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Patient Information Screen – Fields Of Information

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  • Last Name:
    • The patient’s Last Name.
  • First & Middle Name:
    • The Patient’s First and Middle names. Middle names are optional.
  • Preferred Name:
    • This is the name the patient prefers to go by. For example, if the patient’s first name is Daniel but they prefer to go by Dan, you would enter Daniel in the First & Middle name field and Dan in the Preferred name field.
  • SSN:
    • The patient’s Social Security Number.
  • Sex [F / M] & Title:
  • Date of Birth (Age):
    • The patient’s date of birth. The age field is not editable, but will automatically fill out based on the date of birth entered.
  • Referred by:
    • How was the patient referred to your office. This can be an individual or an entity (such as a website or ad/marketing campaign).
  • Family Head:
    • The patient’s family head.  By default, the patient will be their own family head, but a different family head can be assigned here.
  • Address 1:
    • The patient’s street address.
  • Address 2:
    • The patient’s additional address information (such as suite or apartment number).
  • City, State, Zip:
  • First Visit Date:
    • The first date that a treatment was completed on the patient’s Transaction Screen.
  • Last Visit Date:
    • The last date that a treatment was completed on the patient’s Transaction Screen.
  • Provider:
  • Phone (Home/Work):
    • The patient’s home and work phone numbers.
  • Mobile (Home/Work):
    • The patient’s home and work mobile (cell) numbers.
  • Email (Home):
    • The patient’s home email address.
  • Email (Work):
    • The patient’s work email address.
  • Pref. (Home/Work):
    • The patient’s preferred home and work contact information.
  • Emergency Contact:
    • The patient’s emergency contact information.
  • Medical Alert:
    • A list of the patient’s Medical Alerts.

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