View source for Additional Referral Information

The following sets of fields are optional and chosen by selecting yes to each of the following questions:

* Family Doctor Information
* Legal Representation
* Employer Information
* Interpreter Required
* Transportation Required

===Family Doctor Fields===

The following fields are specific to the associated family doctor:

[[Image:Pms7.png]]

[[Image:Pms8.png]]

===Legal Representation Fields===

The following fields are specific to the associated legal representation of the claimant:

[[Image:Pms9.png]]

[[Image:Pms10.png]]

===Employee Information Fields===

The following fields are specific to the employment of the claimant:

[[Image:Pms11.png]]

[[Image:Pms12.png]]

===Claimant Special Needs===

The following fields describe any special needs that the claimant may have for interpreter or transportation:

[[Image:Pms13.png]]

===Languages===

The following languages are displayed in the language list:

* English
* Afrikaans
* Akan
* Albanian
* ASL
* Amharic
* Arabic
* Armenian
* Assyrian
* Ashanti
* Azerbaijani
* Bengali
* Bosnian
* Bulgarian
* Burmese
* Cambodian
* Cantonese
* Catalan
* Chinese
* Creole
* Croatian
* Czech
* Danish
* Dari
* Dinka
* Dutch
* Estonian
* Ewe
* Fanti
* Farsi
* Finnish
* Flemish
* Frafra
* French
* Fuchow
* Fukienese
* Ga
* German
* Greek
* Gujarati
* Hakka
* Hausa
* Hebrew
* Hindi
* Hungarian
* Ibo
* Ilocano
* Indonesian
* Italian
* Japanese
* Katchi
* Kermanji
* Korean
* Kurdish
* Kwa
* Lao
* Latin
* Latvian
* Lithuanian
* Macedonian
* Malay
* Malayalam
* Maltese
* Mandarin
* Marathi
* Norwegian
* Pilipino
* Persian
* Polish
* Portuguese
* Punjabi
* Pushtu
* Romanian
* Russian
* Serbian
* Shanghai
* Singhalese
* Slovak
* Slovenian
* Somali
* Spanish
* Swahili
* Swedish
* Tagalog
* Taiwanese
* Tamil
* Telugu
* Thai
* Tigrinya
* Toisan
* Turkish
* Twi
* Ukrainian
* Urdu
* Vietnamese
* Yiddish
* Yoruba
* Zulu

[[Image:Pms14.png]]


[[Category:System Management]][[Category:Practice Management]][[Category:Applications]]