Intake Tab

The first tab in the Demoghraphics Form is the Intake Tab.

1. Intake

Type: It can be Intake or Patient.
Child/Adult: This selection will change the appearance of some forms throughout the program. For instance, the Parent/Guardian Tab will only display on Demographics if the patient is listed as a child.
Status: It can be Active or Discharged.
Intake By: It is a dropdown containing list of all active staff members. Select the name of the staff member entering the intake.
Initial Contact Method: Indicate whether the patient walked in or initiated contact by telephone or any other means.
Initial Contact Name: Name of the person who initiated the contact. You can rename this field through 'Custom Labels'.

2. Referral

Heard About Us From: Enter how the patient heard about your clinic. Can be configured at: Utilities -> Maintenance -> Heard About Us From.
Referral Source: It can be selected from the dropdown list, or entered manually. It can be through advertisement, existing patient, newspaper, psychologist, website and more.
Referred By: Enter the name of person referring patient to treatment.
Referral Phone and Email: Enter the phone number and email address of the referral.
Reason For Referral Reason for Referral (2) and (3): Here you can enter the various reasons for which the patient seeks treatment. It can be selected from the dropdown list or entered manually. Allowable values can be constrained by the “Restrict Entries: Referral Reason” option on the Preferences tab on the Options Screen.

3. Patient Group

Patient Group: This is where you can assign patients into separate groups for reporting purposes. The default group is named General.
Patient Group ID: If there is an identification number associated with this patient group, enter it here.
Additional Patient Groups: Here you can add any additional Patient Groups the patient belongs to. This is simply for recording purposes as the system is only interested in the Main Patient Group for reporting purposes.

4. Key Dates

Date Entered: Feed the date on which the demographic entry was made.
Date Packet Sent: If any information is sent via mail prior to service delivery, enter the date sent here.
Date Packet Returned: Enter the date the information is returned.
Date of Contact for Appointment: This is the date the patient is first contacted to schedule an appointment.
Date Of Intake Appointment: Date of the initial appointment.
Date Admitted: Enter the date on which intake is formally admitted to the clinic. Type should be switched from Intake to Patient. If not done, the system will prompt you to switch the Type to Patient.
Date Assigned To Follow-Up Clinician: Date on which a clinician is assigned to the case. Maybe same date as date first seen but not later.
Discharge Date: This will only be enabled if Active/Discharged is set to Discharged.
Discharged Sucessfully: Check this box if the client was discharged after successfully completing treatment.

5. Mental Health/Chemical Dependency

Mental Health: Check this box for a Mental Health patient.
Chemical Dependency: Check this box for Chemical Dependency patient.
No Compliance: Check this box to not create a compliance record. If this box is checked, the system will bypass rules for the module(s) marked as "No Compliance".
For example if a customer has MH and CD modules enabled, and only MH is marked as "No Compliance', the rules that are valid for CD will still be applied. Only the MH rules will be bypassed.
Primary: Choose primary treatment plan: Mental Health or Chemical Dependency.

6. Notes

7. Assignments

Intake Service: If your clinic offers different services for the patient's first visit, you can choose one from this dropdown. To set this list go to Utilities> Maintenance> Intake Service Input.
Intake Clinician: It is a list of names of active clinicians. Select the clinician that will complete the intake. This will be automatically set as the clinician on the Compliance record if Compliance Automation is set in the Options form and a follow-up clinician has not already been assigned.
Follow-up Clinician: Select the clinician assigned to the case after intake. This will be automatically set as the clinician on the Compliance record if Compliance Automation is set in the Options form.
Intake Disposition: It is a description of what happened with the intake (selected for a specific program, referred out, or any observations). To set this list go to Utilities> Maintenance> Disposition.
Primary POS (Primary Place of Service): It is where the patient will receive services by the clinician. To set this list go to Utilities> Maintenance> Building.
Diagnosis Type: Enter diagnosis type here as configured in: Utilities> Maintenance> Diagnosis Type Input.

8. Miscellaneous

Hospital ID: Enter the global chart number for the patient. This will display on paperwork output.
Additional ID: Enter any other identification number.
Family ID: Enter an identifier for the patient’s family. This will allow you to track related family members within your program. Once it is entered, click the icon to the right to display a list of all clients with the same Family ID.
Assigned Worker: Enter the caseworker name if applicable.

9. Basic Information

Other sections in the Intake tab are: