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truForm: WinOMScs - Integration Fields

  • Overview

    This includes ALL fields that integrate between truForm and WinOMScs.  If your custom form is setup correctly, items below will populate within your software. Note, if you have additional fields that are NOT listed below, you can manual enter them into your patients account once integration is completed!

    If you use our standard form below, the sections listed below are already integrated!

    Anything below labeled with DOES NOT INTEGRATE, is a field that exists on our standard form above, but does not automatically integrate on either standard or custom.

    Field Count: 296 total truForm fields integrate into your PMS!

  • Patient Info

    *IF YOU ARE USING A CUSTOM FORM:

    • Patient Name on the form must be split out into first name last name in order to integrate correctly.
    • Patient Address/ City/ State / Zip must be split out into its own fields in order to integrate correctly.

    • Dentist/Doctor/Referred By/Nearest Relative Names on the form must be split out into first name last name in order to integrate correctly. 
    1. Prefix
    2. First Name
    3. Middle Initial
    4. Last Name
    5. Suffix
    6. Nickname
    7. Gender
    8. Martial Description
    9. Date of Birth
    10. Age
    11. Social Security Number
    12. Home Phone
    13. Work Phone
    14. Work Ext.
    15. Cell Phone
    16. Email
    1. Address Street Name
    2. Apt 
    3. City
    4. State or Province
    5. Zip or Postal Code
    6. Employer Name
    7. Driver’s License
    8. Patient former patient?
    1. Dentist First Name
    2. Dentist Last Name
    3. Doctor First Name
    4. Doctor Last Name
    5. Referred By First Name
    6. Referred By Last Name
    7. Nearest Relative First Name
    8. Nearest Relative Last Name
    9. Nearest Relative Phone
    10. Payment Method

    DOES NOT INTEGRATE:

    1. Orthodontist First Name
    2. Orthodontist Last Name
    3. Preferred Pharmacy
    4. Pharmacy Tel.

    Emergency Name must be one field (can't be split into first name last name fields, or else it will not integrate).
    1. Emergency Full Name
    2. Home Phone
    3. Work Phone

    DOES NOT INTEGRATE:

    1. Emergency contact relation

  • Responsible Party Info

    *IF YOU ARE USING A CUSTOM FORM: 

    • Responsible Name on the form must be split out into first name last name in order to integrate correctly.
    • Patient Address/ City/ State / Zip must be split out into its own fields in order to integrate correctly.
    1. Prefix
    2. First Name
    3. Last Name
    4. Suffix
    5. Relationship to Patient
    6. Social Security Number
    7. Date of Birth
    1. Address Street Name
    2. Address Street Name 2
    3. City
    4. State or Province
    5. Zip or Postal Code
    6. Employer Name
    7. Home Phone
    8. Work Phone

    DOES NOT INTEGRATE:

    1. Age
    2. Middle Initial
    3. Email Address

  • Spouse/Other Guarantor Info

    • This entire section will not integrate

  • School/Insurance Info

    *IF YOU ARE USING A CUSTOM FORM: School Name/ Address/ City/ State / Zip must be split out into its own fields in order to integrate correctly. 
    1. School Name
    2. School Address Street Name
    3. School Address Street Name 2
    4. School City
    5. School State or Province
    6. School Zip or Postal Code
    7. School Phone
    1. School Status (Full, Part, Not)
    2. Employer Status(Full, Part, Not)
    3. PPO or HMO

  • Insurance Info

    *IF YOU ARE USING A CUSTOM FORM: 

    • Each insurance type (primary medical, primary dental, secondary medical, secondary dental must be separated into its own area for each question below in order to integrate correctly.
    • All Address/ City/ State / Zip must be split out into its own fields in order to integrate correctly.
    • Insured Name on the form must be split out into first name last name in order to integrate correctly. 

