health-Related Social Needs Screening (HRSN) tool"/>
        <type value="group"/>
        <required value="false"/>
        <item>
          <linkId value="96777-8"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="96777-8"/>
            <display
                     value="Accountable health communities (AHC) health-related social needs screening (HRSN) tool"/>
          </code>
          <text
                value="Accountable health communities (AHC) health-related social needs screening (HRSN) tool"/>
          <type value="group"/>
          <required value="false"/>
          <item>
            <linkId value="71802-3"/>
            <code>
              <system value="http://loinc.org"/>
              <code value="71802-3"/>
              <display value="Housing status"/>
            </code>
            <text value="What is your living situation today?"/>
            <type value="choice"/>
            <required value="false"/>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA31993-1"/>
                <display value="I have a steady place to live"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA31994-9"/>
                <display
                         value="I have a place to live today, but I am worried about losing it in the future"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA31995-6"/>
                <display
                         value="I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park)"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="96778-6"/>
            <code>
              <system value="http://loinc.org"/>
              <code value="96778-6"/>
              <display value="Problems with place where you live"/>
            </code>
            <text
                  value="Think about the place you live. Do you have problems with any of the following?"/>
            <type value="choice"/>
            <required value="false"/>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA31996-4"/>
                <display value="Pests such as bugs, ants, or mice"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA28580-1"/>
                <display value="Mold"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA31997-2"/>
                <display value="Lead paint or pipes"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA31998-0"/>
                <display value="Lack of heat"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA31999-8"/>
                <display value="Oven or stove not working"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32000-4"/>
                <display value="Smoke detectors missing or not working"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32001-2"/>
                <display value="Water leaks"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA9-3"/>
                <display value="None of the above"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="96779-4"/>
            <code>
              <system value="http://loinc.org"/>
              <code value="96779-4"/>
              <display
                       value="Has the electric, gas, oil, or water company threatened to shut off services in your home in past 12 months"/>
            </code>
            <text
                  value="In the past 12 months has the electric, gas, oil, or water company threatened to shut off services in your home?"/>
            <type value="choice"/>
            <required value="false"/>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA33-6"/>
                <display value="Yes"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32002-0"/>
                <display value="Already shut off"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="88122-7"/>
            <code>
              <system value="http://loinc.org"/>
              <code value="88122-7"/>
              <display
                       value="Within the past 12 months we worried whether our food would run out before we got money to buy more [U.S. FSS]"/>
            </code>
            <text
                  value="Within the past 12 months, you worried that your food would run out before you got money to buy more."/>
            <type value="choice"/>
            <required value="false"/>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA28397-0"/>
                <display value="Often true"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA6729-3"/>
                <display value="Sometimes true"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA28398-8"/>
                <display value="Never true"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="88123-5"/>
            <code>
              <system value="http://loinc.org"/>
              <code value="88123-5"/>
              <display
                       value="Within the past 12 months the food we bought just didn't last and we didn't have money to get more [U.S. FSS]"/>
            </code>
            <text
                  value="Within the past 12 months, the food you bought just didn't last and you didn't have money to get more."/>
            <type value="choice"/>
            <required value="false"/>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA28397-0"/>
                <display value="Often true"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA6729-3"/>
                <display value="Sometimes true"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA28398-8"/>
                <display value="Never true"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="93030-5"/>
            <code>
              <system value="http://loinc.org"/>
              <code value="93030-5"/>
              <display
                       value="Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"/>
            </code>
            <text
                  value="In the past 12 months, has lack of reliable transportation kept you from medical appointments, meetings, work or from getting things needed for daily living?"/>
            <type value="choice"/>
            <required value="false"/>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA33-6"/>
                <display value="Yes"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="96780-2"/>
            <code>
              <system value="http://loinc.org"/>
              <code value="96780-2"/>
              <display value="Wants help finding or keeping work or a job"/>
            </code>
            <text value="Do you want help finding or keeping work or a job?"/>
            <type value="choice"/>
            <required value="false"/>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA31981-6"/>
                <display value="Yes, help finding work"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA31982-4"/>
                <display value="Yes, help keeping work"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA31983-2"/>
                <display value="I do not need or want help"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="96782-8"/>
            <code>
              <system value="http://loinc.org"/>
              <code value="96782-8"/>
              <display value="Wants help with school or training"/>
            </code>
            <text
                  value="Do you want help with school or training? For example, starting or completing job training or getting a high school diploma, GED or equivalent."/>
            <type value="choice"/>
            <required value="false"/>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA33-6"/>
                <display value="Yes"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="95618-5"/>
            <code>
              <system value="http://loinc.org"/>
              <code value="95618-5"/>
              <display value="Physically hurt you"/>
            </code>
            <text
                  value="How often does anyone, including family and friends, physically hurt you?"/>
            <type value="choice"/>
            <required value="false"/>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA6270-8"/>
                <display value="Never"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10066-1"/>
                <display value="Rarely"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10082-8"/>
                <display value="Sometimes"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA16644-9"/>
                <display value="Fairly often"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA6482-9"/>
                <display value="Frequently"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="95617-7"/>
            <code>
              <system value="http://loinc.org"/>
              <code value="95617-7"/>
              <display value="Insult you or talk down to you"/>
            </code>
            <text
                  value="How often does anyone, including family and friends, insult or talk down to you?"/>
            <type value="choice"/>
            <required value="false"/>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA6270-8"/>
                <display value="Never"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10066-1"/>
                <display value="Rarely"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10082-8"/>
                <display value="Sometimes"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA16644-9"/>
                <display value="Fairly often"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA6482-9"/>
                <display value="Frequently"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="95616-9"/>
            <code>
              <system value="http://loinc.org"/>
              <code value="95616-9"/>
              <display value="Threaten you with physical harm"/>
            </code>
            <text
                  value="How often does anyone, including family and friends, threaten you with harm?"/>
            <type value="choice"/>
            <required value="false"/>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA6270-8"/>
                <display value="Never"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10066-1"/>
                <display value="Rarely"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10082-8"/>
                <display value="Sometimes"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA16644-9"/>
                <display value="Fairly often"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA6482-9"/>
                <display value="Frequently"/>
              </valueCoding>
            </answerOption>
          </item>
          <item>
            <linkId value="95615-1"/>
            <code>
              <system value="http://loinc.org"/>
              <code value="95615-1"/>
              <display value="Scream or curse at you"/>
            </code>
            <text
                  value="How often does anyone, including family and friends, scream or curse at you?"/>
            <type value="choice"/>
            <required value="false"/>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA6270-8"/>
                <display value="Never"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10066-1"/>
                <display value="Rarely"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10082-8"/>
                <display value="Sometimes"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA16644-9"/>
                <display value="Fairly often"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA6482-9"/>
                <display value="Frequently"/>
              </valueCoding>
            </answerOption>
          </item>
        </item>
      </item>
    </Questionnaire>