0.5.12 - ci-build

SpaceflightHealthSimulationsReferenceDocumentation - Local Development build (v0.5.12) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Questionnaire: Astronaut and Space Tourist Medical Screening Questionnaire

Official URL: https://mitre.org/fhir/space-health/Questionnaire/AstronautFlightReadinessQuestionnaire Version: 0.5.12
Active as of 2025-05-18 Computable Name: AstronautFlightReadinessQuestionnaire

A medical screening form for astronaut or space tourism flight readiness, based on FAA Form 8500-8, NASA/ESA standards, and commercial vendor practices.

Structure

LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. AstronautFlightReadinessQuestionnaireA medical screening form for astronaut or space tourism flight readiness, based on FAA Form 8500-8, NASA/ESA standards, and commercial vendor practices.Questionnairehttps://mitre.org/fhir/space-health/Questionnaire/AstronautFlightReadinessQuestionnaire#0.5.12
... introApplication for Space Tourism activities.0..1display
... citizenshipAre you a United States citizen?1..1boolean
... demographic-infoDemographic Information1..1group
.... firstNameFirst Name1..1string
.... middleNameMiddle Name0..1string
.... lastNameLast Name1..1string
.... phoneNumberPhone Number1..1string
.... emailAddressEmail Address1..1string
.... confirmEmailAddressConfirm Email Address1..1string
... birthdateBirthdate1..1date
... sexSex1..1choiceOptions: 2 options
... missionFlight Profile0..1group
.... flightTypeType of Flight0..1choiceOptions: 2 options
.... flightDurationPlanned Mission Duration (days)0..1integer
.... crewRoleCrew Role0..1choiceOptions: 3 options
... medicalHistoryMedical History0..1group
.... cardiacHistoryHistory of cardiac disease (e.g. heart attack, arrhythmia)?0..1boolean
.... neuroHistoryHistory of neurological issues (e.g. stroke, seizures)?0..1boolean
.... psychHistoryHistory of mental health disorders?0..1boolean
.... respiratoryHistoryHistory of respiratory disorders (e.g. asthma, COPD)?0..1boolean
.... gastroHistoryHistory of gastrointestinal disease?0..1boolean
.... renalHistoryHistory of kidney stones or renal disease?0..1boolean
.... allergyHistoryDo you have any allergies?0..1boolean
.... motionSicknessHistory of motion sickness requiring medication?0..1boolean
.... pregnancyStatusAre you currently pregnant?0..1boolean
... medicationsMedications and Supplements0..1group
.... medicationListList all current medications and supplements0..1text
... vitalsVital Signs and Physical Exam0..1group
.... heightHeight (cm)0..1decimal
.... weightWeight (kg)0..1decimal
.... bloodPressureBlood Pressure (mmHg)0..1string
.... heartRateHeart Rate (bpm)0..1integer
... functionalTestsFunctional Capacity0..1group
.... stairClimbAble to climb 7 flights of stairs in under 90 seconds?0..1boolean
.... egressTestAble to exit seat unassisted in emergency simulation?0..1boolean
... certificationMedical Clearance and Physician Certification0..1group
.... certStatusMedically cleared for spaceflight?0..1choice
.... certPhysicianPhysician Name and Contact0..1string
.... certDateDate of Medical Certification0..1date

doco Documentation for this format

Options Sets

Answer options for sex

  • http://hl7.org/fhir/administrative-gender#male ("Male")
  • http://hl7.org/fhir/administrative-gender#female ("Female")

Answer options for flightType

  • Suborbital
  • Orbital

Answer options for crewRole

  • Tourist
  • Pilot
  • Mission Specialist