Referral Source Window

The Referral Source Window is used to add a new referral source that can be selected in the client’s admission.

Field	Description
Referral	Use this field to enter the title of the referrer.
TIN	Use this field to enter the referrer’s tax identification number.
Ref. Type	Use this drop down to select the type of reference.
Contact	Use this field to enter the name of a contact person if referring from an office.
Name	Use this field to enter the referrer’s name.
Address	Use this field to enter the referrer’s address.
Apt	Use this field to enter the referrer’s apartment number.
City	Use this field to enter the referrer’s city.
State	Use this field to enter the referrer’s state.
Zip	Use this field to enter the referrer’s zip code.
County	Use this field to enter the referrer’s county.
Type	Use this drop down to select the type of address.
Evacuation Zone	Use this drop down to select the referrer’s designated evacuation zone.
Home	Use this field to enter the referrer’s home phone number.
Mobile	Use this field to enter the referrer’s mobile phone number.
Work	Use this field to enter the referrer’s work phone number.
Fax	Use this field to enter the referrer’s fax number.
Email	Use this field to enter the referrer’s e-mail address.
Mobile	Select this checkbox to indicate if the referrer’s mobile number is their primary number.

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