{
	"name": "Family Information",
	"version": "1.0",
	"published": true,
	"retired": false,
	"encounter": "Family Information",
	"pages": [
		{
			"label": "FAMILY MEMBERS HIV STATUS AT ENROLLMENT AND FOLLOW-UP VISIT",
			"sections": [
				{
					"label": "FAMILY MEMBERS HIV STATUS",
					"isExpanded": "true",
					"questions": [
						{
							"label": "Relationship type",
							"type": "obs",
							"required": true,
							"questionOptions": {
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								"concept": "1560AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
								"answers": [
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										"concept": "5617AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
										"label": "Parent or spouse",
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									},
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										"concept": "1528AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
										"label": "Child or sibling",
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										]
									}
								]
							},
							"id": "familyMemberType"
						},
						{
							"label": "Age in Years (at enrollment)",
							"type": "obs",
							"required": true,
							"questionOptions": {
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								"max": 200,
								"min": 0,
								"showDate": ""
							},
							"id": "familyMemberAge"
						},
						{
							"label": "Sex",
							"type": "obs",
							"required": true,
							"id": "familyMemberGender",
							"questionOptions": {
								"rendering": "radio",
								"concept": "1533AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
								"conceptMappings": [
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										"relationship": "SAME-AS",
										"type": "LOINC",
										"value": "72143-4"
									},
									{
										"relationship": "SAME-AS",
										"type": "CIEL",
										"value": "1533"
									}
								],
								"answers": [
									{
										"concept": "1534AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
										"label": "Male"
									},
									{
										"concept": "1535AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
										"label": "Female"
									}
								]
							}
						},
						{
							"label": "Health status at enrollment",
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							"questionOptions": {
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								"concept": "4ab0e5e3-fff7-4819-bd2e-4f070eedcd3d",
								"answers": [
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										"concept": "1855AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
										"label": "Healthy",
										"conceptMappings": []
									},
									{
										"concept": "9c849633-3589-42c7-bcb1-b4af7ec392c5",
										"label": "Chronically Ill",
										"conceptMappings": []
									},
									{
										"concept": "160432AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
										"label": "Dead",
										"conceptMappings": []
									}
								]
							},
							"id": "familyMemberHealthStatus"
						},
						{
							"label": "Counseled for HIV?",
							"type": "obs",
							"required": false,
							"id": "counselledForHIV",
							"questionOptions": {
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								"concept": "ff9eccda-485e-4044-ad92-414e97b279c0",
								"answers": [
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										"concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
										"label": "Yes"
									},
									{
										"concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
										"label": "No"
									}
								]
							}
						},
						{
							"label": "Date counselled for HIV",
							"type": "obs",
							"questionOptions": {
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								"concept": "a4c7ffa9-ba89-4f7d-ae01-50c139527ce4"
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							"hide": {
								"hideWhenExpression": "counselledForHIV !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
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							"validators": [
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                                    "type": "date",
                                    "allowFutureDates": "false"
                                }
							],
							"id": "counsellationDate"
						},
						{
							"label": "Tested for HIV?",
							"type": "obs",
							"questionOptions": {
								"rendering": "radio",
								"concept": "164401AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
								"answers": [
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										"concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
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											},
											{
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											{
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											},
											{
												"type": "AMPATH",
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										]
									},
									{
										"concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
										"label": "No",
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											{
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											},
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											},
											{
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										]
									}
								]
							},
							"id": "testedForHIV"
						},
						{
							"label": "Date tested for HIV",
							"type": "obs",
							"questionOptions": {
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								"concept": "164400AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
								"weeksList": "",
								"conceptMappings": [
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										"type": "CIEL",
										"value": "164400"
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								]
							},
							"validators": [
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                                    "type": "date",
                                    "allowFutureDates": "false"
                                }
							],
							"hide": {
								"hideWhenExpression": "testedForHIV !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
							},
							"id": "hivTestDate"
						},
						{
							"label": "HIV test Result",
							"type": "obs",
							"required": false,
							"id": "hivTestResult",
							"hide": {
