diff --git a/packages/smart-forms-renderer/src/components/FormComponents/RepeatGroup/RepeatGroup.tsx b/packages/smart-forms-renderer/src/components/FormComponents/RepeatGroup/RepeatGroup.tsx
index 8f9c6358..51e248c2 100644
--- a/packages/smart-forms-renderer/src/components/FormComponents/RepeatGroup/RepeatGroup.tsx
+++ b/packages/smart-forms-renderer/src/components/FormComponents/RepeatGroup/RepeatGroup.tsx
@@ -24,11 +24,11 @@ import type {
 } from '../../../interfaces/renderProps.interface';
 import type { QuestionnaireItem, QuestionnaireResponseItem } from 'fhir/r4';
 import useInitialiseRepeatGroups from '../../../hooks/useInitialiseRepeatGroups';
-import { nanoid } from 'nanoid';
 import cloneDeep from 'lodash.clonedeep';
 import { useQuestionnaireStore } from '../../../stores';
 import useRepeatGroups from '../../../hooks/useRepeatGroups';
 import RepeatGroupView from './RepeatGroupView';
+import { generateNewRepeatId } from '../../../utils/repeatId';
 
 interface RepeatGroupProps
   extends PropsWithQrRepeatGroupChangeHandler,
@@ -104,7 +104,7 @@ function RepeatGroup(props: RepeatGroupProps) {
     setRepeatGroups([
       ...repeatGroups,
       {
-        nanoId: nanoid(),
+        nanoId: generateNewRepeatId(qItem.linkId),
         qrItem: null
       }
     ]);
diff --git a/packages/smart-forms-renderer/src/components/FormComponents/RepeatItem/RepeatItem.tsx b/packages/smart-forms-renderer/src/components/FormComponents/RepeatItem/RepeatItem.tsx
index 2ac434c6..d822ada8 100644
--- a/packages/smart-forms-renderer/src/components/FormComponents/RepeatItem/RepeatItem.tsx
+++ b/packages/smart-forms-renderer/src/components/FormComponents/RepeatItem/RepeatItem.tsx
@@ -22,7 +22,6 @@ import type {
   PropsWithShowMinimalViewAttribute
 } from '../../../interfaces/renderProps.interface';
 import type { QuestionnaireItem, QuestionnaireResponseItem } from 'fhir/r4';
-import { nanoid } from 'nanoid';
 import { createEmptyQrItem } from '../../../utils/qrItem';
 import { FullWidthFormComponentBox } from '../../Box.styles';
 import AddItemButton from './AddItemButton';
@@ -33,6 +32,7 @@ import useInitialiseRepeatAnswers from '../../../hooks/useInitialiseRepeatAnswer
 import ItemFieldGrid from '../ItemParts/ItemFieldGrid';
 import useReadOnly from '../../../hooks/useReadOnly';
 import { useQuestionnaireStore } from '../../../stores';
+import { generateExistingRepeatId, generateNewRepeatId } from '../../../utils/repeatId';
 
 interface RepeatItemProps
   extends PropsWithQrItemChangeHandler,
@@ -56,7 +56,7 @@ function RepeatItem(props: RepeatItemProps) {
 
   const readOnly = useReadOnly(qItem, parentIsReadOnly);
 
-  const repeatAnswers = useInitialiseRepeatAnswers(qrItem);
+  const repeatAnswers = useInitialiseRepeatAnswers(qItem.linkId, qrItem);
 
   // Event Handlers
   function handleAnswerChange(newQrItem: QuestionnaireResponseItem, index: number) {
@@ -81,7 +81,7 @@ function RepeatItem(props: RepeatItemProps) {
   }
 
   function handleAddItem() {
-    const updatedRepeatAnswers = [...repeatAnswers, { id: nanoid() }];
+    const updatedRepeatAnswers = [...repeatAnswers, { id: generateNewRepeatId(qItem.linkId) }];
 
     onQrItemChange({
       ...createEmptyQrItem(qItem, undefined),
@@ -100,7 +100,7 @@ function RepeatItem(props: RepeatItemProps) {
 
           return (
             <RepeatField
-              key={answer?.id ?? nanoid()}
+              key={answer?.id ?? generateExistingRepeatId(qItem.linkId, index)}
               qItem={qItem}
               qrItem={repeatAnswerQrItem}
               answer={answer}
@@ -131,7 +131,9 @@ function RepeatItem(props: RepeatItemProps) {
             }
 
