{
  "name": "Add HTS Retrospective Form",
  "pages": [
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    {
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    {
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                        "value": "R04.2"
                      },
                      {
                        "type": "PIH",
                        "value": "970"
                      },
                      {
                        "type": "ICPC2",
                        "value": "R24"
                      },
                      {
                        "type": "IMO-ProblemIT",
                        "value": "27441"
                      },
                      {
                        "type": "AMPATH",
                        "value": "6172"
                      },
                      {
                        "type": "SNOMED-CT",
                        "value": "66857006"
                      },
                      {
                        "type": "AMPATH",
                        "value": "967"
                      }
                    ]
                  },
                  {
                    "concept": "133027AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                    "label": "Night sweats",
                    "conceptMappings": [
                      {
                        "type": "ICPC2",
                        "value": "A09"
                      },
                      {
                        "type": "ICD-10-WHO",
                        "value": "R61.1"
                      },
                      {
                        "type": "AMPATH",
                        "value": "6029"
                      },
                      {
                        "type": "SNOMED-CT",
                        "value": "42984000"
                      },
                      {
                        "type": "PIH",
                        "value": "6029"
                      },
                      {
                        "type": "IMO-ProblemIT",
                        "value": "50760"
                      },
                      {
                        "type": "3BT",
                        "value": "10063085"
                      }
                    ]
                  }
                ]
              },
              "id": "tbSymptoms"
            },
            {
              "label": "Is the client experiencing the following STI symptoms?",
              "type": "obs",
              "questionOptions": {
                "rendering": "checkbox",
                "concept": "c4f81292-61a3-4561-a4ae-78be7d16d928",
                "answers": [
                  {
                    "concept": "d8e46cc0-4d08-45d9-a46d-bd083db63057",
                    "label": "Complaints of scrotal swelling and pain (Male)",
                    "conceptMappings": []
                  },
                  {
                    "concept": "60817acb-90f1-4d46-be87-2c47e150770b",
                    "label": "Complaints of urethral discharge or burning when urinating (Male)",
                    "conceptMappings": []
                  },
                  {
                    "concept": "06be8996-ef55-438b-bbb9-5bebeb18e779",
                    "label": "Complaints of lower abdominal pains with or without  vaginal discharge (Female)",
                    "conceptMappings": []
                  },
                  {
                    "concept": "9a24bedc-d42c-422e-9f5d-371b59af0660",
                    "label": "Complaints of vaginal discharge or burning when urinating (Female)",
                    "conceptMappings": []
                  },
                  {
                    "concept": "faf06026-fce9-4d2c-9ef2-24fb45343804",
                    "label": "Complaints of genital sores or swollen inguinal lymph nodes with or without pains",
                    "conceptMappings": []
                  }
                ]
              },
              "id": "stiSymptoms"
            }
          ]
        }
      ]
    },
    {
      "label": "HIV testing",
      "sections": [
        {
          "label": "HIV testing",
          "isExpanded": "true",
          "questions": [
            {
              "label": "Was HIV test conducted?",
              "type": "obs",
              "questionOptions": {
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                "concept": "164401AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
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                    "concept": "cf82933b-3f3f-45e7-a5ab-5d31aaee3da3",
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                        "value": "1065"
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                      {
                        "type": "PIH",
                        "value": "1065"
                      },
                      {
                        "type": "SNOMED CT",
                        "value": "CT: 373066001"
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                    ]
                  },
                  {
                    "concept": "488b58ff-64f5-4f8a-8979-fa79940b1594",
                    "label": "No",
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                  {
                    "concept": "1067AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                    "label": "Unknown",
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                        "type": "CIEL",
                        "value": "1067"
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                      {
                        "type": "AMPATH",
                        "value": "1067"
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                      {
                        "type": "SNOMED CT",
                        "value": "CT: 261665006"
                      },
                      {
                        "type": "PIH",
                        "value": "1067"
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                    ]
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                ]
              },
              "id": "hivTestConducted"
            },
            {
              "label": "Date test was performed",
              "type": "obs",
              "questionOptions": {
                "rendering": "date",
                "concept": "164400AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                "weeksList": ""
