NHS North West Genomics
2.2.0 - ci-build
NHS North West Genomics - Local Development build (v2.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Official URL: https://fhir.nwgenomics.nhs.uk/Questionnaire/VariantReviewAskAtOrderEntry | Version: 2.2.0 | ||||
| Unknown as of 2026-09-20 | Computable Name: | ||||
For analysis purposes only - not an active or planned project.
Ask At Order Entry Questions for the NW GLH paper Genomic Variant Review Request Form (R442.1) - Rare Disease (DOC6004), used alongside the common core order form - see Order Entry Questions. This form does not request a new test on a new specimen - it asks the laboratory to re-review a variant already reported, so its distinctive content is a reference back to that prior report rather than specimen detail.
This Questionnaire is compared against Genomic Test
Order - see NW GLH Paper Test Request
Forms -
but does not yet declare derivedFrom/extends it: unlike the Ask At Order
Entry Questionnaires that originated from an existing digital order-entry
screen (see Order Entry
Questions), this
one hasn't yet been processed into the specific electronic Ask At Order
Entry shape that relationship implies for use in an actual order. It
structures the NW GLH paper Genomic Variant Review Request Form (R442.1) -
Rare Disease (DOC6004) - see NW Genomics paper test request
forms
for how this compares to the other paper forms.
Source form: Genomic Variant Review Request Form, R442.1/DOC6004 (DOCX)
| Item | Paper Form Field | FHIR |
|---|---|---|
| Surname/Forename | Free text | Patient.name |
| D.O.B./Biological Sex/Gender Identity | Free text | Patient.birthDate / Patient.gender / not yet mapped |
| Address/Postcode | Free text | Patient.address |
| Ethnicity | Coded | Patient.extension:ethnicCategory |
| NHS No/Hospital No | Free text | Patient.identifier:nhsNumber / Patient.identifier:MedicalRecordNumber |
| Referring Clinician/Healthcare Professional (Consultant/GP, Hospital/Surgery, Department, E-mail/Tel, Requested by/Cc. Report to) | Free text | PractitionerRole |
| Reason for review | New information / time elapsed / urgent scenario / formal classification required (tick boxes) | ServiceRequest.reasonCode |
| Variant(s) under review | Free text | ServiceRequest.note |
| Prior report reference | "Report reference" free text | ServiceRequest.basedOn -> DiagnosticReport |
| Specialty | Free text (e.g. Core, Cardiology) | PractitionerRole.specialty |
| Additional evidence | Free text | ServiceRequest.note |
This form does not request a new test on a new specimen - it asks the
laboratory to re-review a variant already reported. Its distinguishing
content is therefore a reference back to the prior report, not specimen
detail, and the common core's own Specimen group does not apply. Where the
prior report came from an external GLH, the form asks for a copy to be
attached - the same ServiceRequest.supportingInfo -> DocumentReference ->
Binary pattern used for the family letter on Genetic Clinical
Referral. No
Order Placer Number, Account Number/Hospital Spell Identifier, or clinician
professional identifier (GMC/GMP) field is present on the paper form.
Profile: Questionnaire
| LinkID | Text | Cardinality | Type | Description & Constraints![]() |
|---|---|---|---|---|
![]() |
**For analysis purposes only - not an active or planned project.** **Ask At Order Entry Questions** for the NW GLH paper **Genomic Variant Review Request Form (R442.1) - Rare Disease** (DOC6004), used alongside the [common core order form](Questionnaire-GenomicTestOrder.html) - see [Order Entry Questions](Questionnaire-GenomicTestOrder.html#order-entry-questions). This form does not request a new test on a new specimen - it asks the laboratory to **re-review a variant already reported**, so its distinctive content is a reference back to that prior report rather than specimen detail. | Questionnaire | https://fhir.nwgenomics.nhs.uk/Questionnaire/VariantReviewAskAtOrderEntry#2.2.0 | |
![]() ![]() |
Patient Details | 0..1 | group | Definition: Patient Value Set: |
![]() ![]() ![]() |
Surname | 0..1 | string | Definition: Patient.name.family Value Set: |
![]() ![]() ![]() |
Forename | 0..1 | string | Definition: Patient.name.given Value Set: |
![]() ![]() ![]() |
D.O.B. | 0..1 | date | Definition: Patient.birthDate Value Set: |
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Biological Sex | 0..1 | choice | Definition: Patient.gender Value Set: AdministrativeGender |
![]() ![]() ![]() |
Gender Identity | 0..1 | string | Value Set: |
![]() ![]() ![]() ![]() |
No clean FHIR field identified - distinct from Biological Sex on this form's own layout. | 0..1 | display | Value Set: |
![]() ![]() ![]() |
Address | 0..* | string | Definition: Patient.address.line Value Set: |
![]() ![]() ![]() |
Postcode | 0..1 | string | Definition: Patient.address.postalCode Value Set: |
![]() ![]() ![]() |
Ethnicity | 0..1 | choice | Definition: Patient.extension:ethnicCategory Value Set: Ethnicity |
![]() ![]() ![]() |
NHS No | 0..1 | string | Definition: Patient.identifier:nhsNumber Value Set: |
![]() ![]() ![]() |
Hospital No | 0..1 | string | Definition: Patient.identifier:MedicalRecordNumber Value Set: |
![]() ![]() |
Referring Clinician/Healthcare Professional | 0..1 | group | Definition: PractitionerRole Value Set: |
![]() ![]() ![]() |
Consultant/GP (in full) | 0..1 | string | Definition: PractitionerRole.practitioner.display Value Set: |
![]() ![]() ![]() |
Hospital/Surgery (in full) | 0..1 | string | Definition: PractitionerRole.organization.identifier.value Value Set: |
![]() ![]() ![]() |
Department | 0..1 | choice | Definition: PractitionerRole.specialty.coding.code Value Set: UK Core Practice Setting Code |
![]() ![]() ![]() ![]() |
Distinct from this Questionnaire's own Specialty (e.g. Core, Cardiology) item (NOS/ReviewSpecialty) below - that one is the specialty performing the review, this is the referring clinician's own department. | 0..1 | display | Value Set: |