             return (
-              <Collapse key={answer?.id ?? nanoid()} timeout={200}>
+              <Collapse
+                key={answer?.id ?? generateExistingRepeatId(qItem.linkId, index)}
+                timeout={200}>
                 <RepeatField
                   qItem={qItem}
                   qrItem={repeatAnswerQrItem}
diff --git a/packages/smart-forms-renderer/src/components/FormComponents/Tables/GroupTable.tsx b/packages/smart-forms-renderer/src/components/FormComponents/Tables/GroupTable.tsx
index 5b1d64ed..ef2657b3 100644
--- a/packages/smart-forms-renderer/src/components/FormComponents/Tables/GroupTable.tsx
+++ b/packages/smart-forms-renderer/src/components/FormComponents/Tables/GroupTable.tsx
@@ -25,13 +25,13 @@ import type {
   PropsWithQrRepeatGroupChangeHandler,
   PropsWithShowMinimalViewAttribute
 } from '../../../interfaces/renderProps.interface';
-import { nanoid } from 'nanoid';
 import useReadOnly from '../../../hooks/useReadOnly';
 import GroupTableView from './GroupTableView';
 import type { GroupTableRowModel } from '../../../interfaces/groupTable.interface';
 import { getGroupTableItemsToUpdate } from '../../../utils/groupTable';
 import useGroupTableRows from '../../../hooks/useGroupTableRows';
 import { flushSync } from 'react-dom';
+import { generateNewRepeatId } from '../../../utils/repeatId';
 
 interface GroupTableProps
   extends PropsWithQrRepeatGroupChangeHandler,
@@ -62,7 +62,10 @@ function GroupTable(props: GroupTableProps) {
 
   const readOnly = useReadOnly(qItem, parentIsReadOnly);
 
-  const { tableRows, selectedIds, setTableRows, setSelectedIds } = useGroupTableRows(qrItems);
+  const { tableRows, selectedIds, setTableRows, setSelectedIds } = useGroupTableRows(
+    qItem.linkId,
+    qrItems
+  );
 
   // Generate item labels as table headers
   const qItems = qItem.item;
@@ -114,7 +117,7 @@ function GroupTable(props: GroupTableProps) {
   }
 
   function handleAddRow() {
-    const newRowNanoId = nanoid();
+    const newRowNanoId = generateNewRepeatId(qItem.linkId);
     setTableRows([
       ...tableRows,
       {
diff --git a/packages/smart-forms-renderer/src/hooks/useGroupTableRows.ts b/packages/smart-forms-renderer/src/hooks/useGroupTableRows.ts
index 882540ab..e3ffc63a 100644
--- a/packages/smart-forms-renderer/src/hooks/useGroupTableRows.ts
+++ b/packages/smart-forms-renderer/src/hooks/useGroupTableRows.ts
@@ -19,8 +19,8 @@ import { useState } from 'react';
 import useInitialiseGroupTable from './useInitialiseGroupTable';
 import type { QuestionnaireResponseItem } from 'fhir/r4';
 
-function useGroupTableRows(qrItems: QuestionnaireResponseItem[]) {
-  const initialisedGroupTableRows = useInitialiseGroupTable(qrItems);
+function useGroupTableRows(linkId: string, qrItems: QuestionnaireResponseItem[]) {
+  const initialisedGroupTableRows = useInitialiseGroupTable(linkId, qrItems);
 
   const [tableRows, setTableRows] = useState(initialisedGroupTableRows);
   const [selectedIds, setSelectedIds] = useState<string[]>(
diff --git a/packages/smart-forms-renderer/src/hooks/useInitialiseGroupTable.ts b/packages/smart-forms-renderer/src/hooks/useInitialiseGroupTable.ts
index 05a61cc7..3936ecd6 100644
--- a/packages/smart-forms-renderer/src/hooks/useInitialiseGroupTable.ts
+++ b/packages/smart-forms-renderer/src/hooks/useInitialiseGroupTable.ts
@@ -16,21 +16,24 @@
  */
 
 import type { QuestionnaireResponseItem } from 'fhir/r4';
-import { nanoid } from 'nanoid';
 import type { GroupTableRowModel } from '../interfaces/groupTable.interface';
+import { generateExistingRepeatId, generateNewRepeatId } from '../utils/repeatId';
 
-function useInitialiseGroupTable(qrItems: QuestionnaireResponseItem[]): GroupTableRowModel[] {
+function useInitialiseGroupTable(
+  linkId: string,
+  qrItems: QuestionnaireResponseItem[]
+): GroupTableRowModel[] {
   let initialGroupTableRows: GroupTableRowModel[] = [
     {
-      nanoId: nanoid(),
+      nanoId: generateNewRepeatId(linkId),
       qrItem: null
     }
   ];
 
   if (qrItems.length > 0) {
-    initialGroupTableRows = qrItems.map((qrItem) => {
+    initialGroupTableRows = qrItems.map((qrItem, index) => {
       return {
-        nanoId: nanoid(),
+        nanoId: generateExistingRepeatId(linkId, index),
         qrItem
       };
     });
diff --git a/packages/smart-forms-renderer/src/hooks/useInitialiseRepeatAnswers.ts b/packages/smart-forms-renderer/src/hooks/useInitialiseRepeatAnswers.ts
index 37cdcbdb..933a335d 100644
--- a/packages/smart-forms-renderer/src/hooks/useInitialiseRepeatAnswers.ts
+++ b/packages/smart-forms-renderer/src/hooks/useInitialiseRepeatAnswers.ts
@@ -16,26 +16,23 @@
  */
 
 import type { QuestionnaireResponseItem, QuestionnaireResponseItemAnswer } from 'fhir/r4';
-import { nanoid } from 'nanoid';
 import { useMemo } from 'react';
+import { generateExistingRepeatId, generateNewRepeatId } from '../utils/repeatId';
 
 function useInitialiseRepeatAnswers(
+  linkId: string,
   qrItem: QuestionnaireResponseItem | null
 ): (QuestionnaireResponseItemAnswer | null)[] {
   return useMemo(() => {
-    let initialRepeatAnswers: (QuestionnaireResponseItemAnswer | null)[] = [{ id: nanoid() }];
-
-    if (qrItem?.answer) {
-      initialRepeatAnswers = qrItem.answer.map((answer) => {
-        if (!answer.id) {
-          answer.id = nanoid();
-        }
-        return answer;
-      });
+    if (!qrItem?.answer) {
+      return [{ id: generateNewRepeatId(linkId) }];
     }
 
