---
type: "example"
title: "QuestionnaireResponse Example: questionnaireresponse-example-ussg-fht-answers"
resource: "QuestionnaireResponse"
example: "questionnaireresponse-example-ussg-fht-answers"
---
# QuestionnaireResponse Example: questionnaireresponse-example-ussg-fht-answers

## Example XML



```xml
<?xml version="1.0" encoding="UTF-8"?>
<QuestionnaireResponse xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ../../schema/fhir-single.xsd">
  <id value="ussg-fht-answers"/>
  <questionnaire value="http://hl7.org/fhir/Questionnaire/ussg-fht"/>
  <status value="in-progress"/>
  <subject>
    <reference value="http://hl7.org/fhir/Patient/proband"/>
    <type value="Patient"/>
  </subject>
  <authored value="2008-01-17"/>
  <item>
    <linkId value="0"/>
    <item>
      <linkId value="0.1"/>
      <text value="Date Done"/>
      <answer>
        <valueDate value="2008-01-17"/>
      </answer>
    </item>
  </item>
  <item>
    <linkId value="1"/>
    <definition value="http://loinc.org/fhir/DataElement/54126-8"/>
    <text value="Your health information"/>
    <item>
      <linkId value="1.1"/>
      <item>
        <linkId value="1.1.1"/>
        <definition value="http://loinc.org/fhir/DataElement/54125-0"/>
        <text value="Name"/>
        <answer>
          <valueString value="Annie Proband"/>
        </answer>
      </item>
      <item>
        <linkId value="1.1.2"/>
        <definition value="http://loinc.org/fhir/DataElement/54131-8"/>
        <text value="Gender"/>
        <answer>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA3-6"/>
            <display value="Female"/>
          </valueCoding>
        </answer>
      </item>
      <item>
        <linkId value="1.1.3"/>
        <definition value="http://loinc.org/fhir/DataElement/21112-8"/>
        <text value="Date of Birth"/>
        <answer>
          <valueDate value="1966-04-04"/>
        </answer>
      </item>
      <item>
        <linkId value="1.1.4"/>
        <definition value="http://loinc.org/fhir/DataElement/54132-6"/>
        <text value="Were you born a twin?"/>
        <answer>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA32-8"/>
            <display value="No"/>
          </valueCoding>
        </answer>
      </item>
      <item>
        <linkId value="1.1.5"/>
        <definition value="http://loinc.org/fhir/DataElement/54128-4"/>
        <text value="Were you adopted?"/>
        <answer>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA32-8"/>
            <display value="No"/>
          </valueCoding>
        </answer>
      </item>
      <item>
        <linkId value="1.1.6"/>
        <definition value="http://loinc.org/fhir/DataElement/54135-9"/>
        <text value="Are your parents related to each other in any way other than marriage?"/>
        <answer>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA32-8"/>
            <display value="No"/>
          </valueCoding>
        </answer>
      </item>
      <item>
        <linkId value="1.1.7"/>
        <definition value="http://loinc.org/fhir/DataElement/8302-2"/>
        <text value="Height"/>
        <answer>
          <valueDecimal value="63"/>
          <item>
            <linkId value="1.1.7.1"/>
            <item>
              <linkId value="1.1.7.1.1"/>
              <text value="Units"/>
              <answer>
                <valueCoding>
                  <system value="http://unitsofmeasure.org"/>
                  <code value="[in_i]"/>
                  <display value="inches"/>
                </valueCoding>
              </answer>
            </item>
          </item>
        </answer>
      </item>
      <item>
        <linkId value="1.1.8"/>
        <definition value="http://loinc.org/fhir/DataElement/29463-7"/>
        <text value="Weight"/>
        <answer>
          <valueDecimal value="127"/>
          <item>
            <linkId value="1.1.8.1"/>
            <item>
              <linkId value="1.1.8.1.1"/>
              <text value="Units"/>
              <answer>
                <valueCoding>
                  <system value="http://unitsofmeasure.org"/>
                  <code value="[lb_av]"/>
                  <display value="pounds"/>
                </valueCoding>
              </answer>
            </item>
          </item>
        </answer>
      </item>
      <item>
        <linkId value="1.1.9"/>
        <definition value="http://loinc.org/fhir/DataElement/39156-5"/>
        <text value="Body mass index (BMI) [Ratio]"/>
        <answer>
          <valueDecimal value="22.5"/>
        </answer>
      </item>
      <item>
        <linkId value="1.1.10"/>
        <definition value="http://loinc.org/fhir/DataElement/54134-2"/>
        <text value="Race"/>
        <answer>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA4457-3"/>
            <display value="White"/>
          </valueCoding>
        </answer>
      </item>
      <item>
        <linkId value="1.1.11"/>
        <definition value="http://loinc.org/fhir/DataElement/54133-4"/>
        <text value="Ethnicity"/>
        <answer>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA4611-5"/>
            <display value="Mexican"/>
          </valueCoding>
        </answer>
        <answer>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA10606-4"/>
            <display value="-- South American"/>
          </valueCoding>
        </answer>
      </item>
    </item>
  </item>
  <item>
    <linkId value="2"/>
    <definition value="http://loinc.org/fhir/DataElement/54114-4"/>
    <text value="Family member health information"/>
    <item>
      <linkId value="2.1"/>
<!-- see comment in questionnaire     <item>
        <linkId value="2.1.1"/> -->
        <item>
          <linkId value="2.1.1.1"/>
          <definition value="http://loinc.org/fhir/DataElement/54136-7"/>