    PRIMARY DENTAL

    1. Insured Relation to Patient
    2. Insured Prefix
    3. Insured First Name
    4. Insured Middle Initial
    5. Insured Last Name
    6. Insured Suffix
    7. Insured Gender
    8. Insured Date of Birth
    9. Insured Social Security Number
    10. Insured Home Phone
    11. Insured Home Address Street
    12. Insured Home Address Street 2
    13. Insured City
    14. Insured State or Province
    15. Insured Zip Code or Postal Code
    16. Insured Employer Name
    17. Insured Employer Address
    18. Insured Employer Address 2
    19. Insured Employer City
    20. Insured Employer State or Province
    21. Insured Employer Zip or Postal
    22. Insured Employer Phone Number
    23. Insured Policy Group Name
    24. Insured Policy Group Number
    25. Insured Policy ID
    26. Insured Policy Plan
    27. Insured Insurance Company Name
    28. Insured Insurance Address Street
    29. Insured Insurance Address Street 2
    30. Insured Insurance City
    31. Insured Insurance State or Province
    32. Insured Insurance Zip or Postal Code
    33. Insured Insurance Phone Number

    SECONDARY DENTAL

    1. Insured Relation to Patient
    2. Insured Prefix
    3. Insured First Name
    4. Insured Middle Initial
    5. Insured Last Name
    6. Insured Suffix
    7. Insured Gender
    8. Insured Date of Birth
    9. Insured Social Security Number
    10. Insured Home Phone
    11. Insured Home Address Street
    12. Insured Home Address Street 2
    13. Insured City
    14. Insured State or Province
    15. Insured Zip Code or Postal Code
    16. Insured Employer Name
    17. Insured Employer Address
    18. Insured Employer Address 2
    19. Insured Employer City
    20. Insured Employer State or Province
    21. Insured Employer Zip or Postal
    22. Insured Employer Phone Number
    23. Insured Policy Group Name
    24. Insured Policy Group Number
    25. Insured Policy ID
    26. Insured Policy Plan
    27. Insured Insurance Company Name
    28. Insured Insurance Address Street
    29. Insured Insurance Address Street 2
    30. Insured Insurance City
    31. Insured Insurance State or Province
    32. Insured Insurance Zip or Postal Code
    33. Insured Insurance Phone Number

    PRIMARY MEDICAL

    1. Insured Relation to Patient
    2. Insured Prefix
    3. Insured First Name
    4. Insured Middle Initial
    5. Insured Last Name
    6. Insured Suffix
    7. Insured Gender
    8. Insured Date of Birth
    9. Insured Social Security Number
    10. Insured Home Phone
    11. Insured Home Address Street
    12. Insured Home Address Street 2
    13. Insured City
    14. Insured State or Province
    15. Insured Zip Code or Postal Code
    16. Insured Employer Name
    17. Insured Employer Address
    18. Insured Employer Address 2
    19. Insured Employer City
    20. Insured Employer State or Province
    21. Insured Employer Zip or Postal
    22. Insured Employer Phone Number
    23. Insured Policy Group Name
    24. Insured Policy Group Number
    25. Insured Policy ID
    26. Insured Policy Plan
    27. Insured Insurance Company Name
    28. Insured Insurance Address Street
    29. Insured Insurance Address Street 2
    30. Insured Insurance City
    31. Insured Insurance State or Province
    32. Insured Insurance Zip or Postal Code
    33. Insured Insurance Phone Number

    SECONDARY DENTAL

    1. Insured Relation to Patient
    2. Insured Prefix
    3. Insured First Name
    4. Insured Middle Initial
    5. Insured Last Name
    6. Insured Suffix
    7. Insured Gender
    8. Insured Date of Birth
    9. Insured Social Security Number
    10. Insured Home Phone
    11. Insured Home Address Street
    12. Insured Home Address Street 2
    13. Insured City
    14. Insured State or Province
    15. Insured Zip Code or Postal Code
    16. Insured Employer Name
    17. Insured Employer Address
    18. Insured Employer Address 2
    19. Insured Employer City
    20. Insured Employer State or Province
    21. Insured Employer Zip or Postal
    22. Insured Employer Phone Number
    23. Insured Policy Group Name
    24. Insured Policy Group Number
    25. Insured Policy ID
    26. Insured Policy Plan
    27. Insured Insurance Company Name
    28. Insured Insurance Address Street
    29. Insured Insurance Address Street 2
    30. Insured Insurance City
    31. Insured Insurance State or Province
    32. Insured Insurance Zip or Postal Code
    33. Insured Insurance Phone Number

  • Health History

    *IF YOU ARE USING A CUSTOM FORM:  If you have a group of problems/issues in one question- they will not integrate.  They must be laid out similar to the format given below.

