{
    "name": "POC ICT Offer",
    "version": "1.0",
    "published": true,
    "retired": false,
    "encounter": "ICT Offer",
    "processor": "EncounterFormProcessor",
    "referencedForms": [],
    "uuid": "23b08733-6d26-48b5-bict-general25e1e",
    "encounterType": "23b08733-6d26-48b5-b135-dac294e25e1e",
    "allowUnspecifiedAll": true,
    "pages": [
        {
            "label": "ICT SERVICE OFFERING",
            "sections": [
                {
                    "label": "ICT SERVICE OFFERING",
                    "isExpanded": "true",
                    "questions": [
                        {
                            "label": "Visit date",
                            "type": "obs",
                            "required": false,
                            "id": "visitDate",
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                                "conceptMappings": [],
                                "answers": []
                            }
                        },
                        {
                            "label": "Prioritization for ICT",
                            "type": "obs",
                            "required": false,
                            "id": "priorityCriteria",
                            "questionOptions": {
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                              "conceptMappings": [],
                              "answers": [
                                {
                                    "concept": "4693bef1-4d6b-4546-b2c9-1a3409b6158f",
                                    "label": "Newly Diagnosed"
                                },
                                {
                                    "concept": "7b370f0a-61e2-4cc4-99c1-f38d96d7cee0",
                                    "label": "PLHIV with HVL & Adult"
                                },
                                {
                                    "concept": "bde58790-d3fc-40d6-bcce-f728105f91cf",
                                    "label": "PLHIV restart ART & Adult"
                                },
                                {
                                    "concept": "c1c0c92c-521c-454c-bfd2-52db5b308f6a",
                                    "label": "PLHIV incare with STI"
                                },
                                {
                                  "concept": "cd44c2af-e628-455f-8826-7aab004bd100",
                                  "label": "Enrolled at PMTCT"
                                },
                                {
                                  "concept": "41a9a67e-ce27-4a33-be91-0725209c69b0",
                                  "label": "Key population"
                                },
                                {
                                    "concept": "a30f0bd7-c81c-4f5d-9d9c-12afb084e005",
                                    "label": "Client with new partner"
                                },
                                {
                                    "concept": "c2881eae-b745-499f-872a-62f3a270d793",
                                    "label": "Client with partner not yet disclosed"
                                },
                                {
                                    "concept": "62b44258-b73b-4362-a0bc-f90703ed6d38",
                                    "label": "Client with partner not tested"
                                },
                                {
                                    "concept": "dd0515e2-abe7-457e-bc6a-b7faf14aeecb",
                                    "label": "Client child (<15 Years) not tested"
                                },
                                {
                                    "concept": "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                    "label": "Other"
                                }
                              ]
                            },
                            "validators": []
                          },
                          {
							"label": "Specify other",
							"type": "obs",
							"questionOptions": {
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								"concept": "373c74c7-0957-487f-a7a1-e086857c5fb7"
							},
							"hide": {
								"hideWhenExpression": "!includes('priorityCriteria','5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA')"
							},
							"id": "otherPrioritization"
						},
                        {
                            "label": "Offered",
                            "type": "obs",
                            "required": false,
                            "id": "offered",
                            "questionOptions": {
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                                "concept": "eef33554-8844-48ed-abec-a06e4918b7fe",
                                "conceptMappings": [],
                                "answers": [
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                                        "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                        "label": "Yes"
                                    },
                                    {
                                        "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                        "label": "No"
                                    }
                                ]
                            }
                        },
                        {
                            "label": "Offered date",
                            "type": "obs",
                            "required": false,
                            "hide": {
                                "hideWhenExpression": "offered !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
                            },
                            "id": "offeredDate",
                            "validators": [
								{
                                    "type": "date",
                                    "allowFutureDates": "false"
                                }
							],
                            "questionOptions": {
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                                "concept": "a7c606b1-9f3e-4095-815a-3a623dc738e1",
                                "conceptMappings": [],
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                            }
                        },
                        {
                            "label": "Accepted",
                            "type": "obs",
                            "required": false,
                            "id": "accepted",
                            "hide": {
                                "hideWhenExpression": "offered !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
                            },
                            "questionOptions": {
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                                "conceptMappings": [],
                                "answers": [
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                                        "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                        "label": "Yes"
                                    },
                                    {
                                        "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                        "label": "No"
                                    }
                                ]
                            }
                        },
                        {
                            "label": "Accepted date",
                            "type": "obs",
                            "required": false,
                            "hide": {
                                "hideWhenExpression": "accepted !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
                            },
                            "id": "acceptedDate",
                            "validators": [
								{
                                    "type": "date",
                                    "allowFutureDates": "false"
                                }
							],
                            "questionOptions": {
                                "rendering": "date",
                                "concept": "da8e65a1-04ee-44a0-be4b-d2bc4f002aa4",
                                "conceptMappings": [],
                                "answers": []
                            }
                        },
                        {
                            "label": "Elicited",
                            "type": "obs",
                            "required": false,
                            "id": "elicited",
                            "hide": {
                                "hideWhenExpression": "accepted !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
                            },
                            "questionOptions": {
                                "rendering": "radio",
                                "concept": "77296687-cba5-4e70-9d51-e20e54d50548",
                                "conceptMappings": [],
                                "answers": [
                                    {
                                        "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                        "label": "Yes"
                                    },
                                    {
                                        "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                        "label": "No"
                                    }
                                ]
                            }
                        },
                        {
                            "label": "Reason ICT service not accepted",