          <text value="Relationship to you"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10405-1"/>
              <display value="Daughter"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.2"/>
          <definition value="http://loinc.org/fhir/DataElement/54138-3"/>
          <text value="Name"/>
          <answer>
            <valueString value="Susan"/>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.3"/>
          <definition value="http://loinc.org/fhir/DataElement/54123-5"/>
          <text value="Gender"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA3-6"/>
              <display value="Female"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.4"/>
          <definition value="http://loinc.org/fhir/DataElement/54139-1"/>
          <text value="Living?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA33-6"/>
              <display value="Yes"/>
            </valueCoding>
            <item>
              <linkId value="2.1.1.4.2"/>
              <item>
                <linkId value="2.1.1.4.2.2"/>
                <definition value="http://loinc.org/fhir/DataElement/54141-7"/>
                <text value="Age"/>
                <answer>
                  <valueDecimal value="17"/>
                </answer>
              </item>
            </item>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.5"/>
          <definition value="http://loinc.org/fhir/DataElement/54121-9"/>
          <text value="Was this person born a twin?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.6"/>
          <definition value="http://loinc.org/fhir/DataElement/54122-7"/>
          <text value="Was this person adopted?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
      <!-- </item> -->
    </item>
    <item>
      <linkId value="2.1"/>
      <item>
        <linkId value="2.1.1"/>
        <item>
          <linkId value="2.1.1.1"/>
          <definition value="http://loinc.org/fhir/DataElement/54136-7"/>
          <text value="Relationship to you"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10415-0"/>
              <display value="Brother"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.2"/>
          <definition value="http://loinc.org/fhir/DataElement/54138-3"/>
          <text value="Name"/>
          <answer>
            <valueString value="Brian"/>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.3"/>
          <definition value="http://loinc.org/fhir/DataElement/54123-5"/>
          <text value="Gender"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA2-8"/>
              <display value="Male"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.4"/>
          <definition value="http://loinc.org/fhir/DataElement/54139-1"/>
          <text value="Living?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA33-6"/>
              <display value="Yes"/>
            </valueCoding>
            <item>
              <linkId value="2.1.1.4.2"/>
              <item>
                <linkId value="2.1.1.4.2.2"/>
                <definition value="http://loinc.org/fhir/DataElement/54141-7"/>
                <text value="Age"/>
                <answer>
                  <valueDecimal value="32"/>
                </answer>
              </item>
            </item>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.5"/>
          <definition value="http://loinc.org/fhir/DataElement/54121-9"/>
          <text value="Was this person born a twin?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.6"/>
          <definition value="http://loinc.org/fhir/DataElement/54122-7"/>
          <text value="Was this person adopted?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
      </item>
      <item>
        <linkId value="2.1.2"/>
        <text value="This family member's history of disease"/>
        <item>
          <linkId value="2.1.2.1"/>
          <text value="Disease or Condition"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA14284-6"/>
              <display value="Other Cancer"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.2.2"/>
          <text value="Age at Diagnosis"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10397-0"/>
              <display value="30-39"/>
            </valueCoding>
          </answer>
        </item>
      </item>
    </item>
    <item>
      <linkId value="2.1"/>
      <item>
        <linkId value="2.1.1"/>
        <item>
          <linkId value="2.1.1.1"/>
          <definition value="http://loinc.org/fhir/DataElement/54136-7"/>
          <text value="Relationship to you"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10418-4"/>
              <display value="Sister"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.2"/>
          <definition value="http://loinc.org/fhir/DataElement/54138-3"/>
          <text value="Name"/>
          <answer>
            <valueString value="Janet"/>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.3"/>
          <definition value="http://loinc.org/fhir/DataElement/54123-5"/>
          <text value="Gender"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA3-6"/>
              <display value="Female"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.4"/>
          <definition value="http://loinc.org/fhir/DataElement/54139-1"/>
          <text value="Living?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA33-6"/>
              <display value="Yes"/>
            </valueCoding>
            <item>
              <linkId value="2.1.1.4.2"/>
              <item>
                <linkId value="2.1.1.4.2.2"/>
                <definition value="http://loinc.org/fhir/DataElement/54141-7"/>
                <text value="Age"/>
                <answer>
                  <valueDecimal value="36"/>
                </answer>
              </item>
            </item>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.5"/>
