{ "resourceType" : "Questionnaire", "id" : "bridge2aieconsentmainicfusfenglishschema", "text" : { "status" : "generated", "div" : "
Structure\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
LinkIDTextCardinalityTypeDescription & Constraints\"doco\"
\".\"\".\" Questionnairehttps://kind-lab.github.io/vbai-fhir/Questionnaire-bridge2aieconsentmainicfusfenglishschema#2.2.0
\".\"\".\"\".\" page_1page_10..1string
\".\"\".\"\".\" page2page20..1string
\".\"\".\"\".\" page3page30..1string
\".\"\".\"\".\" page_4page_40..1string
\".\"\".\"\".\" page_5page_50..1string
\".\"\".\"\".\" page6page60..1string
\".\"\".\"\".\" page7page70..1string
\".\"\".\"\".\" page8page80..1string
\".\"\".\"\".\" page_9page_90..1string
\".\"\".\"\".\" consent_usf_questionConsent to Take Part in Research and Authorization for the Collection, Use and Disclosure of Health Information:I freely give my consent to take part in this study and authorize that my health information as agreed above, be collected/disclosed in this study. I understand that by signing this form I am agreeing to take part in research. I have received a copy of this form to take with me. I understand that by filling out the best future contact below, I am consenting to be contacted in the future for further voice data collection if long term follow up is required as part of an eventual extension of this grant after the 4-year duration.Please select one of the three statements below that you consent to.0..1choiceOptions: 3 options
\".\"\".\"\".\" consent_usf_signatureSignature of Person Taking Part in Study\n[Authorization]0..1string
\".\"\".\"\".\" consent_usf_namePrinted Name of Person Taking Part in Study0..1string
\".\"\".\"\".\" consent_usf_dateDate0..1string

\"doco\" Documentation for this format

Options Sets

Answer options for consent_usf_question

" }, "url" : "https://kind-lab.github.io/vbai-fhir/Questionnaire-bridge2aieconsentmainicfusfenglishschema", "version" : "2.2.0", "title" : "bridge2ai_econsent_main_icf_usf_english_schema", "status" : "active", "date" : "2024-05-29T18:29:14Z", "publisher" : "KinD Lab", "contact" : [{ "name" : "KinD Lab", "telecom" : [{ "system" : "url", "value" : "http://fhir.kindlab.sickkids.ca" }] }], "item" : [{ "linkId" : "page_1", "text" : "page_1", "type" : "string" }, { "linkId" : "page2", "text" : "page2", "type" : "string" }, { "linkId" : "page3", "text" : "page3", "type" : "string" }, { "linkId" : "page_4", "text" : "page_4", "type" : "string" }, { "linkId" : "page_5", "text" : "page_5", "type" : "string" }, { "linkId" : "page6", "text" : "page6", "type" : "string" }, { "linkId" : "page7", "text" : "page7", "type" : "string" }, { "linkId" : "page8", "text" : "page8", "type" : "string" }, { "linkId" : "page_9", "text" : "page_9", "type" : "string" }, { "linkId" : "consent_usf_question", "text" : "Consent to Take Part in Research and Authorization for the Collection, Use and Disclosure of Health Information:I freely give my consent to take part in this study and authorize that my health information as agreed above, be collected/disclosed in this study. I understand that by signing this form I am agreeing to take part in research. I have received a copy of this form to take with me. I understand that by filling out the best future contact below, I am consenting to be contacted in the future for further voice data collection if long term follow up is required as part of an eventual extension of this grant after the 4-year duration.Please select one of the three statements below that you consent to.", "type" : "choice", "answerOption" : [{ "valueString" : "I consent to having all data I submit shared only with the researchers of this study." }, { "valueString" : "I consent to having all data I submit shared with the researchers of this study and to having my audio recordings and de-identified written responses shared with other qualified researchers." }, { "valueString" : "I consent to having all data I submit shared with the researchers of this study and to having my audio recordings and de-identified written responses shared with other qualified researchers as well as publicly in the form of an open-source database." }] }, { "linkId" : "consent_usf_signature", "text" : "Signature of Person Taking Part in Study\n[Authorization]", "type" : "string" }, { "linkId" : "consent_usf_name", "text" : "Printed Name of Person Taking Part in Study", "type" : "string" }, { "linkId" : "consent_usf_date", "text" : "Date", "type" : "string" }] }