It's not clear how the Patient Consent profile plays a role in the BSeR IG scoped workflows. While Patient Consent is listed in the Patient Profiles section in http://hl7.org/fhir/us/bser/2019May/CommonTransactionProfiles.html, the diagrams on the Exchange Transactions page (http://hl7.org/fhir/us/bser/2019May/ExchangeTransactions.html) seem to be out of scope (they aren't in orange). The neither Referral Request Supporting Bundle resource nor the Referral Request profile include Consent (which makes sense given that Consent points back to the Patient) so I'm not sure if a Consent resource should be part of the request bundle (it's not part of the sample bundle at http://hl7.org/fhir/us/bser/2019May/BSeRReferralRequestTransaction.html.

Please clarify if/how Consent information is exchanged.

If Consent is exchanged then a few changes to the profile may be in order:

-it seems like Consent.consentingParty should allow a reference to Patient as well as RelatedPerson for the case where the patient can consent for themselves (and avoid the need for a RelatedPerson resource with a relationship of ONESELF).

-If the Consent.actor.reference element is going to be constrained to a Practitioner resource, the valueset in Consent.actor.role should probably be likewise constrained to a value set containing only roles that a Practitioner could play (remove things like claimant, dependent, next of kin, etc)