              },
              "id": "dateTestPerformed"
            },
            {
              "label": "Initial HIV test kit name",
              "type": "obs",
              "questionOptions": {
                "rendering": "radio",
                "concept": "afa64df8-50af-4bc3-8135-6e6603f62068",
                "answers": [
                  {
                    "concept": "5e318e60-3108-4468-90cd-7f2dc1c596a6",
                    "label": "HIV Determine Kit",
                    "conceptMappings": []
                  },
                  {
                    "concept": "59ec348a-14a8-4e88-9b9e-72fa24b949fa",
                    "label": "HIV-Syphilis Duo Kit",
                    "conceptMappings": []
                  }
                ]
              },
              "id": "inititalHIVTestKitName"
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            {
              "label": "Initial HIV test result",
              "type": "obs",
              "questionOptions": {
                "rendering": "radio",
                "concept": "e767ba5d-7560-43ba-a746-2b0ff0a2a513",
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                        "type": "AMPATH",
                        "value": "664"
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                      {
                        "type": "SNOMED-CT",
                        "value": "260385009"
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                      {
                        "type": "PIH",
                        "value": "664"
                      },
                      {
                        "type": "org.openmrs.module.mdrtb",
                        "value": "NEGATIVE"
                      },
                      {
                        "type": "AMPATH",
                        "value": "665"
                      }
                    ]
                  },
                  {
                    "concept": "1138AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                    "label": "Indeterminate",
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                      {
                        "type": "AMPATH",
                        "value": "1138"
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                      {
                        "type": "SNOMED-CT",
                        "value": "82334004"
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                    ]
                  },
                  {
                    "concept": "6378487b-584d-4422-a6a6-56c8830873ff",
                    "label": "Positive",
                    "conceptMappings": []
                  }
                ]
              },
              "id": "initialHIVTestResult"
            },
            {
              "label": "Confirmatory HIV Test Kit Name",
              "type": "obs",
              "questionOptions": {
                "rendering": "radio",
                "concept": "b78d89e7-08aa-484f-befb-1e3e70cd6985",
                "answers": [
                  {
                    "concept": "a099ce71-d75e-433d-a782-0b9ad4f4f655",
                    "label": "HIV First Response Kit",
                    "conceptMappings": []
                  },
                  {
                    "concept": "0d64d0d0-8dcb-4a56-819c-999d52f04db8",
                    "label": "HIV Stat Pack Kit",
                    "conceptMappings": []
                  }
                ]
              },
              "id": "confirmatoryHIVTestKitName"
            },
            {
              "label": "Confirmatory HIV test result",
              "type": "obs",
              "questionOptions": {
                "rendering": "radio",
                "concept": "dbc4f8e9-7098-4585-9509-e2f84a4d8c6e",
                "answers": [
                  {
                    "concept": "664AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                    "label": "Negative",
                    "conceptMappings": [
                      {
                        "type": "AMPATH",
                        "value": "664"
                      },
                      {
                        "type": "SNOMED-CT",
                        "value": "260385009"
                      },
                      {
                        "type": "PIH",
                        "value": "664"
                      },
                      {
                        "type": "org.openmrs.module.mdrtb",
                        "value": "NEGATIVE"
                      },
                      {
                        "type": "AMPATH",
                        "value": "665"
                      }
                    ]
                  },
                  {
                    "concept": "1138AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                    "label": "Indeterminate",
                    "conceptMappings": [
                      {
                        "type": "AMPATH",
                        "value": "1138"
                      },
                      {
                        "type": "SNOMED-CT",
                        "value": "82334004"
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                    ]
                  },
                  {
                    "concept": "6378487b-584d-4422-a6a6-56c8830873ff",
                    "label": "Positive",
                    "conceptMappings": []
                  }
                ]
              },
              "id": "confirmatoryHIVTestResult"
            },
            {
              "label": "Tie Breaker HIV test kit name",
              "type": "obs",
              "questionOptions": {
                "rendering": "radio",
                "concept": "73434a78-e4fc-42f7-a812-f30f3b3cabe3",
                "answers": [
                  {
                    "concept": "780c8ff2-5e11-48f8-ad3d-efa36a0413f6",
                    "label": "HIV SD Bioline Kit",
                    "conceptMappings": []
                  },
                  {
                    "concept": "780c8ff2-5e11-48f8-ad3d-efa36a0413f6",
                    "label": "HIV SD Bioline Kit",
                    "conceptMappings": []
                  }
                ]
              },
              "id": "tieBreakerHIVTestKitName"
            },
            {
              "label": "Tie Breaker HIV test kit result",
              "type": "obs",
              "questionOptions": {