          <definition value="http://loinc.org/fhir/DataElement/54121-9"/>
          <text value="Was this person born a twin?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.6"/>
          <definition value="http://loinc.org/fhir/DataElement/54122-7"/>
          <text value="Was this person adopted?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
      </item>
      <item>
        <linkId value="2.1.2"/>
        <text value="This family member's history of disease"/>
        <item>
          <linkId value="2.1.2.1"/>
          <text value="Disease or Condition"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA14283-8"/>
              <display value="-- Breast Cancer"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.2.2"/>
          <text value="Age at Diagnosis"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10397-0"/>
              <display value="30-39"/>
            </valueCoding>
          </answer>
        </item>
      </item>
    </item>
    <item>
      <linkId value="2.1"/>
      <item>
        <linkId value="2.1.1"/>
        <item>
          <linkId value="2.1.1.1"/>
          <definition value="http://loinc.org/fhir/DataElement/54136-7"/>
          <text value="Relationship to you"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10419-2"/>
              <display value="Nephew"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.2"/>
          <definition value="http://loinc.org/fhir/DataElement/54138-3"/>
          <text value="Name"/>
          <answer>
            <valueString value="Ian"/>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.3"/>
          <definition value="http://loinc.org/fhir/DataElement/54123-5"/>
          <text value="Gender"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA2-8"/>
              <display value="Male"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.4"/>
          <definition value="http://loinc.org/fhir/DataElement/54139-1"/>
          <text value="Living?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA33-6"/>
              <display value="Yes"/>
            </valueCoding>
            <item>
              <linkId value="2.1.1.4.2"/>
              <item>
                <linkId value="2.1.1.4.2.2"/>
                <definition value="http://loinc.org/fhir/DataElement/54141-7"/>
                <text value="Age"/>
                <answer>
                  <valueDecimal value="16"/>
                </answer>
              </item>
            </item>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.5"/>
          <definition value="http://loinc.org/fhir/DataElement/54121-9"/>
          <text value="Was this person born a twin?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.6"/>
          <definition value="http://loinc.org/fhir/DataElement/54122-7"/>
          <text value="Was this person adopted?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
      </item>
    </item>
    <item>
      <linkId value="2.1"/>
      <item>
        <linkId value="2.1.1"/>
        <item>
          <linkId value="2.1.1.1"/>
          <definition value="http://loinc.org/fhir/DataElement/54136-7"/>
          <text value="Relationship to you"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10420-0"/>
              <display value="Niece"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.2"/>
          <definition value="http://loinc.org/fhir/DataElement/54138-3"/>
          <text value="Name"/>
          <answer>
            <valueString value="Helen"/>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.3"/>
          <definition value="http://loinc.org/fhir/DataElement/54123-5"/>
          <text value="Gender"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA3-6"/>
              <display value="Female"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.4"/>
          <definition value="http://loinc.org/fhir/DataElement/54139-1"/>
          <text value="Living?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA33-6"/>
              <display value="Yes"/>
            </valueCoding>
            <item>
              <linkId value="2.1.1.4.2"/>
              <item>
                <linkId value="2.1.1.4.2.2"/>
                <definition value="http://loinc.org/fhir/DataElement/54141-7"/>
                <text value="Age"/>
                <answer>
                  <valueDecimal value="15"/>
                </answer>
              </item>
            </item>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.5"/>
          <definition value="http://loinc.org/fhir/DataElement/54121-9"/>
          <text value="Was this person born a twin?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.6"/>
          <definition value="http://loinc.org/fhir/DataElement/54122-7"/>
          <text value="Was this person adopted?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
      </item>
    </item>
    <item>
      <linkId value="2.1"/>
      <item>
        <linkId value="2.1.1"/>
        <item>
          <linkId value="2.1.1.1"/>
          <definition value="http://loinc.org/fhir/DataElement/54136-7"/>
          <text value="Relationship to you"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10416-8"/>
              <display value="Father"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.2"/>
          <definition value="http://loinc.org/fhir/DataElement/54138-3"/>
          <text value="Name"/>
          <answer>
            <valueString value="Donald"/>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.3"/>
          <definition value="http://loinc.org/fhir/DataElement/54123-5"/>
          <text value="Gender"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA2-8"/>
              <display value="Male"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.4"/>
          <definition value="http://loinc.org/fhir/DataElement/54139-1"/>
