Input Field Names
See Sheet Input Field.
Input Fields are Sheet Field Types where patients input information when filling out forms. Most fields are self-explanatory. Fields that need additional detail have a description noted. The available input fields vary by sheet type.
| Input Text Field Name | Description |
|---|---|
| notes | Available for:
|
| toothnum | Available for Consents. Input tooth number (e.g., extraction consent) |
| misc | Available for Consents, Patient Forms, Medical Histories, Lab Slips, Exam Sheets Input miscellaneous notes. |
| address | |
| address 2 | |
| Birthdate | Patient birthdate. Date format typically follows the format of where the practice is located (e.g., US vs Canada). |
| City | |
| Fname | |
| HmPhone | |
| ICEName | Available for Patient Forms and Medical Histories. Emergency contact name. |
| ICEPhone | Available for Patient Forms and Medical Histories. Emergency contact phone number. |
| ins1CarrierName | |
| ins1CarrierPhone | |
| ins1EmployerName | |
| ins1GroupName | |
| ins1GroupNum | |
| ins1SubscriberID | |
| ins1SubscriberNameF | |
| ins2CarrierName | |
| ins2CarrierPhone | |
| ins2EmployerName | |
| ins2GroupName | |
| ins2GroupNum | |
| ins2SubscriberID | |
| ins2SubscriberNameF | |
| LName | |
| MiddleI | |
| Preferred | Available for Patient Forms. Patient preferred name |
| referredFrom | Available for Patient Forms. Where patient was referred from. |
| SSN | |
| State | Requires two character state abbreviation (e.g., OR, WA, CA). Cannot be used in conjunction with StateNoAbbreviation on the same sheet. |
| StateNoValidation | Does not require two character state abbreviation. Cannot be used in conjunction with State on the same sheet. |
| WkPhone | |
| WirelessPhone | |
| wirelessCarrier | |
| Zip | |
| inputMed 1-20 | Available for Medical Histories. Input medications. Up to 20 allowed on a sheet. |
| labcase.Instructions | Available for Lab Slips. Input lab instructions. |
| Grade Level | Available for Exam Sheets. Input patient's grade in school. |
| Race/Ethnicity | Available for Exam Sheets. Input patient's race or ethnicity. |
| Urgency | Available for Exam Sheets. |
| Comments | Available for Exam Sheets. Input additional comments about patient's health. |