## On this page
A reply to an appointment request for a patient and/or practitioner(s), such as a confirmation or rejection.

## Elements

| Name         | Required | Type                                                                                               | Description                                                                                                                                                                                                                                                                                        |
|--------------|----------|----------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| identifier   |          | [Identifier](/content/docs/api/fhir/datatypes/identifier/index.html)[]                        | External Ids for this item  
Details  
This records identifiers associated with this appointment response concern that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate.                                                               |
| appointment  | ✓        | Reference<[Appointment](/content/docs/api/fhir/resources/appointment/index.html)>              | Appointment this response relates to  
Details  
Appointment that this response is replying to.                                                                                                                                                                                                 |
| start        |          | instant                                                                                            | Time from appointment, or requested new start time  
Details  
Date/Time that the appointment is to take place, or requested new start time.  
This may be either the same as the appointment request to confirm the details of the appointment, or alternately a new time to request a re-negotiation of the start time.  |
| end          |          | instant                                                                                            | Time from appointment, or requested new end time  
Details  
This may be either the same as the appointment request to confirm the details of the appointment, or alternately a new time to request a re-negotiation of the end time.                                                             |
| participantType |        | [CodeableConcept](/content/docs/api/fhir/datatypes/codeableconcept/index.html)[]             | Role of participant in the appointment  
Details  
Role of participant in the appointment.  
The role of the participant can be used to declare what the actor will be doing in the scope of the referenced appointment.  
If the actor is not specified, then it is expected that the actor will be filled in at a later stage of planning.  
This value SHALL be the same as specified on the referenced Appointment so that they can be matched, and subsequently updated.  |
| actor        |          | Reference<[Patient](/content/docs/api/fhir/resources/patient/index.html)<br> 
| [Practitioner](/content/docs/api/fhir/resources/practitioner/index.html)<br> 
| [PractitionerRole](/content/docs/api/fhir/resources/practitionerrole/index.html)<br> 
| [RelatedPerson](/content/docs/api/fhir/resources/relatedperson/index.html)<br> 
| [Device](/content/docs/api/fhir/resources/device/index.html)<br> 
| [HealthcareService](/content/docs/api/fhir/resources/healthcareservice/index.html)<br> 
| [Location](/content/docs/api/fhir/resources/location/index.html)> | Person, Location, HealthcareService, or Device  
Details  
A Person, Location, HealthcareService, or Device that is participating in the appointment.                                                                                                                                                |
| participantStatus | ✓    | code                                                                                              | accepted | declined | tentative | needs-action  
Details  
Participation status of the participant. When the status is declined or tentative if the start/end times are different to the appointment, then these times should be interpreted as a requested time change. When the status is accepted, the times can either be the time of the appointment (as a confirmation of the time) or can be empty.  
This element is labeled as a modifier because the status contains the code entered-in-error that marks the participant as not currently valid. |
| comment      |          | string                                                                                             | Additional comments  
Details  
Additional comments about the appointment.  
This comment is particularly important when the responder is declining, tentatively accepting or requesting another time to indicate the reasons why.                                                                                  |

## Search Parameters

| Name         | Type     | Description                                                                                         | Expression                                                                                         |
|--------------|----------|-----------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------|
| actor        | reference | The Person, Location/HealthcareService or Device that this appointment response replies for       | AppointmentResponse.actor                                                                          |
| appointment  | reference | The appointment that the response is attached to                                                   | AppointmentResponse.appointment                                                                     |
| identifier   | token     | An Identifier in this appointment response                                                          | AppointmentResponse.identifier                                                                     |
| location     | reference | This Response is for this Location                                                                   | AppointmentResponse.actor.where((resolve() is Location))                                         |
| part-status  | token     | The participants acceptance status for this appointment                                              | AppointmentResponse.participantStatus                                                              |
| patient      | reference | This Response is for this Patient                                                                    | AppointmentResponse.actor.where((resolve() is Patient))                                          |
| practitioner  | reference | This Response is for this Practitioner                                                                | AppointmentResponse.actor.where((resolve() is Practitioner))                                      |

## Inherited Elements

| Name                | Required | Type                                                                                                 | Description                                                                                                                                                                                                               |
|---------------------|----------|------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| id                  |          | string                                                                                               | Logical id of this artifact  
Details  
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.  
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.                                 |
| meta                |          | [Meta](/content/docs/api/fhir/datatypes/meta/index.html)                                       | Metadata about the resource  
Details  
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.                                 |
| implicitRules       |          | uri                                                                                                  | A set of rules under which this content was created  
Details  
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.                 |
| language            |          | code                                                                                                 | Language of the resource content  
Details  
The base language in which the resource is written.  
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag).                         |
| text                |          | [Narrative](/content/docs/api/fhir/datatypes/narrative/index.html)                              | Text summary of the resource, for human interpretation  
Details  
A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human.                                                       |
| contained           |          | Resource[]                                                                                           | Contained, inline Resources  
Details  
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.                |
| extension           |          | [Extension](/content/docs/api/fhir/datatypes/extension/index.html)[]                           | Additional content defined by implementations  
Details  
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions.  |
| modifierExtension    |          | [Extension](/content/docs/api/fhir/datatypes/extension/index.html)[]                           | Extensions that cannot be ignored  
Details  
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants.  |

## Appointment Resources
[Appointment](/content/docs/api/fhir/resources/appointment/index.html) resources are used to provide information about a planned meeting that may be in the future or past. They may be for a single meeting or for a series of repeating visits. Examples include a scheduled surgery, a follow-up for a clinical visit, a scheduled conference call between clinicians to discuss a case, the reservation of a piece of diagnostic equipment for a particular use, etc. The visit scheduled by an appointment may be in person or remote (by phone, video conference, etc.) All that matters is that the time and usage of one or more individuals, locations and/or pieces of equipment is being fully or partially reserved for a designated period of time.

This definition takes the concepts of appointments in a clinical setting and also extends them to be relevant in the community healthcare space, and also ease exposure to other appointment/calendar standards widely used outside of Healthcare.

### The basic workflow to create an appointment
- **Making the [Appointment](/content/docs/api/fhir/resources/appointment/index.html) Request**  
When an appointment is required, a requester creates new [Appointment](/content/docs/api/fhir/resources/appointment/index.html) resource with the [Appointment](/content/docs/api/fhir/resources/appointment/index.html).status="proposed".
  
All included participants (optional or mandatory) should have the status="needs-action" to allow filtering and displaying appointments to user-participants for accepting or rejecting new and updated requests. Based on internal system business rules, certain statuses may be automatically updated, for example: "reject because the requested participant is on vacation" or "this type of user is not allowed to request those specific appointments".

- **Replying to the request**  
The reply process is simply performed by the person/system handing the requests updating the participant statuses as needed. If there are multiple systems involved, then these will create [AppointmentResponse](/content/docs/api/fhir/resources/appointmentresponse/index.html) entries with the desired statuses.

Once all participants have their participation status created/updated (and the main system marking the appointment participant records with the [AppointmentResponse](/content/docs/api/fhir/resources/appointmentresponse/index.html) statuses) then the overall status of the [Appointment](/content/docs/api/fhir/resources/appointment/index.html) is updated.