Patient Letters and Forms Merge Field Tags list - with commonly used fields highlighted - Manage [30 Sep21]

Patient Letters and Forms Merge Field Tags list - with commonly used fields highlighted - Manage [30 Sep21]

3FAHL Left: <<3FAHL Left>>
3FAHL Right: <<3FAHL Right>>
Clinic Name: <<Clinic Name>>
Company ADP: <<Company ADP>>
Company VAC: <<Company VAC>>
Company WSIB: <<Company WSIB>>
Contact Address 1: <<Contact Address 1>>
Contact Address 2: <<Contact Address 2>>
Contact Address 3: <<Contact Address 3>>
Contact City: <<Contact City>>
Contact Full Address: <<Contact Full Address>>
Contact Home Phone: <<Contact Home Phone>>
Contact Name: <<Contact Name>>
Contact Postal/Zip: <<Contact Postal/Zip>>
Contact Prov/State: <<Contact Prov/State>>
Contact Relation: <<Contact Relation>>
Contact Work Extension: <<Contact Work Extension>>
Contact Work Phone: <<Contact Work Phone>>
HA L Battery Size: <<HA L Battery Size>>
HA L Description: <<HA L Description>>
HA L Make and Model: <<HA L Make and Model>>
HA L Manufacturer: <<HA L Manufacturer>>
HA L Model: <<HA L Model>>
HA L Price: <<HA L Price>>
HA L Purchase Date: <<HA L Purchase Date>>
HA L Serial: <<HA L Serial>>
HA L Style: <<HA L Style>>
HA R Battery Size: <<HA R Battery Size>>
HA R Description: <<HA R Description>>
HA R Make and Model: <<HA R Make and Model>>
HA R Manufacturer: <<HA R Manufacturer>>
HA R Model: <<HA R Model>>
HA R Price: <<HA R Price>>
HA R Purchase Date: <<HA R Purchase Date>>
HA R Serial: <<HA R Serial>>
HA R Style: <<HA R Style>>
HA Report Battery Size: <<HA Report Battery Size>>
HA Report Description: <<HA Report Description>>
HA Report Make and Model: <<HA Report Make and Model>>
HA Report Manufacturer: <<HA Report Manufacturer>>
HA Report Model: <<HA Report Model>>
HA Report Price: <<HA Report Price>>
HA Report Purchase Date: <<HA Report Purchase Date>>
HA Report Serial: <<HA Report Serial>>
HA Report Style: <<HA Report Style>>
Ins Funding Address 1: <<Ins Funding Address 1>>
Ins Funding Address 2: <<Ins Funding Address 2>>
Ins Funding Address 3: <<Ins Funding Address 3>>
Ins Funding City: <<Ins Funding City>>
Ins Funding Postal/Zip: <<Ins Funding Postal/Zip>>
Ins Funding Source: <<Ins Funding Source>>
Ins Funding State/Prov: <<Ins Funding State/Prov>>
Last Appointment Date: <<Last Appointment Date>>
Last Appointment Time: <<Last Appointment Time>>
Location ACC Number: <<Location ACC Number>>
Location ADP: <<Location ADP>>
Location Address 1: <<Location Address 1>>
Location Address 2: <<Location Address 2>>
Location Address 3: <<Location Address 3>>
Location Address Full: <<Location Address Full>>
Location City: <<Location City>>
Location Email: <<Location Email>>
Location Fax: <<Location Fax>>
Location Formatted Address 1: <<Location Formatted Address 1>>
Location Formatted Address 2: <<Location Formatted Address 2>>
Location Formatted Address 3: <<Location Formatted Address 3>>
Location Name: <<Location Name>>
Location Name on Forms: <<Location Name on Forms>>
Location Postal/Zip: <<Location Postal/Zip>>
Location Prov/State: <<Location Prov/State>>
Location Site ID: <<Location Site ID>>
Location Tel: <<Location Tel>>
Location VAC: <<Location VAC>>
Location Vendor Number: <<Location Vendor Number>>
Location WSIB: <<Location WSIB>>
Medi Ref Phys Medi Number: <<Medi Ref Phys Medi Number>>
Medi Ref Phys Medi Prac: <<Medi Ref Phys Medi Prac>>
Medi Ref Phys Prac Addr1: <<Medi Ref Phys Prac Addr1>>
Medi Ref Phys Prac Addr2: <<Medi Ref Phys Prac Addr2>>
Medi Ref Phys Prac City: <<Medi Ref Phys Prac City>>
Medi Ref Phys Prac Email: <<Medi Ref Phys Prac Email>>
Medi Ref Phys Prac Phone: <<Medi Ref Phys Prac Phone>>
