All fields marked with asterisk (star) * are required fields

a) Enter the Last Name and First name and Middle name of the new Patient in the relevant boxes.

b) Enter the address in the Addr1/Addr2 boxes.

c) Enter the Zip Code; the City, State and Country details will be updated automatically.

Contact Information

a) Enter the Home and Cell numbers, Work phone and Ext.

b) Enter a valid E-mail in the box provided.

Additional Information

a) Enter the DOB (Date of Birth) of the patient and choose the Gender Male/Female.

b) Enter the SSN of the patient.

c) Click in the Marital box and choose the marital status of the patient.

d) Click in the Pref. Language box and choose the Language from the list.

e) Similarly choose the Race and Ethnicity from the respective boxes. (This information is not compulsory.)

Status/Acc. Type

a) Click in the Employment box and choose the employment status from the list. Similarly choose the Student status from the list if required.

b) Click in the ACC Type box and choose the account type from the list.

Provider/PCP Information

a) Click in the Rendering Provider box and choose the name of the Rendering provider from the list. The Rendering Provider will automatically be added as the PCP/Ref. Physician in the box below.

b) If the PCP/Referring Physician is different but is from the same practice, click in the box to list all the providers and choose the PCP/Referring Physician from the list.

c) If the PCP/Referring Physician is not in the list, click on the button to search or add the PCP/Referring Physician. The buttons to search and add providers will be displayed as shown below.

c) Click on the search button to open the Provider Search screen. Type the name or part of the name of the provider and click the Search button. The providers having the given name will be listed as shown below.

d) Click on the required provider from the list. The providers name will be displayed in the PCP/Ref. Physician box.

e) If the provider does not appear in the list, you will have to add the provider. Click on the

button next to the PCP/Referring Physician box. (See How to add a PCP/Referring Physician)