Last Name

Client's last name, as a text entry field accepting alpha characters, hyphens, and apostrophes.

First Name

Client's first name, as a text entry field accepting alpha characters, hyphens, and apostrophes.

Birth Date

Client's date of birth, as a date entry field using the format MM/DD/YYYY. On entry, the system accepts a valid birth date after 01/01/1890.

NOTE: The birth date cannot be changed to a date that is after the client's existing immunizations. An error message displays  and the user will be expected to resolve the conflict with the existing immunizations via the edit immunization screen or by changing the Birth Date.

Mother's Maiden Last

The maiden last name of the client's mother, as a text entry field accepting alpha characters, hyphens, and apostrophes. This is a required field when entering a new client.  Once the record is initially  saved, the phrase "(On File)"  displays  notifying that this information is recorded but hidden for confidentiality.

Mother's First Name

Client's mother's first name, as a text entry field accepting alpha characters, hyphens, and apostrophes.

Gender

Client's gender, as a drop-down selection field.

Middle Name

Client's middle name, as a text entry field accepting alpha characters, hyphens, and apostrophes.

Suffix

Client's name suffix if applicable, as a drop-down selection field.

SSN

Client's SSN number, as numeric entry fields in 000-00-0000 format. Once the record is initially saved, only the last four digits display for confidentiality.

Medicaid ID

Client's Medicaid identification number. This is a general entry field with no system restrictions on character entry.

Birth Order

A number indicating the order in which the client was born, as a numeric entry field.

Birth Country

Country where the client was born. At client entry, this field defaults to United States.

Birth State

State where  the client was born.

NOTE: The Birth State and Birth County are not part of the required entry fields to save a new client record. Those fields are located in the Address Information Section.

Birth County

County where the client was born.

Client Type

Displays the client's consent status. (IC = ImmTrac Child; IA = ImmTrac Adult; DC = Disaster Consented, Adult or Child; DU = Disaster Unconsented, Adult or Child; FR = First Responder, Adult; FM = First Responder Family Member, Adult.)

Client Identifier

Displays the organization-specific client identifier assigned to the client in the Organization Information Section.

ImmTrac2 ID

Displays the ImmTrac2 system identifier assigned to the client.

ImmTrac2 Client

Displays an indicator (Yes/No) of the client's consent status for participation in the registry.

Disaster Client

Displays an indicator (Yes/No) of whether the client has a disaster-related antiviral, immunization, or medication (AIM) record saved in the client's immunization record.

Last Updated by

Displays the organization, date, and user who most recently updated the record.

Created By

Displays the organization, date, and user who created the client record.