| Name | Description | Type | Additional information |
|---|---|---|---|
| ReferralID | integer |
None. |
|
| CaseID | integer |
None. |
|
| StagingName | string |
None. |
|
| ApplicantFirstName | string |
None. |
|
| ApplicantMiddleName | string |
None. |
|
| ApplicantLastName | string |
None. |
|
| ApplicantSuffix | string |
None. |
|
| ApplicantDOB | string |
None. |
|
| SSN | string |
None. |
|
| ApplicantPrevDDSID | string |
None. |
|
| ApplicantCountyName | string |
None. |
|
| HasMedicaid | string |
None. |
|
| HasInsurance | string |
None. |
|
| RequestorName | string |
None. |
|
| RequestorPhone | string |
None. |
|
| ReferralReason | string |
None. |
|
| ReferralCode | string |
None. |
|
| ReferralSourceID | integer |
None. |
|
| ReferralSource | string |
None. |
|
| ReferralSourceOtherDesc | string |
None. |
|
| ReferralNotes | string |
None. |
|
| ApplicantAddressLine1 | string |
None. |
|
| ApplicantAddressLine2 | string |
None. |
|
| ApplicantCity | string |
None. |
|
| ApplicantState | string |
None. |
|
| ApplicantZipCode | string |
None. |
|
| ApplicantPhoneNumber | string |
None. |
|
| ApplicantEmailAddress | string |
None. |
|
| DrivingDirections | string |
None. |
|
| PrioritySource | string |
None. |
|
| Gender | string |
None. |
|
| Ethnicity | string |
None. |
|
| HasApplicantGraduatedHighSchool | string |
None. |
|
| Race | string |
None. |
|
| MedicaidNumber | string |
None. |
|
| HasLegalGuardian | string |
None. |
|
| ParentGuardianFirstName | string |
None. |
|
| ParentGuardianMiddleName | string |
None. |
|
| ParentGuardianLastName | string |
None. |
|
| ParentGuardianSuffix | string |
None. |
|
| ParentGuardianAddrSameAsApplicant | string |
None. |
|
| ParentGuardianMailAddrSameAsPhysical | string |
None. |
|
| ParentGuardianAddressLine1 | string |
None. |
|
| ParentGuardianAddressLine2 | string |
None. |
|
| ParentGuardianCity | string |
None. |
|
| ParentGuardianCounty | string |
None. |
|
| ParentGuardianState | string |
None. |
|
| ParentGuardianZip | string |
None. |
|
| ParentGuardianSSN | string |
None. |
|
| ParentGuardianCellPhone | string |
None. |
|
| ParentGuardianHomePhone | string |
None. |
|
| ParentGuardianWorkPhone | string |
None. |
|
| ParentGuardianExtension | string |
None. |
|
| ParentGuardianEmail | string |
None. |
|
| ParentGuardianFax | string |
None. |
|
| GuardianType | string |
None. |
|
| GuradianTypeOtherDesc | string |
None. |
|
| IsPrimaryCareGiver | string |
None. |
|
| HasAdditionalContact | string |
None. |
|
| AdditionalContactFirstName | string |
None. |
|
| AdditionalContactMiddleName | string |
None. |
|
| AdditionalContactLastName | string |
None. |
|
| AdditionalContactSuffix | string |
None. |
|
| AdditionalContactnAddrSameAsApplicant | string |
None. |
|
| AdditionalContactMailAddrSameAsPhysical | string |
None. |
|
| AdditionalContactAddressLine1 | string |
None. |
|
| AdditionalContactAddressLine2 | string |
None. |
|
| AdditionalContactCity | string |
None. |
|
| AdditionalContactCounty | string |
None. |
|
| AdditionalContactState | string |
None. |
|
| AdditionalContactZip | string |
None. |
|
| AdditionalContactSSN | string |
None. |
|
| AdditionalContactCellPhone | string |
None. |
|
| AdditionalContactHomePhone | string |
None. |
|
| AdditionalContactWorkPhone | string |
None. |
|
| AdditionalContactExtension | string |
None. |
|
| AdditionalContactEmail | string |
None. |
|
| AdditionalContactFax | string |
None. |