{
  "type": "smart-health-checkin-response",
  "version": "1",
  "requestId": "sample-form-phq2",
  "artifacts": [
    {
      "id": "fhir-patient",
      "mediaType": "application/fhir+json",
      "fhirVersion": "4.0.1",
      "fulfills": [
        "patient"
      ],
      "value": {
        "resourceType": "Bundle",
        "type": "collection",
        "entry": [
          {
            "fullUrl": "urn:uuid:1e4be02a-300c-5ba6-8497-e81042d8d61f",
            "resource": {
              "resourceType": "Patient",
              "id": "1e4be02a-300c-5ba6-8497-e81042d8d61f",
              "meta": {
                "profile": [
                  "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient",
                  "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Patient"
                ],
                "lastUpdated": "2026-09-25T12:00:00Z"
              },
              "extension": [
                {
                  "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race",
                  "extension": [
                    {
                      "url": "ombCategory",
                      "valueCoding": {
                        "system": "urn:oid:2.16.840.1.113883.6.238",
                        "code": "2106-3",
                        "display": "White"
                      }
                    },
                    {
                      "url": "text",
                      "valueString": "White"
                    }
                  ]
                },
                {
                  "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity",
                  "extension": [
                    {
                      "url": "ombCategory",
                      "valueCoding": {
                        "system": "urn:oid:2.16.840.1.113883.6.238",
                        "code": "2186-5",
                        "display": "Not Hispanic or Latino"
                      }
                    },
                    {
                      "url": "text",
                      "valueString": "Not Hispanic or Latino"
                    }
                  ]
                }
              ],
              "identifier": [
                {
                  "system": "https://smart-health-checkin.org/connectathon/patient-id",
                  "value": "aria-test-1981"
                }
              ],
              "name": [
                {
                  "use": "official",
                  "family": "Test",
                  "given": [
                    "Aria"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "555-0100",
                  "use": "mobile"
                },
                {
                  "system": "email",
                  "value": "aria.test@example.org"
                }
              ],
              "gender": "female",
              "birthDate": "1981-04-12",
              "address": [
                {
                  "use": "home",
                  "line": [
                    "100 Example Street"
                  ],
                  "city": "Madison",
                  "state": "WI",
                  "postalCode": "53703",
                  "country": "US"
                }
              ],
              "communication": [
                {
                  "language": {
                    "coding": [
                      {
                        "system": "urn:ietf:bcp:47",
                        "code": "en",
                        "display": "English"
                      }
                    ]
                  }
                }
              ]
            }
          }
        ]
      }
    },
    {
      "id": "qr-phq2",
      "mediaType": "application/fhir+json",
      "fhirVersion": "4.0.1",
      "fulfills": [
        "phq2"
      ],
      "value": {
        "resourceType": "QuestionnaireResponse",
        "questionnaire": "https://smart-health-checkin.org/connectathon/Questionnaire/phq-2.json",
        "status": "completed",
        "subject": {
          "reference": "urn:uuid:1e4be02a-300c-5ba6-8497-e81042d8d61f"
        },
        "authored": "2026-10-01T15:00:00Z",
        "item": [
          {
            "linkId": "phq2-1",
            "text": "Little interest or pleasure in doing things",
            "answer": [
              {
                "valueCoding": {
                  "system": "http://loinc.org",
                  "code": "LA6569-3",
                  "display": "Several days"
                }
              }
            ]
          },
          {
            "linkId": "phq2-2",
            "text": "Feeling down, depressed, or hopeless",
            "answer": [
              {
                "valueCoding": {
                  "system": "http://loinc.org",
                  "code": "LA6569-3",
                  "display": "Several days"
                }
              }
            ]
          }
        ]
      }
    }
  ],
  "requestStatus": [
    {
      "item": "patient",
      "status": "fulfilled"
    },
    {
      "item": "phq2",
      "status": "fulfilled"
    }
  ]
}