truForm & EDDSON Integration Fields

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Instructions below ONLY apply to truForm with EDDSON Integration.

This document includes ALL fields that integrate between TruForm and EDDSON. If your custom form is set up correctly, items listed below will populate within your software.

Note, if you have additional fields on your form that are NOT listed below, you can manually enter them into your patient's account once integration is completed!

If you use our standard form below, the sections listed below are already integrated!

• OMS STANDARD PBHS PATIENT REGISTRATION & HEALTH HISTORY

Integration Field Count: 15 total fields integrate!

PATIENT INFORMATION
*IF YOU ARE USING A CUSTOM FORM: Patient Name on the form must be split out into first name last name in order to integrate correctly.  [See Example]			*IF YOU ARE USING A CUSTOM FORM: Patient Address/ City/ State / Zip must be split out into its own fields in order to integrate correctly.   [See Example]
First Name Last name Middle Initial Nickname Gender Date of Birth Social Security Number Email Address Home Phone Cell Phone			Address Street Name Address Apt City State or Province  Zip or Postal Code