                "rendering": "radio",
                "concept": "bfc5fbb9-2b23-422e-a741-329bb2597032",
                "answers": [
                  {
                    "concept": "664AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                    "label": "Negative",
                    "conceptMappings": [
                      {
                        "type": "AMPATH",
                        "value": "664"
                      },
                      {
                        "type": "SNOMED-CT",
                        "value": "260385009"
                      },
                      {
                        "type": "PIH",
                        "value": "664"
                      },
                      {
                        "type": "org.openmrs.module.mdrtb",
                        "value": "NEGATIVE"
                      },
                      {
                        "type": "AMPATH",
                        "value": "665"
                      }
                    ]
                  },
                  {
                    "concept": "1138AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                    "label": "Indeterminate",
                    "conceptMappings": [
                      {
                        "type": "AMPATH",
                        "value": "1138"
                      },
                      {
                        "type": "SNOMED-CT",
                        "value": "82334004"
                      }
                    ]
                  },
                  {
                    "concept": "6378487b-584d-4422-a6a6-56c8830873ff",
                    "label": "Positive",
                    "conceptMappings": []
                  }
                ]
              },
              "id": "tieBreakerHIVTestKitResult"
            },
            {
              "label": "Final HIV test result",
              "type": "obs",
              "questionOptions": {
                "rendering": "radio",
                "concept": "e16b0068-b6a2-46b7-aba9-e3be00a7b4ab",
                "answers": [
                  {
                    "concept": "664AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                    "label": "Negative",
                    "conceptMappings": [
                      {
                        "type": "AMPATH",
                        "value": "664"
                      },
                      {
                        "type": "SNOMED-CT",
                        "value": "260385009"
                      },
                      {
                        "type": "PIH",
                        "value": "664"
                      },
                      {
                        "type": "org.openmrs.module.mdrtb",
                        "value": "NEGATIVE"
                      },
                      {
                        "type": "AMPATH",
                        "value": "665"
                      }
                    ]
                  },
                  {
                    "concept": "1138AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                    "label": "Indeterminate",
                    "conceptMappings": [
                      {
                        "type": "AMPATH",
                        "value": "1138"
                      },
                      {
                        "type": "SNOMED-CT",
                        "value": "82334004"
                      }
                    ]
                  },
                  {
                    "concept": "6378487b-584d-4422-a6a6-56c8830873ff",
                    "label": "Positive",
                    "conceptMappings": []
                  }
                ]
              },
              "id": "finalHIVTestResult"
            }
          ]
        }
      ]
    },
    {
      "label": "Recency testing",
      "sections": [
        {
          "label": "Recency testing",
          "isExpanded": "true",
          "questions": [
            {
              "label": "Patient consent",
              "type": "obs",
              "questionOptions": {
                "rendering": "radio",
                "concept": "1710AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                "conceptMappings": [
                  {
                    "type": "SNOMED-CT",
                    "value": "182771004"
                  }
                ],
                "answers": [
                  {
                    "label": "Yes",
                    "concept": "cf82933b-3f3f-45e7-a5ab-5d31aaee3da3"
                  },
                  {
                    "label": "No",
                    "concept": "488b58ff-64f5-4f8a-8979-fa79940b1594"
                  }
                ]
              },
              "id": "recencyTestingConsent"
            },
            {
              "label": "Was recency test conducted?",
              "type": "obs",
              "questionOptions": {
                "rendering": "radio",
                "concept": "65e18678-18db-4801-9625-50d3302c780c",
                "answers": [
                  {
                    "concept": "cf82933b-3f3f-45e7-a5ab-5d31aaee3da3",
                    "label": "Yes",
                    "conceptMappings": [
                      {
                        "type": "CIEL",
                        "value": "1065"
                      },
                      {
                        "type": "AMPATH",
                        "value": "1065"
                      },
                      {
                        "type": "PIH",
                        "value": "1065"
                      },
                      {
                        "type": "SNOMED CT",
                        "value": "CT: 373066001"
                      }
                    ]
                  },
                  {
                    "concept": "488b58ff-64f5-4f8a-8979-fa79940b1594",
                    "label": "No",
                    "conceptMappings": []
                  },
                  {
                    "concept": "1067AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                    "label": "Unknown",
                    "conceptMappings": [
                      {
                        "type": "CIEL",
                        "value": "1067"
                      },
                      {
                        "type": "AMPATH",
                        "value": "1067"
                      },
                      {
