Edit Entry Screen

With the Edit screen, you can edit information that was previously recorded. You may change any of the information for a record. The input fields for Health Care Provider are described below. Some of these fields are required and some are optional. The required fields are indicated by an asterisk symbol (*). You must click the Save button for your changes to be recorded. After you click "Save" or "Cancel" you will be taken back to the Summary screen. The "Reset" button will return the fields to the original values before any changes were made. You may also choose to delete the entry by clicking the "Delete" button. If for some reason the system is not able to process your entry, the page will refresh with a message explaining what must be done to proceed.

Using this Page

Provider Type (Required) - You must enter a provider type to identify this record. Select a provider type from the drop-down list (Primary, Specialist, Dentist, Eye, and Other Clinician). Primary is selected by default; however you can only have one health care provider assigned with this type. If the type of provider you wish to enter is not in the list, select Other Clinician and complete the next field.

Other Clinician - Enter the type of clinician here if it was not in the Provider Type list. You may enter up to 25 characters.

Provider First Name (Required) - Enter the first name of your health care provider in this field. You may enter up to 50 characters.

Provider Last Name (Required) - Enter the last name of your health care provider in this field. You may enter up to 50 characters.

Provider Phone Number (Required) - Enter the phone number of your health care provider in this field. Enter the provider's extension into the next field.

Ext - Enter the provider's phone extension in this field.

Provider Email Address - Enter the email address of your health care provider in this field. You may enter up to 50 characters.

Provider Comments - This is where you can enter any additional thoughts you had about this particular health care provider. You may enter up to 255 characters.

Save - You must click this button to save the entry.