---
type: "example"
title: "Questionnaire Example: questionnaire-example-practitioner-info"
resource: "Questionnaire"
example: "questionnaire-example-practitioner-info"
---
# Questionnaire Example: questionnaire-example-practitioner-info

## Example XML



```xml
<?xml version="1.0" encoding="UTF-8"?>

<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="example-practitioner-info"/>
  <status value="draft"/>
  <item>
    <linkId value="core-props"/>
    <type value="group"/>
    <repeats value="false"/>
    <item>
      <linkId value="Practitioner.active"/>
      <definition value="http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.active"/>
      <text value="Active"/>
      <type value="boolean"/>
    </item>
    <item>
      <linkId value="Practitioner.gender"/>
      <definition value="http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.gender"/>
      <text value="Gender"/>
      <type value="coding"/>
    </item>
    <item>
      <linkId value="Practitioner.birthDate"/>
      <definition value="http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.birthDate"/>
      <text value="Birth Date"/>
      <type value="date"/>
    </item>
    <item>
      <linkId value="Practitioner.name.text"/>
      <definition value="http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.name.text"/>
      <text value="Name"/>
      <type value="string"/>
    </item>
    <item>
      <linkId value="Practitioner.address.line"/>
      <definition value="http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.address.line"/>
      <text value="Address"/>
      <type value="string"/>
      <repeats value="true"/>
    </item>
    <item>
      <linkId value="Practitioner.address.postalCode"/>
      <definition value="http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.address.postalCode"/>
      <text value="Post Code"/>
      <type value="string"/>
    </item>
  </item>
  <item>
    <linkId value="Practitioner.qualification"/>
    <definition value="http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.qualification"/>
    <text value="Qualifications"/>
    <type value="group"/>
    <repeats value="true"/>
    <item>
      <linkId value="Practitioner.qualification.code.coding.code"/>
      <definition value="http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.qualification.code.coding.code"/>
      <text value="Code"/>
      <type value="string"/>
    </item>
    <item>
      <linkId value="Practitioner.qualification.code.coding.display"/>
      <definition value="http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.qualification.code.coding.display"/>
      <text value="Display"/>
      <type value="string"/>
    </item>
    <item>
      <linkId value="Practitioner.qualification.period.end"/>
      <definition value="http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.qualification.period.end"/>
      <text value="Completion Year"/>
      <type value="dateTime"/>
    </item>
    <item>
      <linkId value="Practitioner.qualification.issuer.display"/>
      <definition value="http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.qualification.issuer.display"/>
      <text value="Issued by"/>
      <type value="string"/>
    </item>
  </item>
</Questionnaire>
```