@prefix fhir: . @prefix owl: . @prefix rdf: . @prefix rdfs: . @prefix xsd: . # - resource ------------------------------------------------------------------- a fhir:Questionnaire ; fhir:nodeRole fhir:treeRoot ; fhir:id [ fhir:v "AstronautFlightReadinessQuestionnaire"] ; # fhir:text [ fhir:status [ fhir:v "extensions" ] ; fhir:div [ fhir:v "

Generated Narrative: Questionnaire AstronautFlightReadinessQuestionnaire

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LinkIDTextCardinalityTypeDescription & Constraints\"doco\"
\".\"\".\" 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
\".\"\".\"\".\" age-checkAre you currently between the ages of 28 and 55?1..1boolean
\".\"\".\"\".\" 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
"^^rdf:XMLLiteral ] ] ; # fhir:url [ fhir:v "https://mitre.org/fhir/space-health/Questionnaire/AstronautFlightReadinessQuestionnaire"^^xsd:anyURI ; fhir:l ] ; # fhir:version [ fhir:v "0.5.12"] ; # fhir:name [ fhir:v "AstronautFlightReadinessQuestionnaire"] ; # fhir:title [ fhir:v "Astronaut and Space Tourist Medical Screening Questionnaire"] ; # fhir:status [ fhir:v "active"] ; # fhir:date [ fhir:v "2025-05-18"^^xsd:date] ; # fhir:publisher [ fhir:v "MITRE"] ; # fhir:contact ( [ fhir:name [ fhir:v "MITRE" ] ; fhir:telecom ( [ fhir:system [ fhir:v "url" ] ; fhir:value [ fhir:v "https://www.mitre.org/" ] ] ) ] ) ; # fhir:description [ fhir:v "A medical screening form for astronaut or space tourism flight readiness, based on FAA Form 8500-8, NASA/ESA standards, and commercial vendor practices."] ; # fhir:item ( [ fhir:linkId [ fhir:v "intro" ] ; fhir:text [ fhir:v "Application for Space Tourism activities." ] ; fhir:type [ fhir:v "display" ] ] [ fhir:linkId [ fhir:v "citizenship" ] ; fhir:text [ fhir:v "Are you a United States citizen?" ] ; fhir:type [ fhir:v "boolean" ] ; fhir:required [ fhir:v true ] ] [ fhir:linkId [ fhir:v "demographic-info" ] ; fhir:text [ fhir:v "Demographic Information" ] ; fhir:type [ fhir:v "group" ] ; fhir:required [ fhir:v true ] ; fhir:item ( [ fhir:linkId [ fhir:v "firstName" ] ; fhir:text [ fhir:v "First Name" ] ; fhir:type [ fhir:v "string" ] ; fhir:required [ fhir:v true ] ] [ fhir:linkId [ fhir:v "middleName" ] ; fhir:text [ fhir:v "Middle Name" ] ; fhir:type [ fhir:v "string" ] ] [ fhir:linkId [ fhir:v "lastName" ] ; fhir:text [ fhir:v "Last Name" ] ; fhir:type [ fhir:v "string" ] ; fhir:required [ fhir:v true ] ] [ fhir:linkId [ fhir:v "phoneNumber" ] ; fhir:text [ fhir:v "Phone Number" ] ; fhir:type [ fhir:v "string" ] ; fhir:required [ fhir:v true ] ] [ fhir:linkId [ fhir:v "emailAddress" ] ; fhir:text [ fhir:v "Email Address" ] ; fhir:type [ fhir:v "string" ] ; fhir:required [ fhir:v true ] ] [ fhir:linkId [ fhir:v "confirmEmailAddress" ] ; fhir:text [ fhir:v "Confirm Email Address" ] ; fhir:type [ fhir:v "string" ] ; fhir:required [ fhir:v true ] ] ) ] [ fhir:linkId [ fhir:v "age-check" ] ; fhir:text [ fhir:v "Are you currently between the ages of 28 and 55?" ] ; fhir:type [ fhir:v "boolean" ] ; fhir:required [ fhir:v true ] ] [ fhir:linkId [ fhir:v "birthdate" ] ; fhir:text [ fhir:v "Birthdate" ] ; fhir:type [ fhir:v "date" ] ; fhir:required [ fhir:v true ] ] [ fhir:linkId [ fhir:v "sex" ] ; fhir:text [ fhir:v "Sex" ] ; fhir:type [ fhir:v "choice" ] ; fhir:required [ fhir:v true ] ; fhir:answerOption ( [ fhir:value [ a fhir:Coding ; fhir:system [ fhir:v "http://hl7.org/fhir/administrative-gender"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "male" ] ; fhir:display [ fhir:v "Male" ] ] ] [ fhir:value [ a fhir:Coding ; fhir:system [ fhir:v "http://hl7.org/fhir/administrative-gender"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "female" ] ; fhir:display [ fhir:v "Female" ] ] ] ) ] [ fhir:linkId [ fhir:v "mission" ] ; fhir:text [ fhir:v "Flight Profile" ] ; fhir:type [ fhir:v "group" ] ; fhir:item ( [ fhir:linkId [ fhir:v "flightType" ] ; fhir:text [ fhir:v "Type of Flight" ] ; fhir:type [ fhir:v "choice" ] ; fhir:answerOption ( [ fhir:value [ a fhir:String ; fhir:v "Suborbital" ] ] [ fhir:value [ a fhir:String ; fhir:v "Orbital" ] ] ) ] [ fhir:linkId [ fhir:v "flightDuration" ] ; fhir:text [ fhir:v "Planned Mission Duration (days)" ] ; fhir:type [ fhir:v "integer" ] ] [ fhir:linkId [ fhir:v "crewRole" ] ; fhir:text [ fhir:v "Crew Role" ] ; fhir:type [ fhir:v "choice" ] ; fhir:answerOption ( [ fhir:value [ a fhir:String ; fhir:v "Tourist" ] ] [ fhir:value [ a fhir:String ; fhir:v "Pilot" ] ] [ fhir:value [ a fhir:String ; fhir:v "Mission Specialist" ] ] ) ] ) ] [ fhir:linkId [ fhir:v "medicalHistory" ] ; fhir:text [ fhir:v "Medical History" ] ; fhir:type [ fhir:v "group" ] ; fhir:item ( [ fhir:linkId [ fhir:v "cardiacHistory" ] ; fhir:text [ fhir:v "History of cardiac disease (e.g. heart attack, arrhythmia)?" ] ; fhir:type [ fhir:v "boolean" ] ] [ fhir:linkId [ fhir:v "neuroHistory" ] ; fhir:text [ fhir:v "History of neurological issues (e.g. stroke, seizures)?" ] ; fhir:type [ fhir:v "boolean" ] ] [ fhir:linkId [ fhir:v "psychHistory" ] ; fhir:text [ fhir:v "History of mental health disorders?" ] ; fhir:type [ fhir:v "boolean" ] ] [ fhir:linkId [ fhir:v "respiratoryHistory" ] ; fhir:text [ fhir:v "History of respiratory disorders (e.g. asthma, COPD)?" ] ; fhir:type [ fhir:v "boolean" ] ] [ fhir:linkId [ fhir:v "gastroHistory" ] ; fhir:text [ fhir:v "History of gastrointestinal disease?" ] ; fhir:type [ fhir:v "boolean" ] ] [ fhir:linkId [ fhir:v "renalHistory" ] ; fhir:text [ fhir:v "History of kidney stones or renal disease?" ] ; fhir:type [ fhir:v "boolean" ] ] [ fhir:linkId [ fhir:v "allergyHistory" ] ; fhir:text [ fhir:v "Do you have any allergies?" ] ; fhir:type [ fhir:v "boolean" ] ] [ fhir:linkId [ fhir:v "motionSickness" ] ; fhir:text [ fhir:v "History of motion sickness requiring medication?" ] ; fhir:type [ fhir:v "boolean" ] ] [ fhir:linkId [ fhir:v "pregnancyStatus" ] ; fhir:text [ fhir:v "Are you currently pregnant?" ] ; fhir:type [ fhir:v "boolean" ] ] ) ] [ fhir:linkId [ fhir:v "medications" ] ; fhir:text [ fhir:v "Medications and Supplements" ] ; fhir:type [ fhir:v "group" ] ; fhir:item ( [ fhir:linkId [ fhir:v "medicationList" ] ; fhir:text [ fhir:v "List all current medications and supplements" ] ; fhir:type [ fhir:v "text" ] ] ) ] [ fhir:linkId [ fhir:v "vitals" ] ; fhir:text [ fhir:v "Vital Signs and Physical Exam" ] ; fhir:type [ fhir:v "group" ] ; fhir:item ( [ fhir:linkId [ fhir:v "height" ] ; fhir:text [ fhir:v "Height (cm)" ] ; fhir:type [ fhir:v "decimal" ] ] [ fhir:linkId [ fhir:v "weight" ] ; fhir:text [ fhir:v "Weight (kg)" ] ; fhir:type [ fhir:v "decimal" ] ] [ fhir:linkId [ fhir:v "bloodPressure" ] ; fhir:text [ fhir:v "Blood Pressure (mmHg)" ] ; fhir:type [ fhir:v "string" ] ] [ fhir:linkId [ fhir:v "heartRate" ] ; fhir:text [ fhir:v "Heart Rate (bpm)" ] ; fhir:type [ fhir:v "integer" ] ] ) ] [ fhir:linkId [ fhir:v "functionalTests" ] ; fhir:text [ fhir:v "Functional Capacity" ] ; fhir:type [ fhir:v "group" ] ; fhir:item ( [ fhir:linkId [ fhir:v "stairClimb" ] ; fhir:text [ fhir:v "Able to climb 7 flights of stairs in under 90 seconds?" ] ; fhir:type [ fhir:v "boolean" ] ] [ fhir:linkId [ fhir:v "egressTest" ] ; fhir:text [ fhir:v "Able to exit seat unassisted in emergency simulation?" ] ; fhir:type [ fhir:v "boolean" ] ] ) ] [ fhir:linkId [ fhir:v "certification" ] ; fhir:text [ fhir:v "Medical Clearance and Physician Certification" ] ; fhir:type [ fhir:v "group" ] ; fhir:item ( [ fhir:linkId [ fhir:v "certStatus" ] ; fhir:text [ fhir:v "Medically cleared for spaceflight?" ] ; fhir:type [ fhir:v "choice" ] ] [ fhir:linkId [ fhir:v "certPhysician" ] ; fhir:text [ fhir:v "Physician Name and Contact" ] ; fhir:type [ fhir:v "string" ] ] [ fhir:linkId [ fhir:v "certDate" ] ; fhir:text [ fhir:v "Date of Medical Certification" ] ; fhir:type [ fhir:v "date" ] ] ) ] ) . # # -------------------------------------------------------------------------------------