Patient Master

Add New Patient

First Name: *

Last Name: *

Date of Birth: *

Gender: * Select Gender Male Female Other

Patient ID/MRN: *

Phone Number: *

Email:

Preferred Language: * Select Language English Spanish French German Italian Portuguese Chinese Arabic Other

Insurance:

Secondary Phone Number:

Assigned Nurse: Select Nurse Sarah Johnson Emily Davis Michael Brown Jessica Wilson Amanda Miller

Caregiver Name:

Assigned Provider: Select Provider Dr. Michael Smith Dr. Lisa Anderson Dr. Robert Johnson Dr. Sarah Williams Dr. James Brown

Caregiver Phone Number:

Enrollment Date:

Status: Active Inactive Pending

Medical Conditions:

Address:

Care Program Enrollment

RPM (Remote Patient Monitoring)

CCM (Chronic Care Management)

BHI (Behavioral Health Integration)

RTM (Remote Therapeutic Monitoring)

APCM (Advanced Primary Care Management)

Add Patient Clear

Patient Management

Export to Excel

Name	DOB	MRN	Phone	Secondary Phone	Email	Language	Provider	Nurse	Caregiver	Caregiver Phone	Programs	Enrollment Date	Status	Actions
Smith, John	1965-03-15	MRN001	(555) 123-4567	(555) 123-4568	john.smith@email.com	English	Dr. Michael Smith	Sarah Johnson	Mary Smith	(555) 123-4569	RPM, CCM	2024-01-15	Active	Edit Inactive
Davis, Mary	1958-07-22	MRN002	(555) 234-5678	-	mary.davis@email.com	Spanish	Dr. Lisa Anderson	Emily Davis	-	-	RPM, BHI	2024-02-10	Active	Edit Inactive
Johnson, Robert	1972-11-08	MRN003	(555) 345-6789	(555) 345-6790	robert.johnson@email.com	English	Dr. Robert Johnson	Michael Brown	Linda Johnson	(555) 345-6791	CCM, RTM	2024-03-05	Active	Edit Inactive
Williams, Susan	1980-09-14	MRN004	(555) 456-7890	-	susan.williams@email.com	French	Dr. Sarah Williams	Jessica Wilson	Tom Williams	(555) 456-7891	RPM	2024-12-20	Pending	Edit Inactive
Brown, Michael	1953-01-30	MRN005	(555) 567-8901	(555) 567-8902	michael.brown@email.com	English	Dr. James Brown	Amanda Miller	Sarah Brown	(555) 567-8903	RPM, CCM, APCM	2024-11-12	Active	Edit Inactive