104104-5
Mental Health Household Members panel
Active
103935-3 Are you in a committed relationship?
Fully-Specified Name
- Component
- Are you in a committed relationship
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
Are you in a committed relationship
Basic Attributes
- Class
- SURVEY.COVID
- Type
- Surveys
- First Released
- Version 2.77
- Last Updated
- Version 2.77 (ADD)
- Order vs. Observation
- Observation
Normative Answer List LL6496-5
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) | 1 | LA33-6 | |
| No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) | 2 | LA32-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 104104-5 | Mental Health Household Members panel |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
103936-1 If you selected 'Yes' in question 1, which household type do you live in?
Observation ID in Form
5.2
Fully-Specified Name
- Component
- Which household type do you live in
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
Which household type do you live in
Basic Attributes
- Class
- SURVEY.COVID
- Type
- Surveys
- First Released
- Version 2.77
- Last Updated
- Version 2.77 (ADD)
- Order vs. Observation
- Observation
Normative Answer List LL6388-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| the same household | 1 | LA33820-4 | |
| 2. in a different household | 2 | LA33821-2 | |
| 3. partly in the same household | 3 | LA33822-0 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 104104-5 | Mental Health Household Members panel |
103937-9 If you selected 'Yes' in question 1, what would you say how is the mental health of your partner?
Reference Information
Observation ID in Form
5.3
Fully-Specified Name
- Component
- What would you say how is the mental health of your partner is
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
What would you say how is the mental health of your partner is
Basic Attributes
- Class
- SURVEY.COVID
- Type
- Surveys
- First Released
- Version 2.77
- Last Updated
- Version 2.77 (ADD)
- Order vs. Observation
- Observation
Normative Answer List LL6389-2
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| 1 - Excellent | LA21636-8 | ||
| 2. very good | LA33824-6 | ||
| 3 - good | LA33825-3 | ||
| 4 - fair | LA33826-1 | ||
| 5 - poor | LA33827-9 | ||
| 6 - not applicable | LA33828-7 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 104104-5 | Mental Health Household Members panel |
103938-7 If you selected 'Yes' in question 1, what would you say is the quality of your partnership?
Observation ID in Form
5.4
Fully-Specified Name
- Component
- What would you say is the quality of your partnership
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
What would you say is the quality of your partnership
Basic Attributes
- Class
- SURVEY.COVID
- Type
- Surveys
- First Released
- Version 2.77
- Last Updated
- Version 2.77 (ADD)
- Order vs. Observation
- Observation
Normative Answer List LL6389-2
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| 1 - Excellent | LA21636-8 | ||
| 2. very good | LA33824-6 | ||
| 3 - good | LA33825-3 | ||
| 4 - fair | LA33826-1 | ||
| 5 - poor | LA33827-9 | ||
| 6 - not applicable | LA33828-7 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 104104-5 | Mental Health Household Members panel |
103939-5 Do you have underage persons in your household?
Fully-Specified Name
- Component
- Do you have underage persons in your household
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
Do you have underage persons in your household
Basic Attributes
- Class
- SURVEY.COVID
- Type
- Surveys
- First Released
- Version 2.77
- Last Updated
- Version 2.77 (ADD)
- Order vs. Observation
- Observation
Normative Answer List LL6496-5
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) | 1 | LA33-6 | |
| No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) | 2 | LA32-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 104104-5 | Mental Health Household Members panel |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
104078-1 If you selected 'Yes' in question 5, what is the number of underage persons?
Fully-Specified Name
- Component
- Number of underage persons in household
- Property
- Num
- Time
- Pt
- System
- ^Patient
- Scale
- Qn
- Method
Long Common Name
Number of underage persons in household
Basic Attributes
- Class
- SURVEY.COVID
- Type
- Surveys
- First Released
- Version 2.77
- Last Updated
- Version 2.78 (MIN)
- Order vs. Observation
- Observation
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 104084-9 | Children and work family balance panel |
| 104104-5 | Mental Health Household Members panel |
Example Units
| Unit | Source |
|---|---|
| {#} | Example UCUM Units |
103941-1 If you selected 'Yes' in question 5, for each underage person. What would you say how is the mental health of underage person?
Fully-Specified Name
- Component
- For each underage person what would you say how is the mental health of underage person
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
For each underage person what would you say how is the mental health of underage person
Basic Attributes
- Class
- SURVEY.COVID
- Type
- Surveys
- First Released
- Version 2.77
- Last Updated
- Version 2.77 (ADD)
- Order vs. Observation
- Observation
Normative Answer List LL6389-2
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| 1 - Excellent | LA21636-8 | ||
| 2. very good | LA33824-6 | ||
| 3 - good | LA33825-3 | ||
| 4 - fair | LA33826-1 | ||
| 5 - poor | LA33827-9 | ||
| 6 - not applicable | LA33828-7 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 104104-5 | Mental Health Household Members panel |
103942-9 Do you have comments?
Fully-Specified Name
- Component
- Mental health of household members comments
- Property
- Imp
- Time
- Pt
- System
- ^Patient
- Scale
- Nar
- Method
Long Common Name
Mental health of household members comments
Basic Attributes
- Class
- SURVEY.COVID
- Type
- Surveys
- First Released
- Version 2.77
- Last Updated
- Version 2.77 (ADD)
- Order vs. Observation
- Observation
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 104104-5 | Mental Health Household Members panel |