{
  "resourceType": "Questionnaire",
  "status": "active",
  "item": [
    {
      "linkId": "allergy",
      "text": "Allergies",
      "type": "group",
      "item": [
        {
          "linkId": "allergy-none",
          "text": "No known allergies",
          "type": "boolean"
        },
        {
          "linkId": "allergy-entry",
          "text": "Allergy",
          "type": "group",
          "repeats": true,
          "item": [
            {
              "linkId": "allergy-substance",
              "text": "Allergen (medication, food or other)",
              "type": "string",
              "required": true
            },
            {
              "linkId": "allergy-reaction",
              "text": "Reaction",
              "type": "string"
            },
            {
              "linkId": "allergy-severity",
              "text": "Severity",
              "type": "choice",
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "radio-button"
                      }
                    ]
                  }
                }
              ],
              "answerOption": [
                {
                  "valueString": "Mild"
                },
                {
                  "valueString": "Moderate"
                },
                {
                  "valueString": "Severe"
                }
              ]
            }
          ],
          "enableWhen": [
            {
              "question": "allergy-none",
              "operator": "!=",
              "answerBoolean": true
            }
          ]
        }
      ]
    }
  ]
}