PatientAdministrationCustomBak

Primary key - Unique identifier for each patient administration custom backup record

Admission reference - Links to the patient admission/case (PatientAdministration.AdmitID)

Creation date - Date when the custom backup record was created

Created by user - UserID of the person who created the custom backup record

Update date - Date when the custom backup record was last modified

Updated by user - UserID of the person who last modified the custom backup record

Deletion date - Date when the custom backup record was soft-deleted

Call/fax date - Date when initial contact was made via call or fax

Referral source name - Name of the person or organization that made the referral

Referral source fax - Fax number of the referral source

Referral source phone - Phone number of the referral source

Relationship to child - Referral source’s relationship to the child

Organization affiliation - Organization that the referral source is affiliated with

Referral source address - Address of the referral source

How became aware - How the referral source became aware of early intervention services

Legal guardianship status - Information about legal guardianship arrangements

Child welfare social worker name - Name of the child welfare social worker if applicable

Legal guardian phone - Phone number of the legal guardian

Child welfare social worker phone - Phone number of the child welfare social worker

Child welfare social worker fax - Fax number of the child welfare social worker

Developmental areas of concern - Specific developmental areas where concerns have been identified

Medical areas of concern - Specific medical areas where concerns have been identified

Referral source diagnosis - Diagnosis provided by the referral source

Referral source ICD code - ICD diagnostic code provided by the referral source

Developmental and medical concerns - Detailed description of developmental and medical concerns

Screening completed - Information about screenings that have been completed

Agencies working with child - List of other agencies currently working with the child

Primary caregiver names - Names of the primary caregivers for the child

Referral source relationship to child - Specific relationship between referral source and child

Referral source city - City where the referral source is located

Referral source state - State where the referral source is located

Referral source zip code - Zip code where the referral source is located

Hours needed - Number of service hours needed per week or month

Left ear hearing screening - Boolean result of hearing screening for left ear

Right ear hearing screening - Boolean result of hearing screening for right ear