Medi Ref Phys Prac Postal: <<Medi Ref Phys Prac Postal>>
Medi Ref Phys Prac State: <<Medi Ref Phys Prac State>>
Medi Req Phys Medi Number: <<Medi Req Phys Medi Number>>
Medi Req Phys Medi Prac: <<Medi Req Phys Medi Prac>>
Medi Req Phys Prac Addr1: <<Medi Req Phys Prac Addr1>>
Medi Req Phys Prac Addr2: <<Medi Req Phys Prac Addr2>>
Medi Req Phys Prac City: <<Medi Req Phys Prac City>>
Medi Req Phys Prac Email: <<Medi Req Phys Prac Email>>
Medi Req Phys Prac Phone: <<Medi Req Phys Prac Phone>>
Medi Req Phys Prac Postal: <<Medi Req Phys Prac Postal>>
Medi Req Phys Prac State: <<Medi Req Phys Prac State>>
Medicare Expiry: <<Medicare Expiry>>
Medicare Number: <<Medicare Number>>
Medicare Position: <<Medicare Position>>
Medicare Ref Phys Addr1: <<Medicare Ref Phys Addr1>>
Medicare Ref Phys Addr2: <<Medicare Ref Phys Addr2>>
Medicare Ref Phys City: <<Medicare Ref Phys City>>
Medicare Ref Phys First: <<Medicare Ref Phys First>>
Medicare Ref Phys Full: <<Medicare Ref Phys Full>>
Medicare Ref Phys Last: <<Medicare Ref Phys Last>>
Medicare Ref Phys Postal: <<Medicare Ref Phys Postal>>
Medicare Ref Phys Practice: <<Medicare Ref Phys Practice>>
Medicare Ref Phys State: <<Medicare Ref Phys State>>
Medicare Ref Phys Title: <<Medicare Ref Phys Title>>
Medicare Referral End: <<Medicare Referral End>>
Medicare Referral Start: <<Medicare Referral Start>>
Medicare Referral Written: <<Medicare Referral Written>>
Medicare Referring Phys: <<Medicare Referring Phys>>
Medicare Req Phys Addr1: <<Medicare Req Phys Addr1>>
Medicare Req Phys Addr2: <<Medicare Req Phys Addr2>>
Medicare Req Phys City: <<Medicare Req Phys City>>
Medicare Req Phys First: <<Medicare Req Phys First>>
Medicare Req Phys Full: <<Medicare Req Phys Full>>
Medicare Req Phys Last: <<Medicare Req Phys Last>>
Medicare Req Phys Postal: <<Medicare Req Phys Postal>>
Medicare Req Phys Practice: <<Medicare Req Phys Practice>>
Medicare Req Phys State: <<Medicare Req Phys State>>
Medicare Req Phys Title: <<Medicare Req Phys Title>>
Medicare Requesting Phys: <<Medicare Requesting Phys>>
Medicare Requesting Spec: <<Medicare Requesting Spec>>
Next Appointment Date: <<Next Appointment Date>>
Next Appointment Time: <<Next Appointment Time>>
OHS Eligibility ID: <<OHS Eligibility ID>>
Patient ACC Number: <<Patient ACC Number>>
Patient Address 1: <<Patient Address 1>>
Patient Address 2: <<Patient Address 2>>
Patient Address 3: <<Patient Address 3>>
Patient Battery L: <<Patient Battery L>>
Patient Battery R: <<Patient Battery R>>
Patient Case Number: <<Patient Case Number>>
Patient City: <<Patient City>>
Patient DOB: <<Patient DOB>>
Patient DOB YYYY-MM-DD: <<Patient DOB YYYY-MM-DD>>
Patient DOB YYYY/MM/DD: <<Patient DOB YYYY/MM/DD>>
Patient Email: <<Patient Email>>
Patient Fax: <<Patient Fax>>
Patient First Name: <<Patient First Name>>
Patient Fitting Type: <<Patient Fitting Type>>
Patient Formatted Address 1: <<Patient Formatted Address 1>>
Patient Formatted Address 2: <<Patient Formatted Address 2>>
Patient Formatted Address 3: <<Patient Formatted Address 3>>
Patient Full Address: <<Patient Full Address>>
Patient Funding Number: <<Patient Funding Number>>
Patient Funding Source: <<Patient Funding Source>>
Patient Gender: <<Patient Gender>>
Patient Gender Description: <<Patient Gender Description>>
Patient HSP Number: <<Patient HSP Number>>
Patient Health Card Number: <<Patient Health Card Number>>
Patient Hearing Loss: <<Patient Hearing Loss>>
Patient Hearing Loss Left: <<Patient Hearing Loss Left>>
Patient Hearing Loss Right: <<Patient Hearing Loss Right>>
Patient Home Phone: <<Patient Home Phone>>
Patient Last Name: <<Patient Last Name>>