![]() ![]() ![]() |
E-mail/Tel | 0..1 | string | Definition: PractitionerRole.telecom.value Value Set: |
![]() ![]() ![]() |
Requested by/Cc. Report to | 0..1 | string | Value Set: |
![]() ![]() ![]() ![]() |
Same genuinely-additional-person gap identified on the GMS WGS national forms' own Main Contact group and Genomic Test Order - Common Fields We May Have Missed (Copy Report To). | 0..1 | display | Value Set: |
![]() ![]() |
Ask At Order Entry Questions | 0..1 | group | Value Set: |
![]() ![]() ![]() |
Reason for review | 1..1 | choice | Definition: ServiceRequest.reasonCode Value Set: Options: 4 options |
![]() ![]() ![]() ![]() |
Covers similar ground to Reason For Variant Re-Interpretation Request in NW Genomic General Ask At Order Questions (NOS/VariantReinterpretationReason), which is a single free-text field - this form's four named reasons are kept as their own coded item rather than reused, since they are specific eligibility criteria for requesting a review, not a general free-text reason. | 0..1 | display | Value Set: |
![]() ![]() ![]() |
Variant(s) under review | 1..1 | string | Definition: ServiceRequest.note Value Set: |
![]() ![]() ![]() |
Prior report reference | 1..1 | reference | Definition: ServiceRequest.basedOn Value Set: |
![]() ![]() ![]() ![]() |
If this variant was reported by an external GLH, please attach a copy of the report - ServiceRequest.supportingInfo -> DocumentReference -> Binary, the same pattern used for the family letter on Genetic Clinical Referral. | 0..1 | display | Value Set: |
![]() ![]() ![]() |
Specialty (e.g. Core, Cardiology) | 0..1 | string | Definition: PractitionerRole.specialty.coding.code Value Set: |
![]() ![]() ![]() |
Additional evidence (new clinical or scientific information) | 0..1 | string | Definition: ServiceRequest.note Value Set: |
Documentation for this format | ||||
Options Sets
Answer options for NOS/VariantReviewReason
Profile: Questionnaire
Patient Details
Surname
Forename
D.O.B.
Biological Sex
Gender Identity
No clean FHIR field identified - distinct from Biological Sex on this form's own layout.
Address
Postcode
Ethnicity
NHS No
Hospital No
Referring Clinician/Healthcare Professional
Consultant/GP (in full)
Hospital/Surgery (in full)
Department
Distinct from this Questionnaire's own Specialty (e.g. Core, Cardiology) item (NOS/ReviewSpecialty) below - that one is the specialty performing the review, this is the referring clinician's own department.
E-mail/Tel
Requested by/Cc. Report to
Same genuinely-additional-person gap identified on the GMS WGS national forms' own Main Contact group and Genomic Test Order - Common Fields We May Have Missed (Copy Report To).
Ask At Order Entry Questions
Reason for review*
Covers similar ground to Reason For Variant Re-Interpretation Request in NW Genomic General Ask At Order Questions (NOS/VariantReinterpretationReason), which is a single free-text field - this form's four named reasons are kept as their own coded item rather than reused, since they are specific eligibility criteria for requesting a review, not a general free-text reason.
Variant(s) under review*
Prior report reference*
If this variant was reported by an external GLH, please attach a copy of the report - ServiceRequest.supportingInfo -> DocumentReference -> Binary, the same pattern used for the family letter on Genetic Clinical Referral.
Specialty (e.g. Core, Cardiology)
Additional evidence (new clinical or scientific information)
Profile: Questionnaire
| LinkID | Description & Constraints![]() |
|---|---|
![]() |
Definition: Patient Value Set: |
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Definition: Patient.name.family Value Set: |
![]() ![]() |
Definition: Patient.name.given Value Set: |
![]() ![]() |
Definition: Patient.birthDate Value Set: |
![]() ![]() |
Definition: Patient.gender Value Set: AdministrativeGender |
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Value Set: |
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Value Set: |
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Definition: Patient.address.line Value Set: |
![]() ![]() |
Definition: Patient.address.postalCode Value Set: |
![]() ![]() |
Definition: Patient.extension:ethnicCategory Value Set: Ethnicity |
![]() ![]() |
Definition: Patient.identifier:nhsNumber Value Set: |
![]() ![]() |
Definition: Patient.identifier:MedicalRecordNumber Value Set: |
![]() |
Definition: PractitionerRole Value Set: |
![]() ![]() |
Definition: PractitionerRole.practitioner.display Value Set: |
![]() ![]() |
Definition: PractitionerRole.organization.identifier.value Value Set: |
![]() ![]() |
Definition: PractitionerRole.specialty.coding.code Value Set: UK Core Practice Setting Code |
![]() ![]() ![]() |
Value Set: |
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Definition: PractitionerRole.telecom.value Value Set: |
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Value Set: |
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Value Set: |
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Value Set: |
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Definition: ServiceRequest.reasonCode Value Set: Options: 4 options |
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Value Set: |
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Definition: ServiceRequest.note Value Set: |
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Definition: ServiceRequest.basedOn Value Set: |
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Value Set: |
![]() ![]() |
Definition: PractitionerRole.specialty.coding.code Value Set: |
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Definition: ServiceRequest.note Value Set: |
Documentation for this format | |
Try this questionnaire out:
There are currently no QuestionnaireResponse instances for this Questionnaire defined in this IG.