          <text value="Living?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA33-6"/>
              <display value="Yes"/>
            </valueCoding>
            <item>
              <linkId value="2.1.1.4.2"/>
              <item>
                <linkId value="2.1.1.4.2.2"/>
                <definition value="http://loinc.org/fhir/DataElement/54141-7"/>
                <text value="Age"/>
                <answer>
                  <valueDecimal value="52"/>
                </answer>
              </item>
            </item>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.5"/>
          <definition value="http://loinc.org/fhir/DataElement/54121-9"/>
          <text value="Was this person born a twin?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.6"/>
          <definition value="http://loinc.org/fhir/DataElement/54122-7"/>
          <text value="Was this person adopted?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
      </item>
    </item>
    <item>
      <linkId value="2.1"/>
      <item>
        <linkId value="2.1.1"/>
        <item>
          <linkId value="2.1.1.1"/>
          <definition value="http://loinc.org/fhir/DataElement/54136-7"/>
          <text value="Relationship to you"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10425-9"/>
              <display value="Paternal Uncle"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.2"/>
          <definition value="http://loinc.org/fhir/DataElement/54138-3"/>
          <text value="Name"/>
          <answer>
            <valueString value="Eric"/>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.3"/>
          <definition value="http://loinc.org/fhir/DataElement/54123-5"/>
          <text value="Gender"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA2-8"/>
              <display value="Male"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.4"/>
          <definition value="http://loinc.org/fhir/DataElement/54139-1"/>
          <text value="Living?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA33-6"/>
              <display value="Yes"/>
            </valueCoding>
            <item>
              <linkId value="2.1.1.4.2"/>
              <item>
                <linkId value="2.1.1.4.2.2"/>
                <definition value="http://loinc.org/fhir/DataElement/54141-7"/>
                <text value="Age"/>
                <answer>
                  <valueDecimal value="56"/>
                </answer>
              </item>
            </item>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.5"/>
          <definition value="http://loinc.org/fhir/DataElement/54121-9"/>
          <text value="Was this person born a twin?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.6"/>
          <definition value="http://loinc.org/fhir/DataElement/54122-7"/>
          <text value="Was this person adopted?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
      </item>
    </item>
    <item>
      <linkId value="2.1"/>
      <item>
        <linkId value="2.1.1"/>
        <item>
          <linkId value="2.1.1.1"/>
          <definition value="http://loinc.org/fhir/DataElement/54136-7"/>
          <text value="Relationship to you"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10421-8"/>
              <display value="Paternal Aunt"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.2"/>
          <definition value="http://loinc.org/fhir/DataElement/54138-3"/>
          <text value="Name"/>
          <answer>
            <valueString value="Fiona"/>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.3"/>
          <definition value="http://loinc.org/fhir/DataElement/54123-5"/>
          <text value="Gender"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA3-6"/>
              <display value="Female"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.4"/>
          <definition value="http://loinc.org/fhir/DataElement/54139-1"/>
          <text value="Living?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA33-6"/>
              <display value="Yes"/>
            </valueCoding>
            <item>
              <linkId value="2.1.1.4.2"/>
              <item>
                <linkId value="2.1.1.4.2.2"/>
                <definition value="http://loinc.org/fhir/DataElement/54141-7"/>
                <text value="Age"/>
                <answer>
                  <valueDecimal value="57"/>
                </answer>
              </item>
            </item>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.5"/>
          <definition value="http://loinc.org/fhir/DataElement/54121-9"/>
          <text value="Was this person born a twin?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.6"/>
          <definition value="http://loinc.org/fhir/DataElement/54122-7"/>
          <text value="Was this person adopted?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
      </item>
      <item>
        <linkId value="2.1.2"/>
        <text value="This family member's history of disease"/>
        <item>
          <linkId value="2.1.2.1"/>
          <text value="Disease or Condition"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10543-9"/>
              <display value="-- Skin Cancer"/>
            </valueCoding>
          </answer>
        </item>
      </item>
    </item>
    <item>
      <linkId value="2.1"/>
      <item>
        <linkId value="2.1.1"/>
        <item>
          <linkId value="2.1.1.1"/>
          <definition value="http://loinc.org/fhir/DataElement/54136-7"/>
          <text value="Relationship to you"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10423-4"/>
              <display value="Paternal Grandfather"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.2"/>
          <definition value="http://loinc.org/fhir/DataElement/54138-3"/>
          <text value="Name"/>
          <answer>
