A fhir questionnaire that captures base properties for skin care research

skincare.questionnaire.json

{
  "resourceType": "Questionnaire",
  "id": "dermadao-skin-care-assessment-v1",
  "version": "1.0.0",
  "name": "SkinCareAssessmentQuestionnaire",
  "title": "Skin Care Assessment Questionnaire",
  "status": "active",
  "experimental": false,
  "date": "2025-09-15T00:00:00Z",
  "publisher": "DermaDAO",
  "description": "A comprehensive questionnaire to assess demographic information and skin characteristics for personalized skin care recommendations and analysis.",
  "purpose": "To collect essential demographic and dermatological information for skin care assessment and treatment recommendations.",
  "subjectType": ["Patient"],
  "item": [
    {
      "linkId": "age-range",
      "code": [
        {
          "system": "http://loinc.org",
          "code": "21612-7",
          "display": "Age reported"
        }
      ],
      "text": "Age Range",
      "type": "choice",
      "required": true,
      "repeats": false,
      "answerValueSet": "http://codes.welshare.app/ValueSet/dermatology/custom-age-groups.json",
      "answerOption": [
        {
          "valueCoding": {
            "system": "http://codes.welshare.app/CodeSystem/dermatology/custom-age-groups.json",
            "code": "<18",
            "display": "Under 18"
          }
        },
        {
          "valueCoding": {
            "system": "http://codes.welshare.app/CodeSystem/dermatology/custom-age-groups.json",
            "code": "18-24",
            "display": "Age 18-24"
          }
        },
        {
          "valueCoding": {
            "system": "http://codes.welshare.app/CodeSystem/dermatology/custom-age-groups.json",
            "code": "25-34",
            "display": "Age 25-34"
          }
        },
        {
          "valueCoding": {
            "system": "http://codes.welshare.app/CodeSystem/dermatology/custom-age-groups.json",
            "code": "35-44",
            "display": "Age 35-44"
          }
        },
        {
          "valueCoding": {
            "system": "http://codes.welshare.app/CodeSystem/dermatology/custom-age-groups.json",
            "code": "45-54",
            "display": "Age 45-54"
          }
        },
        {
          "valueCoding": {
            "system": "http://codes.welshare.app/CodeSystem/dermatology/custom-age-groups.json",
            "code": "55-64",
            "display": "Age 55-64"
          }
        },
        {
          "valueCoding": {
            "system": "http://codes.welshare.app/CodeSystem/dermatology/custom-age-groups.json",
            "code": ">64",
            "display": "65+"
          }
        }
      ]
    },
    {
      "linkId": "gender",
      "code": [
        {
          "system": "http://loinc.org",
          "code": "76691-5",
          "display": "Gender identity"
        }
      ],
      "text": "Gender",
      "type": "choice",
      "required": true,
      "repeats": false,
      "answerValueSet": "http://loinc.org/vs/LL3322-6",
      "answerOption": [
        {
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA22878-5",
            "display": "Identifies as male"
          }
        },
        {
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA22879-3",
            "display": "Identifies as female"
          }
        },
        {
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA22880-1",
            "display": "Female-to-male transsexual"
          }
        },
        {
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA22881-9",
            "display": "Male-to-female transsexual"
          }
        },
        {
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA22882-7",
            "display": "Identifies as non-conforming"
          }
        },
        {
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA46-8",
            "display": "Other"
          }
        },
        {
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA20384-6",
            "display": "Asked but unknown"
          }
        }
      ]
    },
    {
      "linkId": "skin-type",
      "text": "How would you describe your skin type?",
      "type": "choice",
      "required": true,
      "repeats": false,
      "answerOption": [
        {
          "valueCoding": {
            "system": "http://codes.welshare.app/CodeSystem/dermatology/custom-skin-types.json",
            "code": "dry",
            "display": "Dry"
          }
        },
        {
          "valueCoding": {
            "system": "http://codes.welshare.app/CodeSystem/dermatology/custom-skin-types.json",
            "code": "oily",
            "display": "Oily"
          }
        },
        {
          "valueCoding": {
            "system": "http://codes.welshare.app/CodeSystem/dermatology/custom-skin-types.json",
            "code": "combination",
            "display": "Combination"
          }
        },
        {
          "valueCoding": {
            "system": "http://codes.welshare.app/CodeSystem/dermatology/custom-skin-types.json",
            "code": "sensitive",
            "display": "Sensitive"
          }
        },
        {
          "valueCoding": {
            "system": "http://codes.welshare.app/CodeSystem/dermatology/custom-skin-types.json",
            "code": "unknown",
            "display": "Unsure"
          }
        }
      ]
    },
    {
      "linkId": "race-ethnicity",
      "code": [
        {
          "system": "http://loinc.org",
          "code": "46463-6",
          "display": "Race or ethnicity"
        }
      ],
      "text": "Ethnicity / Skin Tone (optional)",
      "type": "choice",
      "required": false,
      "repeats": false,
      "answerValueSet": "http://loinc.org/vs/LL247-8",
      "answerOption": [
        {
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA6155-1",
            "display": "American Indian or Alaska Native"
          }
        },
        {
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA6156-9",
            "display": "Asian"
          }
        },
        {
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA6162-7",
            "display": "Black or African-American"
          }
        },
        {
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA6214-6",
            "display": "Hispanic or Latino"
          }
        },
        {
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA6266-6",
            "display": "Native Hawaiian or Pacific Islander"
          }
        },
        {
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA4457-3",
            "display": "White"
          }
        },
        {
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA4489-6",
            "display": "Unknown"
          }
        }
      ]
    },
    {
      "linkId": "email-address",
      "code": [
        {
          "system": "http://loinc.org",
          "code": "76458-9",
          "display": "Email address"
        }
      ],
      "text": "Email Address (optional)",
      "type": "string",
      "required": false,
      "repeats": false,
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/regex",
          "valueString": "^[a-zA-Z0-9._%+-]+@[a-zA-Z0-9.-]+\\.[a-zA-Z]{2,}$"
        }
      ]
    },
    {
      "linkId": "privy-did",
      "text": "Privy DID (optional)",
      "type": "string",
      "required": false,
      "repeats": false
    },
    {
      "linkId": "facial-photo",
      "text": "Upload a selfie (facing front, well-lit, makeup-free)",
      "type": "attachment",
      "required": true,
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "image/png"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "image/webp"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "image/heic"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/mimeType",
          "valueCode": "image/jpeg"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/maxSize",
          "valueDecimal": 10240000
        }
      ]
    }
  ]
}