Allergies — FHIR Questionnaire Template

'No known allergies' plus a repeatable list of allergens with reaction and severity.

Scoring

No scoring — a data-collection fragment.

Questions

1. No known allergies
2. Allergen (medication, food or other)
3. Reaction
4. Severity
   • Mild
   • Moderate
   • Severe

Source and license

Source: Original wording written for this builder.

License: Original wording written for this builder; covered by the project license (non-commercial use with attribution; commercial use needs written permission). (link)

Provided to save authoring effort, not as medical advice — confirm the scale and its cut-offs for your use case.

Use it

1. Download the FHIR Questionnaire JSON, or
2. open the Builder, choose + Add → From template…, search for “Allergies” and insert it. It arrives as one titled group with its calculations wired, and you can keep editing it.

More templates

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