                            "type": "obs",
                            "required": false,
                            "hide": {
                                "hideWhenExpression": "accepted !== '1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
                            },
                            "id": "notAccepted",
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                                "concept": "59fa6f41-a1d0-45bc-af79-643b2e7dcd23",
                                "conceptMappings": [],
                                "answers": [
                                    {
                                        "concept": "8611a257-6b96-464f-8ae2-410c9c692c55",
                                        "label": "No reason"
                                    },
                                    {
                                        "concept": "7a203f1c-3ff1-492d-af7d-d804d7d1f84a",
                                        "label": "No time"
                                    },
                                    {
                                        "concept": "53384cd2-dff0-4db2-b403-78bd3d8903cd",
                                        "label": "Fear of disclosure"
                                    },
                                    {
                                        "concept": "3c2c53ec-efa8-4254-bb0c-202c4bb9d750",
                                        "label": "Afraid of IPV"
                                    },
                                    {
                                        "concept": "6369d2cb-bf3d-44e4-8cd3-639b40bd8ce1",
                                        "label": "Prefer other HF"
                                    },
                                    {
                                        "concept": "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                        "label": "Other"
                                    }
                                ]
                            }
                        },
                        {
							"label": "Specify other reason",
							"type": "obs",
							"questionOptions": {
								"rendering": "text",
								"concept": "f39fc7e2-0485-43dc-9d22-b065850710c8"
							},
							"hide": {
								"hideWhenExpression": "!includes('notAccepted','5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA')"
							},
							"id": "otherReason"
						}
                    ]
                },
                {
                    "label": "IPV/AE",
                    "isExpanded": "true",
                    "questions": [
                        {
                            "label": "High risk for IPV",
                            "type": "obs",
                            "required": false,
                            "id": "highRiskIpv",
                            "questionOptions": {
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                                "concept": "6cb09073-5bc1-4cbb-a13c-27c98956231b",
                                "conceptMappings": [],
                                "answers": [
                                    {
                                        "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                        "label": "Yes"
                                    },
                                    {
                                        "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                        "label": "No"
                                    }
                                ]
                            }
                        },
                        {
                            "label": "AE reported",
                            "type": "obs",
                            "required": false,
                            "id": "aeReported",
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                                "concept": "ff68acf5-9a2f-44c9-a2a3-fa8807dcb04a",
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                                "answers": [
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                                        "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                        "label": "Yes"
                                    },
                                    {
                                        "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                        "label": "No"
                                    }
                                ]
                            }
                        },
                        {
                            "label": "Adverse event type",
                            "type": "obs",
                            "required": false,
                            "id": "adverseEventType",
                            "questionOptions": {
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                                "conceptMappings": [],
                                "answers": [
                                    {
                                        "concept": "1058AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                        "label": "Divorce"
                                    },
                                    {
                                        "concept": "74f8c5a5-be94-4605-947f-2eb2cac3c187",
                                        "label": "Loss of relationship"
                                    },
                                    {
                                        "concept": "c405b20b-0845-4721-b09b-d067fd36a594",
                                        "label": "Loss of support"
                                    },
                                    {
                                        "concept": "0f27a4b6-5f19-4c44-9d6d-abcdd9fd8d30",
                                        "label": "Stigma"
                                    },
                                    {
                                        "concept": "8da00bae-4655-46ba-b442-e3ca50b8bf96",
                                        "label": "Job loss"
                                    },
                                    {
                                        "concept": "158835AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                        "label": "Social exclusion"
                                    },
                                    {
                                        "concept": "a9cd93c0-fcd4-46d3-80aa-12d1a74fc8d4",
                                        "label": "Verbal abuse"
                                    },
                                    {
                                        "concept": "152292AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                        "label": "Physical abuse"
                                    },
                                    {
                                        "concept": "807fa6a8-a2ff-45db-9b41-72949fd9401d",
                                        "label": "Loneliness"
                                    },
                                    {
                                        "concept": "159524AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                        "label": "Cessation of sexual intercourse"
                                    },
                                    {
                                        "concept": "134660AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                        "label": "Marital discord"
                                    },
                                    {
                                        "concept": "0ef9b5ba-8690-4c63-8b38-ed9a6a263a39",
                                        "label": "Taking away access to children"
                                    },
                                    {
                                        "concept": "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                        "label": "Other"
                                    }
                                ]
                            }
                        },
                        {
							"label": "Specify other type",
							"type": "obs",
							"questionOptions": {
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								"concept": "37002efb-7044-47b4-bcbc-d900161fc7ee"
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							"hide": {
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							},
							"id": "otherType"
						},
                        {
                            "label": " Linked to appropriate care",
                            "type": "obs",
                            "required": false,
                            "id": "linkedToApp",
                            "questionOptions": {
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                                "concept": "f4817ca2-a67f-46e3-8c97-864612ccbb47",
                                "conceptMappings": [],
                                "answers": [
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                                        "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                        "label": "Yes"
                                    },
                                    {
                                        "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
                                        "label": "No"
                                    }
                                ]
                            },
                            "validators": []
                        }
                    ]
                }
            ]
        }
    ],
    "availableIntents": [
		{
			"intent": "*",
			"display": "default_intent"
		}
	]
}