                        "type": "SNOMED CT",
                        "value": "CT: 261665006"
                      },
                      {
                        "type": "PIH",
                        "value": "1067"
                      }
                    ]
                  }
                ]
              },
              "id": "recencyTestConducted"
            },
            {
              "label": "Recency test result",
              "type": "obs",
              "questionOptions": {
                "rendering": "radio",
                "concept": "165092AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                "conceptMappings": [
                  {
                    "type": "SNOMED-CT",
                    "value": "271918004"
                  }
                ],
                "answers": [
                  {
                    "concept": "165090AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                    "label": "Recent",
                    "conceptMappings": [
                      {
                        "type": "SNOMED-CT",
                        "value": "6493001"
                      }
                    ]
                  },
                  {
                    "concept": "165091AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                    "label": "Long duration",
                    "conceptMappings": [
                      {
                        "type": "SNOMED-CT",
                        "value": "260384008"
                      }
                    ]
                  }
                ]
              },
              "id": "recencyTestResult"
            },
            {
              "label": "Was the client given the result",
              "type": "obs",
              "questionOptions": {
                "rendering": "radio",
                "concept": "164848AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                "answers": [
                  {
                    "concept": "cf82933b-3f3f-45e7-a5ab-5d31aaee3da3",
                    "label": "Yes",
                    "conceptMappings": [
                      {
                        "type": "CIEL",
                        "value": "1065"
                      },
                      {
                        "type": "AMPATH",
                        "value": "1065"
                      },
                      {
                        "type": "PIH",
                        "value": "1065"
                      },
                      {
                        "type": "SNOMED CT",
                        "value": "CT: 373066001"
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                    ]
                  },
                  {
                    "concept": "488b58ff-64f5-4f8a-8979-fa79940b1594",
                    "label": "No",
                    "conceptMappings": []
                  },
                  {
                    "concept": "1067AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                    "label": "Unknown",
                    "conceptMappings": [
                      {
                        "type": "CIEL",
                        "value": "1067"
                      },
                      {
                        "type": "AMPATH",
                        "value": "1067"
                      },
                      {
                        "type": "SNOMED CT",
                        "value": "CT: 261665006"
                      },
                      {
                        "type": "PIH",
                        "value": "1067"
                      }
                    ]
                  }
                ]
              },
              "id": "clientReceivedResults"
            },
            {
              "label": "When the client received the HIV test result?",
              "type": "obs",
              "questionOptions": {
                "rendering": "date",
                "concept": "160082AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA"
              },
              "id": "recencyTestDate"
            },
            {
              "label": "Were results received as a couple?",
              "type": "obs",
              "questionOptions": {
                "rendering": "radio",
                "concept": "445846e9-b929-4519-bc83-d51c051918f5",
                "answers": [
                  {
                    "concept": "cf82933b-3f3f-45e7-a5ab-5d31aaee3da3",
                    "label": "Yes",
                    "conceptMappings": [
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                        "type": "CIEL",
                        "value": "1065"
                      },
                      {
                        "type": "AMPATH",
                        "value": "1065"
                      },
                      {
                        "type": "PIH",
                        "value": "1065"
                      },
                      {
                        "type": "SNOMED CT",
                        "value": "CT: 373066001"
                      }
                    ]
                  },
                  {
                    "concept": "488b58ff-64f5-4f8a-8979-fa79940b1594",
                    "label": "No",
                    "conceptMappings": []
                  },
                  {
                    "concept": "1067AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                    "label": "Unknown",
                    "conceptMappings": [
                      {
                        "type": "CIEL",
                        "value": "1067"
                      },
                      {
                        "type": "AMPATH",
                        "value": "1067"
                      },
                      {
                        "type": "SNOMED CT",
                        "value": "CT: 261665006"
                      },
                      {
                        "type": "PIH",
                        "value": "1067"
                      }
                    ]
                  }
                ]
              },
              "id": "resultsReceivedAsCouple"
            },
            {
              "label": "Couple results",
              "type": "obs",
              "questionOptions": {
                "rendering": "radio",
                "concept": "5f38bc97-d6ca-43f8-a019-b9a9647d0c6a",
                "answers": [
                  {
