PATIENT MANAGEMENT PROGRAM
Patient First Name
Patient First and Last Names
Patient Flags
First Visit Date
Patient Middle Name
Last name followed by First
Last Payment Amount
Last Payment Date
Last Statement Date
Last Visit Date
Maiden Name
Birth Month and Day
MVA Accident date
MVA Claim Number
MVA Company Code
MVA Contact
MVA Phone Extension
MVA File/Policy Number
MVA Allowable amount of visits
MVA Phone number
MVA 1st Treatment Date
Number of Visits
Next Visit Date & Time
Next Visit Appt Status
Patient A/R type
Patient Category
Patient Number
Patient Type
Payment Type
Patient 2nd listed Phone #
Patient 2nd listed Extension #
Name of 2nd listed Phone #
Patient 3rd listed Phone #
Patient 3rd listed Extension
Name of 3rd listed Phone #
Patient 4th listed Phone #
Patient 4th listed Extension
Name of 3rd listed Phone #
Patient Home Phone #
Patient Postal Code
Province
Referred By
Referral Method
Send Statements To:
Social Insurance #
Patient Surname
WSIB 1st Treatment Date
%[First]
%[Fl]
%[Flag]
%[Fv_date]
%[Init]
%[Lf]
%[Lp_amt]
%[L-_date]
%[Ls_date]
%[Lv_date]
%[Maiden_Name]
%[Mmdd]
%MVA_AccDate]
%[MVA_ClaimNo]
%[MVA_Code]
%[MVA_Contact]
%[MVA_Ext]
%[MVA_FileNo]
%[MVA_NoVisits]
%[MVA_Phone]
%[MVA_TreatDate]
%[No_visit]
%[Nv_datetime]
%Nv_status]
%[OnAR]
%[Pat_cat]
%[Pat_no]
%[Patient_type]
%[Pay_type]
%[Phone_2]
%[Phone_2ext]
%[Phone_2lab]
%[Phone_3]
%[Phone_3ext]
%[Phone_3lab]
%[Phone_4]
%[Phone_4ext]
%[Phone_4lab]
%[Phone_home]
%[Post]
%[Province]
%[Ref_by]
%[Ref_method]
%[SendTo]
%[Sin_no]
%[Surname]
%[Tr_date]
100
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Reports