Referrer Tab

Field/Option/Button

Description

(drop-down arrow button)

Select one of the following options to perform an action:

Case Definition - Opens the disease information in another browser tab or window and displays the Centers for Disease Control and Prevention (CDC) or other source, such as Red Book Online
Vaccination Records - Opens the patient vaccination record from the registry application (if it exists) in another browser tab or window. This option is available only for human cases. See View Vaccination Records
Print Investigation - Select this option to print a summary of the case information. See Print a Case Investigation
Print Case Report - Select this option to print the case report. This option is available only for human cases
Print Physician Card - Select this option to print the case details entered by the physician card user. This option is available when the case has been entered by a physician card user
Debug HL7 CDC Export - Opens a new browser tab or window to display the fields that are being sent to the CDC. This option is available when the disease of the opened investigation is exported using any other method than NETSS export (configured in CDC Export Mapping) and is displayed when the HL7 CDC Debug Export permission is granted in the Administrative Debug Permissions section. See Debug HL7 CDC Export
Debug Database for Patient - This option is visible when the Debug Mode permission is granted in the Administrative Debug Permissions section. It displays the database information about the patient. Contact STC to use this
Debug Database for Case - This option is visible when the Debug Mode permission is granted in the Administrative Debug Permissions section. It displays the database information about the case. Contact STC to use this

Field/Option	Description
Referrer's Name - Title	The name title of the person providing the report.
Referrer's Name - Last Name	The last name of the person providing the report.
Referrer's Name - First Name	The first name of the person providing the report.
Referrer's Facility
Facility Name	The facility name of the person providing the report. After selecting a facility from the drop-down list, the following fields in the Person Providing Report section are automatically populated: Type Public Health District Street State City Zip County/Borough
Type	The type of facility of the person providing the report. Examples: Clinics, ER, Hospital, HSP, or Laboratory. This field is automatically populated based on the facility selected in the Facility Name field. A facility can be of more than one type. This is a read-only field.
Public Health District	State-configurable option. This field is required for Mississippi. The public health district of the facility for the Person Providing Report section. This field is automatically populated based on the facility selected in the Facility Name field. This is a read-only field.
Phone	The referrer's phone number.
Ext	The referrer's extension number, if applicable.
Email	The referrer's email address.
Facility Address
Street	The street address of the reporting facility. This field is automatically populated based on the facility selected in the Facility Name field in the Referrer's Facility section. This is a read-only field.
State	The state of the reporting facility. This field is automatically populated based on the facility selected in the Facility Name field in the Referrer's Facility section. This is a read-only field.
City	The city of the reporting facility. This field is automatically populated based on the facility selected in the Facility Name field in the Referrer's Facility section. This is a read-only field.
Zip	The zip code of the reporting facility. This field is automatically populated based on the facility selected in the Facility Name field in the Referrer's Facility section. This is a read-only field.
County/Borough	The county/borough of the reporting facility. This field is automatically populated based on the facility selected in the Facility Name field in the Referrer's Facility section. This is a read-only field.

Field/Option

Description

Title

The name title of the primary or attending physician. Example: M.D.

Last Name

The last name of the primary or attending physician. Click in the field and type the first few letters of the physician's first or last name. When the pop-up list of physician names appears, select the last name of the physician from the list. After selecting the physician's name, the following fields are automatically populated:

Physician Facility Name
Phone
Ext
Email
Street 1
Street 2
State
City
Zip
County/Borough

First Name

The first name of the primary or attending physician. Click in the field and type the first few letters of the physician's first or last name. When the pop-up list of physician names appears, select the first name of the physician from the list. After selecting the physician's name, the following fields are automatically populated:

Physician Facility Name
Phone
Ext
Email
Street 1
Street 2
State
City
Zip
County/Borough

Physician Facility Name

The name of the facility the physician is associated with.

Phone

The phone number of the primary or attending physician.

Ext

The phone number extension of the primary or attending physician, if applicable.

Email

The email address of the primary or attending physician.

Facility Address

Street1

The first line of the primary or attending physician's address.

Street2

The second line of the primary or attending physician's address.

State

The state name of the primary or attending physician's address.

NOTE: If the state is changed, the City, Zip and County/Borough fields are cleared. If the state is not the customer’s state, the County/Borough is disabled. If County/Borough is changed, the City and Zip fields are cleared.

City

The city of the primary or attending physician's address. First, select a state, then type the first four letters of the City name and a pop-up list of city names and zip codes appears. Select the city name and zip from the list. The City, Zip, and County/Borough code fields are populated with the stored information.

NOTE: If the state is changed, the City, Zip and County/Borough fields are cleared. If the state is not the customer’s state, the County/Borough is disabled. If County/Borough is changed, the City and Zip fields are cleared.

Zip

The zip code of the primary or attending physician's address. This field is automatically populated by selecting the City field.

NOTE: If the state is changed, the City, Zip and County/Borough fields are cleared. If the state is not the customer’s state, the County/Borough is disabled. If County/Borough is changed, the City and Zip fields are cleared.

County/Borough

The county/borough of the primary or attending physician.

NOTE: If the state is changed, the City, Zip and County/Borough fields are cleared. If the state is not the customer’s state, the County/Borough is disabled. If County/Borough is changed, the City and Zip fields are cleared.

Field/Option	Description
First Letter
Letter Sent?	Select Yes or No to indicate whether the first letter was sent or not from the drop-down list.
Date Letter Sent	If Yes is selected in the Letter Sent field, click in field to enter the date when the first letter was sent or select it from the calendar pop-up. Today's date is the default date.
Print	Click this button to print the letter. The letter is opened in another browser window or tab. Click the Send to Printer button to print the letter.
Second Letter
Letter Sent?	Select Yes or No to indicate whether the second letter was sent or not from the drop-down list.
Date Letter Sent?	If Yes is selected in the Letter Sent field, click in field to enter the date when the second letter was sent or select it from the calendar pop-up. Today's date is the default date.
Print	Click this button to print the letter. The letter is opened in another browser window or tab. Click the Send to Printer button to print the letter.
First Call to Provider
Call Made?	Select Yes or No to indicate whether the first call was made or not from the drop-down list.
Date	If Yes is selected in the Call Made field, click in field to enter the date when the first call was made to the provider or select it from the calendar pop-up. Today's date is the default date.
Second Call to Provider
Call Made?	Select No or Yes from the drop-down list.
Date	If Yes is selected in the Call Made field, click in field to enter the date when the second call was made to the provider or select it from the calendar pop-up. Today's date is the default date.
Case Report Form
Received?	Select No or Yes from the drop-down list.
Date	If Yes is selected in the Received field, click in field to enter the date when the case report form was received or select it from the calendar pop-up. Today's date is the default date.