-    return initialRepeatAnswers;
-  }, [qrItem]);
+    return qrItem.answer.map((answer, index) => ({
+      ...answer,
+      id: answer.id ?? generateExistingRepeatId(linkId, index)
+    }));
+  }, [linkId, qrItem]);
 }
 
 export default useInitialiseRepeatAnswers;
diff --git a/packages/smart-forms-renderer/src/hooks/useInitialiseRepeatGroups.ts b/packages/smart-forms-renderer/src/hooks/useInitialiseRepeatGroups.ts
index 0aa3d457..dec11307 100644
--- a/packages/smart-forms-renderer/src/hooks/useInitialiseRepeatGroups.ts
+++ b/packages/smart-forms-renderer/src/hooks/useInitialiseRepeatGroups.ts
@@ -16,9 +16,9 @@
  */
 
 import type { QuestionnaireItem, QuestionnaireResponseItem } from 'fhir/r4';
-import { nanoid } from 'nanoid';
 import type { RepeatGroupSingle } from '../interfaces/repeatGroup.interface';
 import { useMemo } from 'react';
+import { generateExistingRepeatId, generateNewRepeatId } from '../utils/repeatId';
 
 function useInitialiseRepeatGroups(
   qItem: QuestionnaireItem,
@@ -28,15 +28,15 @@ function useInitialiseRepeatGroups(
     () => {
       let initialRepeatGroupAnswers: RepeatGroupSingle[] = [
         {
-          nanoId: nanoid(),
+          nanoId: generateNewRepeatId(qItem.linkId),
           qrItem: null
         }
       ];
 
       if (qrItems.length > 0) {
-        initialRepeatGroupAnswers = qrItems.map((qrItem) => {
+        initialRepeatGroupAnswers = qrItems.map((qrItem, index) => {
           return {
-            nanoId: nanoid(),
+            nanoId: generateExistingRepeatId(qItem.linkId, index),
             qrItem
           };
         });
diff --git a/packages/smart-forms-renderer/src/utils/manageForm.ts b/packages/smart-forms-renderer/src/utils/manageForm.ts
index 52ee8b44..9a4d26b8 100644
--- a/packages/smart-forms-renderer/src/utils/manageForm.ts
+++ b/packages/smart-forms-renderer/src/utils/manageForm.ts
@@ -9,6 +9,7 @@ import { initialiseQuestionnaireResponse } from './initialise';
 import { removeEmptyAnswers } from './removeEmptyAnswers';
 import { readEncounter, readPatient, readUser } from '../api/smartClient';
 import type Client from 'fhirclient/lib/Client';
+import cloneDeep from 'lodash.clonedeep';
 
 /**
  * Build the form with an initial Questionnaire and an optional filled QuestionnaireResponse.
@@ -95,7 +96,7 @@ export async function initialiseFhirClient(fhirClient: Client): Promise<void> {
  * @author Sean Fong
  */
 export function getResponse(): QuestionnaireResponse {
-  return questionnaireResponseStore.getState().updatableResponse;
+  return cloneDeep(questionnaireResponseStore.getState().updatableResponse);
 }
 
 /**
diff --git a/packages/smart-forms-renderer/src/utils/repeatId.ts b/packages/smart-forms-renderer/src/utils/repeatId.ts
new file mode 100644
index 00000000..ff9e7c4b
--- /dev/null
+++ b/packages/smart-forms-renderer/src/utils/repeatId.ts
@@ -0,0 +1,27 @@
+/*
+ * Copyright 2024 Commonwealth Scientific and Industrial Research
+ * Organisation (CSIRO) ABN 41 687 119 230.
+ *
+ * Licensed under the Apache License, Version 2.0 (the "License");
+ * you may not use this file except in compliance with the License.
+ * You may obtain a copy of the License at
+ *
+ *     http://www.apache.org/licenses/LICENSE-2.0
+ *
+ * Unless required by applicable law or agreed to in writing, software
+ * distributed under the License is distributed on an "AS IS" BASIS,
+ * WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+ * See the License for the specific language governing permissions and
+ * limitations under the License.
+ */
+
+import { nanoid } from 'nanoid';
+
+export function generateNewRepeatId(linkId: string): string {
+  return `${linkId}-${nanoid()}`;
+}
+
+export function generateExistingRepeatId(linkId: string, index: number): string {
+  const paddedIndex = index.toString().padStart(6, '0');
+  return `${linkId}-${paddedIndex}`;
+}