Sign-In "The Phoenix" PATIENT SIGN-IN Today's Date Indicate who is filling out this Sign-In Link? Cindy Liz Kelsy Rylie Tom Pam CARE Indicate Patient Location Below? (Client Entity) 3 Links Tower7th Street TreatmentAll AbilitiesAll AbilitiesAperture Testing LabAthertonBaylors HouseBeecon RecoveryBonnevilleBristol VillageBristol Village Building "A"Brooke MunsonBud BaileyCannon Heights Adult Learning CenterCapital VillaCatholic Community Center St. Vincent Dining HallCBC CLINICCentral City ApartmentsCentral Utah Veterans Home - PaysonCHRISTMAS BOX HOUSECOUNTY HIGH RISEDADiamond RecoveryDominguez ParkEagle View TownhomesEscalanteFairpark ApartmentsFellowship ManorFirst Step House GrantFortitude CorrectionalFreedom LandingFriendship ManorGail Miller Resource CenterGAIL MILLER RESOURCE CENTERGERALDINE E. KINGGlendale Senior HousingHamilton PlaceHarmony GardensHaven Men's DowntownHolding Out HelpHolding Out Help/Holly's HomeHomeless Resource FairsHouse Of HopeHousing AuthorityHousing ConnectHurricane Hills Town HomesIncline at AnthemINDIVIDUAL SCHEDULEIOOF TowerJerald MerrillJourney Treatment CenterJOURNEY TREATMENT CENTER/BAYLORKelly BensonKelly Benson ApartmentsKOERNER INSTITUTELegacy House TaylorsvilleLIBERTY RECOVERY RESIDENTIALLiberty Recovery- WEST JORDANLIBERTY WELLS SENIOR CENTERLincoln TowersLowell ApartmentsMartha's TerraceMicro ShelterMulti-Ethnic Sr CitzenMVPMVPNorthern Utah Community Correctional CenterNUCCOdyssey House Fact TeamODYSSEY HOUSE FACT TEAMOdyssey House IntakeOdyssey House LighthouseOdyssey House Men's In HouseOrange Street CorrectionsPalmer CourtPamela Atkinson Resource CenterParkway CommonsPhillips Plaza Senior ApartmentsPhoenix RecoveryPlymouth ViewPrestonPreston PlaceRed Cliff Manor ApartmentsRendon TerraceRescue MissionRescue Mission of Salt LakeRevolve ApartmentsRichmond FlatsRoadhome- MidvaleRoads to IndependenceSalt Lake City LibrarySean Herrick ApartmentsSenior Living On WashingtonSharon GardensSharon GardensSilver Pines ApartmentsSt Benedict ManorSt Marks TowerSt. Marks GardenSURGICAL CENTERSwitchpoint Overflow ShelterSwitchpoint Overflow ShelterTaylor GardensTaylor SpringsTesting clientThe ArenaThe GardenThe Garden at South JordanTHE HAVENThe Haven - South JordanThe Haven- Men's DowntownThe Haven-West Jordan Men'sThe Ivy-DraperThe Point SLCTHE ROAD HOMEThe Ville Rose ParkTHE VILLE- MAGNATHE VILLE- OVERFLOW SHELTERThrive RecoveryTIMPANOGAS COMMUNITY CORRECTIONAL CENTERTIMPANOGAS COMMUNITY CORRECTIONAL CENTERUnion GardensUtah Harm ReductionValley Fair VillageVictoria Woods SandyVictoria Woods West ValleyVictory OutreachVillage SquareVOA DETOXWARM SPRINGS PARKWasatch ManorWatercourse WayWest Jordan Correctional FacilityWEST JORDAN CORRECTIONAL FACILITYWest Jordan IIWest Jordan IIWest Jordan Senior HousingWillowood ApartmentsYRCYWCA DO WE HAVE XRAYS FOR THIS PATIENTS THAT ARE LESS THAN 3 MONTHS OLD? YES NO PLAN 1 PLAN 1 MAXILLARY MANDIBULAR PERMANANT TEETH PERMANANT TEETH SUGGESTED EXTRACTIONS SUGGESTED EXTRACTIONS SUGGESTED RESTORATIONS SUGGESTED RESTORATIONS NO TREATMENT NO TREATMENT PLAN 2 PLAN 2 MAXILLARY MANDIBULAR # OF PERMANANT TEETH # OF PERMANANT TEETH SUGGESTED EXTRACTIONS SUGGESTED EXTRACTIONS SUGGESTED RESTORATIONS SUGGESTED RESTORATIONS NO TREATMENT NO TREATMENT NEXT CLIENT EVENT DATE CLICK WHEN REVIEW IS COMPLETE CLICK WHEN REVIEW IS COMPLETE Archive Patient in Slack when Created? (If you are seeing patient today select "DO NOT Archive When Created") Archive Slack When Created DO NOT Archive Slack When Created Who would you like add to the slack channel? Cindy Liz Kelsy Rylie Tom Pam CARE Follow-Up Click the Box Below Once Follow-up is Resolved * Follow-Up Complete DI# First Name * Last Name * Preferred Name Phone * Email Date of Birth * No Phone Number was Provided No Date of Birth was Provided Address * Apt # Zip Code CURVE LINK VERIFIED OR ADDED ALL PATIENT INFO VERIFIED OR ADDED ALL PATIENT INFO Primary Insurance Info Insurance Basics Primary Insurance Company * CLICK HEREMEDICARE ONLYMEDICAIDMEDICARE/MEDICAIDAetnaBCBSCignaDelta DentalDental DirectDental SelectDentaTrustEMIGuardianHumanaHumana DualMCNA (Medicaid)Met DentalMolinaMolina DualSelect HealthSelect Health DualUnited HealthcareUnited Healthcare DualOther Primary Insurance Company Primary Policy # ALL AVAILABLE PATIENT INFO IS ADDED ALL AVAILABLE PATIENT INFO IS ADDED Click "Dental Info" Below Sign-InDental InfoPage 3 Next Δ