            <valueString value="Bob"/>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.3"/>
          <definition value="http://loinc.org/fhir/DataElement/54123-5"/>
          <text value="Gender"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA2-8"/>
              <display value="Male"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.4"/>
          <definition value="http://loinc.org/fhir/DataElement/54139-1"/>
          <text value="Living?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
            <item>
              <linkId value="2.1.1.4.1"/>
              <item>
                <linkId value="2.1.1.4.1.1"/>
                <definition value="http://loinc.org/fhir/DataElement/54112-8"/>
                <text value="Cause of Death"/>
                <answer>
                  <valueCoding>
                    <system value="http://loinc.org"/>
                    <code value="LA10537-1"/>
                    <display value="-- Colon Cancer"/>
                  </valueCoding>
                </answer>
              </item>
              <item>
                <linkId value="2.1.1.4.1.2"/>
                <definition value="http://loinc.org/fhir/DataElement/54113-6"/>
                <text value="Age at Death"/>
                <answer>
                  <valueCoding>
                    <system value="http://loinc.org"/>
                    <code value="LA10400-2"/>
                    <display value="OVER 60"/>
                  </valueCoding>
                </answer>
              </item>
            </item>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.5"/>
          <definition value="http://loinc.org/fhir/DataElement/54121-9"/>
          <text value="Was this person born a twin?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.6"/>
          <definition value="http://loinc.org/fhir/DataElement/54122-7"/>
          <text value="Was this person adopted?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
      </item>
      <item>
        <linkId value="2.1.2"/>
        <text value="This family member's history of disease"/>
        <item>
          <linkId value="2.1.2.1"/>
          <text value="Disease or Condition"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10537-1"/>
              <display value="-- Colon Cancer"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.2.2"/>
          <text value="Age at Diagnosis"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10400-2"/>
              <display value="OVER 60"/>
            </valueCoding>
          </answer>
        </item>
      </item>
    </item>
    <item>
      <linkId value="2.1"/>
      <item>
        <linkId value="2.1.1"/>
        <item>
          <linkId value="2.1.1.1"/>
          <definition value="http://loinc.org/fhir/DataElement/54136-7"/>
          <text value="Relationship to you"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10424-2"/>
              <display value="Paternal Grandmother"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.2"/>
          <definition value="http://loinc.org/fhir/DataElement/54138-3"/>
          <text value="Name"/>
          <answer>
            <valueString value="Claire"/>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.3"/>
          <definition value="http://loinc.org/fhir/DataElement/54123-5"/>
          <text value="Gender"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA3-6"/>
              <display value="Female"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.4"/>
          <definition value="http://loinc.org/fhir/DataElement/54139-1"/>
          <text value="Living?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
            <item>
              <linkId value="2.1.1.4.1"/>
              <item>
                <linkId value="2.1.1.4.1.1"/>
                <definition value="http://loinc.org/fhir/DataElement/54112-8"/>
                <text value="Cause of Death"/>
                <answer>
                  <valueCoding>
                    <system value="http://loinc.org"/>
                    <code value="LA10589-2"/>
                    <display value="-- Other/Unexpected"/>
                  </valueCoding>
                  <item>
                    <linkId value="2.1.1.4.1.1.1"/>
                    <text value="Please specify"/>
                    <answer>
                      <valueString value="Lou Gehrigs"/>
                    </answer>
                  </item>
                </answer>
              </item>
              <item>
                <linkId value="2.1.1.4.1.2"/>
                <definition value="http://loinc.org/fhir/DataElement/54113-6"/>
                <text value="Age at Death"/>
                <answer>
                  <valueCoding>
                    <system value="http://loinc.org"/>
                    <code value="LA10400-2"/>
                    <display value="OVER 60"/>
                  </valueCoding>
                </answer>
              </item>
            </item>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.5"/>
          <definition value="http://loinc.org/fhir/DataElement/54121-9"/>
          <text value="Was this person born a twin?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.6"/>
          <definition value="http://loinc.org/fhir/DataElement/54122-7"/>
          <text value="Was this person adopted?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
      </item>
    </item>
    <item>
      <linkId value="2.1"/>
      <item>
        <linkId value="2.1.1"/>
        <item>
          <linkId value="2.1.1.1"/>
          <definition value="http://loinc.org/fhir/DataElement/54136-7"/>
          <text value="Relationship to you"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10417-6"/>
              <display value="Mother"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.2"/>
