Generated Narrative: Contract

status: executed

contentDerivative: Content Registration (Contract Content Derivation Codes#registration)

issued: 2013-11-01T21:18:27-04:00

applies: 2013-11-01T21:18:27-04:00 --> (ongoing)

subject: Patient/f201 "Roel"

type: Opt-in consent directive (consentdirective-type#OPTIN)

subType: Health Care Directive (Consent Category Codes#hcd)

term

Offers

-	Type	Decision	Text
*	Statutory (Contract Term Type Codes#statutory)	opt-in (ActCode#OPTIN)	Can't refuse

Assets

-	Period
*	2013-11-01T21:18:27-04:00 --> 2019-11-01T21:18:27-04:00

action

type: Action A (Contract Action Codes#action-a)

subject

reference: Organization/f001: VA Ann Arbor Healthcare System "Burgers University Medical Center"

role: Recipient of restricted health information (consent-actor-type#IR "Recipient")

subject

reference: Organization/2: Community Mental Health Clinic "XYZ Insurance"

role: Sender of restricted health information (consent-actor-type#IS "Sender")

intent: health program reporting (ActReason#HPRGRP)

status: Sample ()

signer

type: SELF (Details: http://mdhhs.org/fhir/consent-signer-type code SELF = 'SELF', stated as 'null')

party: Patient/f201: Alice Recruit "Roel"

Signatures

-	Type	When	Who
*	Author's Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.1 = 'Author's Signature', stated as 'null')	8 Feb 2017, 8:57:34 pm	Patient/f201 "Roel"

Legals