								"hideWhenExpression": "testedForHIV !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
							},
							"questionOptions": {
							  "rendering": "select",
							  "concept": "2e770be1-7397-4684-bea6-6632c23b00d7",
							  "conceptMappings": [],
							  "answers": [
								{
								  "concept": "703AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
								  "label": "Positive"
								},
								{
								  "concept": "5e4fc757-0b14-49ae-b3b7-419666f41e15",
								  "label": "Negative"
								},
								{
								  "concept": "165649AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
								  "label": "Inconclusive"
								}
							  ]
							},
							"validators": []
						  },
						{
							"label": "Enrolled in care?",
							"type": "obs",
							"questionOptions": {
								"rendering": "radio",
								"concept": "3ca41707-40ef-424c-9e1a-923a407e68fc",
								"answers": [
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										"concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
										"label": "Yes",
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												"type": "PIH",
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											},
											{
												"type": "PIH",
												"value": "1065"
											},
											{
												"type": "AMPATH",
												"value": "1065"
											},
											{
												"type": "CIEL",
												"value": "1065"
											},
											{
												"type": "PIH-Malawi",
												"value": "1065"
											},
											{
												"type": "CIEL",
												"value": "1065"
											},
											{
												"type": "SNOMED-CT",
												"value": "373066001"
											},
											{
												"type": "SNOMED CT",
												"value": "CT: 373066001"
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											{
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											},
											{
												"type": "AMPATH",
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										]
									},
									{
										"concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
										"label": "No",
										"conceptMappings": [
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											}
										]
									}
								]
							},
							"hide": {
								"hideWhenExpression": "hivTestResult !== '703AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
							},
							"id": "enrolledInCare"
						},
						{
							"label": "Date enrolled in care",
							"type": "obs",
							"questionOptions": {
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								"concept": "1ebc345c-6f09-43e1-a616-d7e52fff4c7d"
							},
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							},
							"validators": [
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                                    "type": "date",
                                    "allowFutureDates": "false"
                                }
							],
							"id": "dateEnrolledInCare"
						},
						{
							"label": "Started ART?",
							"type": "obs",
							"questionOptions": {
								"rendering": "radio",
								"concept": "1149AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
								"conceptMappings": [
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										"type": "PIH-Malawi",
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									},
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									},
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								],
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											{
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											{
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									},
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										"concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
										"label": "No",
										"conceptMappings": [
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										]
									}
								]
							},
							"hide": {
								"hideWhenExpression": "hivTestResult !== '703AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
							},
							"id": "artStarted"
						},
						{
							"label": "Date started ART",
							"type": "obs",
							"questionOptions": {
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									},
									{
										"type": "SNOMED-MVP",
										"value": "1595991000105005"
									},
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										"type": "CIEL",
										"value": "159599"
									}
								]
							},
							"hide": {
								"hideWhenExpression": "artStarted !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
							},
							"validators": [
								{
                                    "type": "date",
                                    "allowFutureDates": "false"
                                }
							],
							"id": "artStartDate"
						},
						{
							"label": "Unique ART Number",
							"type": "obs",
							"questionOptions": {
								"rendering": "text",								
								"concept": "162054AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA"
							},
							"behaviours": [
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									"intent": "edit",
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										"concept": "162054AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA"
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								},
								{
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							],
							"hide": {
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							},
							"id": "uniqueArtNumber"
						},
						{
							"label": "Remark",
							"type": "obs",
							"questionOptions": {
								"rendering": "textarea",
								"concept": "165095AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
								"rows": "5",
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										"type": "CIEL",
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								]
							},
							"validators": [
								{
								  "type": "js_expression",
								  "failsWhenExpression": "myValue.length > 250",
								  "message": "Please use a maximum of 250 characters"
								}
							  ],
							"id": "remark"
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					]
				}
			]
		}
	],
	"availableIntents": [
		{
			"intent": "*",
			"display": "default_intent"
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	"processor": "EncounterFormProcessor",
	"uuid": "8ea1c633-2582-42ca-8859-6cba03e72ac3",
	"referencedForms": [],
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}