          <definition value="http://loinc.org/fhir/DataElement/54138-3"/>
          <text value="Name"/>
          <answer>
            <valueString value="Harriet"/>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.3"/>
          <definition value="http://loinc.org/fhir/DataElement/54123-5"/>
          <text value="Gender"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA3-6"/>
              <display value="Female"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.4"/>
          <definition value="http://loinc.org/fhir/DataElement/54139-1"/>
          <text value="Living?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
            <item>
              <linkId value="2.1.1.4.1"/>
              <item>
                <linkId value="2.1.1.4.1.1"/>
                <definition value="http://loinc.org/fhir/DataElement/54112-8"/>
                <text value="Cause of Death"/>
                <answer>
                  <valueCoding>
                    <system value="http://loinc.org"/>
                    <code value="LA15682-0"/>
                    <display value="-- Ovarian Cancer"/>
                  </valueCoding>
                </answer>
              </item>
              <item>
                <linkId value="2.1.1.4.1.2"/>
                <definition value="http://loinc.org/fhir/DataElement/54113-6"/>
                <text value="Age at Death"/>
                <answer>
                  <valueCoding>
                    <system value="http://loinc.org"/>
                    <code value="LA10399-6"/>
                    <display value="50-59"/>
                  </valueCoding>
                </answer>
              </item>
            </item>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.5"/>
          <definition value="http://loinc.org/fhir/DataElement/54121-9"/>
          <text value="Was this person born a twin?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.6"/>
          <definition value="http://loinc.org/fhir/DataElement/54122-7"/>
          <text value="Was this person adopted?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
      </item>
      <item>
        <linkId value="2.1.2"/>
        <text value="This family member's history of disease"/>
        <item>
          <linkId value="2.1.2.1"/>
          <text value="Disease or Condition"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA15682-0"/>
              <display value="-- Ovarian Cancer"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.2.2"/>
          <text value="Age at Diagnosis"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10398-8"/>
              <display value="40-49"/>
            </valueCoding>
          </answer>
        </item>
      </item>
    </item>
    <item>
      <linkId value="2.1"/>
      <item>
        <linkId value="2.1.1"/>
        <item>
          <linkId value="2.1.1.1"/>
          <definition value="http://loinc.org/fhir/DataElement/54136-7"/>
          <text value="Relationship to you"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10414-3"/>
              <display value="Maternal Uncle"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.2"/>
          <definition value="http://loinc.org/fhir/DataElement/54138-3"/>
          <text value="Name"/>
          <answer>
            <valueString value="Rudy"/>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.3"/>
          <definition value="http://loinc.org/fhir/DataElement/54123-5"/>
          <text value="Gender"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA2-8"/>
              <display value="Male"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.4"/>
          <definition value="http://loinc.org/fhir/DataElement/54139-1"/>
          <text value="Living?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA33-6"/>
              <display value="Yes"/>
            </valueCoding>
            <item>
              <linkId value="2.1.1.4.2"/>
              <item>
                <linkId value="2.1.1.4.2.2"/>
                <definition value="http://loinc.org/fhir/DataElement/54141-7"/>
                <text value="Age"/>
                <answer>
                  <valueDecimal value="60"/>
                </answer>
              </item>
            </item>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.5"/>
          <definition value="http://loinc.org/fhir/DataElement/54121-9"/>
          <text value="Was this person born a twin?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.6"/>
          <definition value="http://loinc.org/fhir/DataElement/54122-7"/>
          <text value="Was this person adopted?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
      </item>
    </item>
    <item>
      <linkId value="2.1"/>
      <item>
        <linkId value="2.1.1"/>
        <item>
          <linkId value="2.1.1.1"/>
          <definition value="http://loinc.org/fhir/DataElement/54136-7"/>
          <text value="Relationship to you"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10410-1"/>
              <display value="Maternal Aunt"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.2"/>
          <definition value="http://loinc.org/fhir/DataElement/54138-3"/>
          <text value="Name"/>
          <answer>
            <valueString value="Julie"/>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.3"/>
          <definition value="http://loinc.org/fhir/DataElement/54123-5"/>
          <text value="Gender"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA3-6"/>
              <display value="Female"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.4"/>
          <definition value="http://loinc.org/fhir/DataElement/54139-1"/>
          <text value="Living?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA33-6"/>
              <display value="Yes"/>
            </valueCoding>
            <item>