                    "concept": "3a27187f-da7a-4f6b-986d-6521f343326d",
                    "label": "Concordant Positive",
                    "conceptMappings": []
                  },
                  {
                    "concept": "c1504c2b-a8bf-44bf-ab1e-1d342ba051ae",
                    "label": "Concordant Negative",
                    "conceptMappings": []
                  },
                  {
                    "concept": "c2d2bea8-2db5-4730-86b1-592c9408f567",
                    "label": "Discordant",
                    "conceptMappings": []
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                ]
              },
              "id": "coupleResults"
            }
          ]
        }
      ]
    },
    {
      "label": "Post-test counselling",
      "sections": [
        {
          "label": "Post-test counselling",
          "isExpanded": "true",
          "questions": [
            {
              "label": "Was post-test counselling conducted?",
              "type": "obs",
              "questionOptions": {
                "rendering": "radio",
                "concept": "159382AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                "conceptMappings": [
                  {
                    "type": "PIH",
                    "value": "969"
                  },
                  {
                    "type": "SNOMED-CT",
                    "value": "313077009"
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                ],
                "answers": [
                  {
                    "concept": "1067AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                    "label": "Unknown",
                    "conceptMappings": [
                      {
                        "type": "CIEL",
                        "value": "1067"
                      },
                      {
                        "type": "AMPATH",
                        "value": "1067"
                      },
                      {
                        "type": "SNOMED CT",
                        "value": "CT: 261665006"
                      },
                      {
                        "type": "PIH",
                        "value": "1067"
                      }
                    ]
                  },
                  {
                    "concept": "cf82933b-3f3f-45e7-a5ab-5d31aaee3da3",
                    "label": "Yes",
                    "conceptMappings": [
                      {
                        "type": "CIEL",
                        "value": "1065"
                      },
                      {
                        "type": "AMPATH",
                        "value": "1065"
                      },
                      {
                        "type": "PIH",
                        "value": "1065"
                      },
                      {
                        "type": "SNOMED CT",
                        "value": "CT: 373066001"
                      }
                    ]
                  },
                  {
                    "concept": "488b58ff-64f5-4f8a-8979-fa79940b1594",
                    "label": "No",
                    "conceptMappings": []
                  }
                ]
              },
              "id": "postTestCounsellingDone"
            }
          ]
        }
      ]
    },
    {
      "label": "Referrals",
      "sections": [
        {
          "label": "Referrals",
          "isExpanded": "true",
          "questions": [
            {
              "label": "Was the client referred to prevention services?",
              "type": "obs",
              "questionOptions": {
                "rendering": "checkbox",
                "concept": "5f394708-ca7d-4558-8d23-a73de181b02d",
                "answers": [
                  {
                    "concept": "88cdde2b-753b-48ac-a51a-ae5e1ab24846",
                    "label": "Pre Exposure Prophylaxis (PEP)",
                    "conceptMappings": []
                  },
                  {
                    "concept": "46da10c7-49e3-45e5-8e82-7c529d52a1a8",
                    "label": "STI Testing and Treatment",
                    "conceptMappings": []
                  },
                  {
                    "concept": "1691AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                    "label": "Post-exposure prophylaxis",
                    "conceptMappings": []
                  },
                  {
                    "concept": "162223AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                    "label": "Voluntary male circumcision clinic",
                    "conceptMappings": []
                  },
                  {
                    "concept": "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                    "label": "Other",
                    "conceptMappings": [
                      {
                        "type": "PIH-Malawi",
                        "value": "6408"
                      },
                      {
                        "type": "org.openmrs.module.mdrtb",
                        "value": "OTHER"
                      },
                      {
                        "type": "SNOMED-MVP",
                        "value": "56221000105001"
                      },
                      {
                        "type": "PIH",
                        "value": "5622"
                      },
                      {
                        "type": "AMPATH",
                        "value": "5622"
                      },
                      {
                        "type": "SNOMED-CT",
                        "value": "74964007"
                      }
                    ]
                  },
                  {
                    "concept": "da0238c1-0ddd-49cc-b10d-c552391b6332",
                    "label": "Harm Reduction for People Who Inject Drugs",
                    "conceptMappings": []
                  },
                  {
                    "concept": "ac2e75dc-fceb-4591-9ffb-3f852c0750d9",
                    "label": "Behavioural Interventions to Support Risk Reduction - for KP",
                    "conceptMappings": []
                  },
                  {
                    "concept": "0be6a668-b4ff-4fc5-bbae-0e2a86af1bd1",
                    "label": "Post-GBV Care",
                    "conceptMappings": []
                  },
                  {
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