Patient Maintenance Expiry: <<Patient Maintenance Expiry>>
Patient Middle Initial: <<Patient Middle Initial>>
Patient Mobile Phone: <<Patient Mobile Phone>>
Patient NDIS Number: <<Patient NDIS Number>>
Patient NDIS Plan End: <<Patient NDIS Plan End>>
Patient NDIS Plan Start: <<Patient NDIS Plan Start>>
Patient Name First Last: <<Patient Name First Last>>
Patient Name Last First: <<Patient Name Last First>>
Patient Number: <<Patient Number>>
Patient OHS Number: <<Patient OHS Number>>
Patient Postal/Zip: <<Patient Postal/Zip>>
Patient Prov/State: <<Patient Prov/State>>
Patient Sec Funding Number: <<Patient Sec Funding Number>>
Patient Sec Funding Source: <<Patient Sec Funding Source>>
Patient Short Name: <<Patient Short Name>>
Patient Specialist: <<Patient Specialist>>
Patient Street Name: <<Patient Street Name>>
Patient Street Number: <<Patient Street Number>>
Patient Title: <<Patient Title>>
Patient User Defined 1: <<Patient User Defined 1>>
Patient User Defined 2: <<Patient User Defined 2>>
Patient User Defined 3: <<Patient User Defined 3>>
Patient User Defined 4: <<Patient User Defined 4>>
Patient User Defined 5: <<Patient User Defined 5>>
Patient User Defined 6: <<Patient User Defined 6>>
Patient Work Phone: <<Patient Work Phone>>
Patient Work Phone Extension: <<Patient Work Phone Extension>>
Physician Address 1: <<Physician Address 1>>
Physician Address 2: <<Physician Address 2>>
Physician Address 3: <<Physician Address 3>>
Physician Billing Number: <<Physician Billing Number>>
Physician City: <<Physician City>>
Physician Clinic Name: <<Physician Clinic Name>>
Physician First Name: <<Physician First Name>>
Physician Formatted Address 1: <<Physician Formatted Address 1>>
Physician Formatted Address 2: <<Physician Formatted Address 2>>
Physician Formatted Address 3: <<Physician Formatted Address 3>>
Physician Full Name: <<Physician Full Name>>
Physician Last Name: <<Physician Last Name>>
Physician Number: <<Physician Number>>
Physician Postal/Zip: <<Physician Postal/Zip>>
Physician Practice: <<Physician Practice>>
Physician Prov/State: <<Physician Prov/State>>
Physician Title: <<Physician Title>>
Pref Contact Address 1: <<Pref Contact Address 1>>
Pref Contact Address 2: <<Pref Contact Address 2>>
Pref Contact Address 3: <<Pref Contact Address 3>>
Pref Contact City: <<Pref Contact City>>
Pref Contact Name: <<Pref Contact Name>>
Pref Contact Postal/Zip: <<Pref Contact Postal/Zip>>
Pref Contact Prov/State: <<Pref Contact Prov/State>>
Primary Funding Address 1: <<Primary Funding Address 1>>
Primary Funding Address 2: <<Primary Funding Address 2>>
Primary Funding Address 3: <<Primary Funding Address 3>>
Primary Funding City: <<Primary Funding City>>
Primary Funding Number: <<Primary Funding Number>>
Primary Funding Postal/Zip: <<Primary Funding Postal/Zip>>
Primary Funding Source: <<Primary Funding Source>>
Primary Funding State/Prov: <<Primary Funding State/Prov>>
Sec Funding Address 1: <<Sec Funding Address 1>>
Sec Funding Address 2: <<Sec Funding Address 2>>
Sec Funding Address 3: <<Sec Funding Address 3>>
Sec Funding City: <<Sec Funding City>>
Sec Funding Number: <<Sec Funding Number>>
Sec Funding Postal/Zip: <<Sec Funding Postal/Zip>>
Sec Funding Source: <<Sec Funding Source>>
Sec Funding State/Prov: <<Sec Funding State/Prov>>
Specialist Email: <<Specialist Email>>
Specialist Name: <<Specialist Name>>
Specialist Number: <<Specialist Number>>
Specialist Phone: <<Specialist Phone>>
Todays Date: <<Todays Date>>
Todays Date YYYY-MM-DD: <<Todays Date YYYY-MM-DD>>
Todays Date YYYY/MM/DD: <<Todays Date YYYY/MM/DD>>
Todays Date YYYYMMDD: <<Todays Date YYYYMMDD>>

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