              <linkId value="2.1.1.4.2"/>
              <item>
                <linkId value="2.1.1.4.2.2"/>
                <definition value="http://loinc.org/fhir/DataElement/54141-7"/>
                <text value="Age"/>
                <answer>
                  <valueDecimal value="57"/>
                </answer>
              </item>
            </item>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.5"/>
          <definition value="http://loinc.org/fhir/DataElement/54121-9"/>
          <text value="Was this person born a twin?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.6"/>
          <definition value="http://loinc.org/fhir/DataElement/54122-7"/>
          <text value="Was this person adopted?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
      </item>
    </item>
    <item>
      <linkId value="2.1"/>
      <item>
        <linkId value="2.1.1"/>
        <item>
          <linkId value="2.1.1.1"/>
          <definition value="http://loinc.org/fhir/DataElement/54136-7"/>
          <text value="Relationship to you"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10412-7"/>
              <display value="Maternal Grandfather"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.2"/>
          <definition value="http://loinc.org/fhir/DataElement/54138-3"/>
          <text value="Name"/>
          <answer>
            <valueString value="Ian"/>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.3"/>
          <definition value="http://loinc.org/fhir/DataElement/54123-5"/>
          <text value="Gender"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA2-8"/>
              <display value="Male"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.4"/>
          <definition value="http://loinc.org/fhir/DataElement/54139-1"/>
          <text value="Living?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
            <item>
              <linkId value="2.1.1.4.1"/>
              <item>
                <linkId value="2.1.1.4.1.1"/>
                <definition value="http://loinc.org/fhir/DataElement/54112-8"/>
                <text value="Cause of Death"/>
                <answer>
                  <valueCoding>
                    <system value="http://loinc.org"/>
                    <code value="LA16286-9"/>
                    <display value="-- Heart Attack"/>
                  </valueCoding>
                </answer>
              </item>
              <item>
                <linkId value="2.1.1.4.1.2"/>
                <definition value="http://loinc.org/fhir/DataElement/54113-6"/>
                <text value="Age at Death"/>
                <answer>
                  <valueCoding>
                    <system value="http://loinc.org"/>
                    <code value="LA10400-2"/>
                    <display value="OVER 60"/>
                  </valueCoding>
                </answer>
              </item>
            </item>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.5"/>
          <definition value="http://loinc.org/fhir/DataElement/54121-9"/>
          <text value="Was this person born a twin?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.6"/>
          <definition value="http://loinc.org/fhir/DataElement/54122-7"/>
          <text value="Was this person adopted?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
      </item>
    </item>
    <item>
      <linkId value="2.1"/>
      <item>
        <linkId value="2.1.1"/>
        <item>
          <linkId value="2.1.1.1"/>
          <definition value="http://loinc.org/fhir/DataElement/54136-7"/>
          <text value="Relationship to you"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10413-5"/>
              <display value="Maternal Grandmother"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.2"/>
          <definition value="http://loinc.org/fhir/DataElement/54138-3"/>
          <text value="Name"/>
          <answer>
            <valueString value="Gladys"/>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.3"/>
          <definition value="http://loinc.org/fhir/DataElement/54123-5"/>
          <text value="Gender"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA3-6"/>
              <display value="Female"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.4"/>
          <definition value="http://loinc.org/fhir/DataElement/54139-1"/>
          <text value="Living?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
            <item>
              <linkId value="2.1.1.4.1"/>
              <item>
                <linkId value="2.1.1.4.1.1"/>
                <definition value="http://loinc.org/fhir/DataElement/54112-8"/>
                <text value="Cause of Death"/>
                <answer>
                  <valueCoding>
                    <system value="http://loinc.org"/>
                    <code value="LA19526-5"/>
                    <display value="-- Other/Unknown"/>
                  </valueCoding>
                </answer>
              </item>
              <item>
                <linkId value="2.1.1.4.1.2"/>
                <definition value="http://loinc.org/fhir/DataElement/54113-6"/>
                <text value="Age at Death"/>
                <answer>
                  <valueCoding>
                    <system value="http://loinc.org"/>
                    <code value="LA10400-2"/>
                    <display value="OVER 60"/>
                  </valueCoding>
                </answer>
              </item>
            </item>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.5"/>
          <definition value="http://loinc.org/fhir/DataElement/54121-9"/>
          <text value="Was this person born a twin?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.6"/>
          <definition value="http://loinc.org/fhir/DataElement/54122-7"/>
          <text value="Was this person adopted?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
      </item>
      <item>
        <linkId value="2.1.2"/>
        <text value="This family member's history of disease"/>
        <item>
          <linkId value="2.1.2.1"/>
          <text value="Disease or Condition"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA14283-8"/>
              <display value="-- Breast Cancer"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.2.2"/>
          <text value="Age at Diagnosis"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10399-6"/>
              <display value="50-59"/>
            </valueCoding>
          </answer>
        </item>
      </item>
      <item>
        <linkId value="2.1.2"/>
        <text value="This family member's history of disease"/>
        <item>
          <linkId value="2.1.2.1"/>
          <text value="Disease or Condition"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA16982-3"/>
              <display value="-- Asthma"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.2.2"/>
          <text value="Age at Diagnosis"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10395-4"/>
              <display value="Childhood"/>
            </valueCoding>
          </answer>
        </item>
      </item>
    </item>
    <item>
      <linkId value="2.1"/>
      <item>
        <linkId value="2.1.1"/>
        <item>
          <linkId value="2.1.1.1"/>
          <definition value="http://loinc.org/fhir/DataElement/54136-7"/>
          <text value="Relationship to you"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10411-9"/>
              <display value="Maternal Cousin"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.2"/>
          <definition value="http://loinc.org/fhir/DataElement/54138-3"/>
          <text value="Name"/>
          <answer>
            <valueString value="Karren"/>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.3"/>
          <definition value="http://loinc.org/fhir/DataElement/54123-5"/>
          <text value="Gender"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA3-6"/>
              <display value="Female"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.4"/>
          <definition value="http://loinc.org/fhir/DataElement/54139-1"/>
          <text value="Living?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA33-6"/>
              <display value="Yes"/>
            </valueCoding>
            <item>
              <linkId value="2.1.1.4.2"/>
              <item>
                <linkId value="2.1.1.4.2.2"/>
                <definition value="http://loinc.org/fhir/DataElement/54141-7"/>
                <text value="Age"/>
                <answer>
                  <valueDecimal value="30"/>
                </answer>
              </item>
            </item>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.5"/>
          <definition value="http://loinc.org/fhir/DataElement/54121-9"/>
          <text value="Was this person born a twin?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.6"/>
          <definition value="http://loinc.org/fhir/DataElement/54122-7"/>
          <text value="Was this person adopted?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
      </item>
      <item>
        <linkId value="2.1.2"/>
        <text value="This family member's history of disease"/>
        <item>
          <linkId value="2.1.2.1"/>
          <text value="Disease or Condition"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA14283-8"/>
              <display value="-- Breast Cancer"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.2.2"/>
          <text value="Age at Diagnosis"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10397-0"/>
              <display value="30-39"/>
            </valueCoding>
          </answer>
        </item>
      </item>
    </item>
    <item>
      <linkId value="2.1"/>
      <item>
        <linkId value="2.1.1"/>
        <item>
          <linkId value="2.1.1.1"/>
          <definition value="http://loinc.org/fhir/DataElement/54136-7"/>
          <text value="Relationship to you"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10411-9"/>
              <display value="Maternal Cousin"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.2"/>
          <definition value="http://loinc.org/fhir/DataElement/54138-3"/>
          <text value="Name"/>
          <answer>
            <valueString value="Mary"/>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.3"/>
          <definition value="http://loinc.org/fhir/DataElement/54123-5"/>
          <text value="Gender"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA3-6"/>
              <display value="Female"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.4"/>
          <definition value="http://loinc.org/fhir/DataElement/54139-1"/>
          <text value="Living?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA33-6"/>
              <display value="Yes"/>
            </valueCoding>
            <item>
              <linkId value="2.1.1.4.2"/>
              <item>
                <linkId value="2.1.1.4.2.2"/>
                <definition value="http://loinc.org/fhir/DataElement/54141-7"/>
                <text value="Age"/>
                <answer>
                  <valueDecimal value="31"/>
                </answer>
              </item>
            </item>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.5"/>
          <definition value="http://loinc.org/fhir/DataElement/54121-9"/>
          <text value="Was this person born a twin?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="2.1.1.6"/>
          <definition value="http://loinc.org/fhir/DataElement/54122-7"/>
          <text value="Was this person adopted?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </item>
      </item>
    </item>
  </item>
</QuestionnaireResponse>
```