    Some items we group together, will come over as one item, see below:
    1. Reason for today's office visit
    2. Are you in good health
    3. Weight
    4. Height
    5. Have there been any changes in your general health in the past year
    6. Are you under the care of a physician
    7. If so, for what are you being treated
    8. Date of last visit
    9. Have you had any illness, operation or been hospitalized in the past five years
    10. If so, describe
    11. Do you have unhealed / recurrent injuries or inflamed areas, growths or sore spots in or around your mouth
    12. If so, describe where
    13. Do you have a prosthetic joint / implant
    14. If so, describe where
    15. Have you had a heart valve replacement or vascular graft
    16. Rheumatic fever
    17. Damaged heart valves / mitral valve prolapse
    18. Heart murmur
    19. High blood pressure
    20. Low blood pressure
    21. Chest pain / angina
      *Comes over as angina
    22. Heart attack(s)
    23. Irregular heart beat
    24. Cardiac pacemaker
    25. Heart surgery
    26. Pneumonia, bronchitis, chronic cough
      *Comes over as bronchitis/chronic cough
    27. Asthma
    28. Hay fever / sinus problems
    29. Snoring
    30. Sleep apnea / CPAP
    31. Difficult breathing / other lung trouble
      *Comes over as other lung trouble
    32. Tuberculosis
    33. Emphysema
    34. Do you smoke or vape
    35. Do you use chewing tobacco
    36. Blood transfusion
    37. Blood disorder such as anemia
      *      Comes over as anemia
    38. Bruise easily
    39. Bleeding tendency / abnormal bleed
      *Comes over as bleeding tendency
    40. Hepatitis, jaundice, or liver disease
    1. Infectious mononucleosis
    2. Gallbladder trouble
    3. Fainting spells
    4. Convulsions / epilepsy
    5. Stroke
    6. Thyroid trouble
    7. Diabetes
    8. Low blood sugar
    9. Kidney trouble
    10. Are you on dialysis
    11. Swollen ankles / arthritis / joint disease
      *Comes over as arthritis
    12. Stomach ulcers / acid reflux
      *Comes over as stomach ulcers
    13. Contagious diseases
    14. Sexually transmitted diseases
    15. Problems with immune system
      Possibly from medication / surgery, etc.
    16. Delay in healing
    17. A tumor or growth
    18. Cancer / radiation therapy / chemotherapy
      *Comes over as xray or chemo
    19.  Chronic fatigue / night sweats
    20. Are you on a diet
    21. A history of alcohol abuse and / or treatment for alcohol abuse
    22. A history of marijuana or illegal drug use
    23. Contact lenses
    24. Eye disease / glaucoma
    25. Mental health problems / anxiety / depression
      *Comes over as mental health problems
    26. A removable dental appliance
    27. Pain or clicking of jaws when eating

    DOES NOT INTEGRATE: 

    1. Have you ever had general anesthesia
    2. Have you, or a family member, had any unusual or serious reactions to general anesthesia
    3. Has a physician or previous dentist recommended that you take antibiotics prior to your dental treatment
    4. If so, how much a day do you smoke/vape
    5. High cholesterol
    6. Alcohol intake? 
    7. If so, drinks per Day
    8. If so, drinks per Week
    9. Osteoporosis / osteopenia
    10. Osteonecrosis
    11. COVID-19
    12. Autoimmune disease

  • Women Only

    1. Is there a possibility of pregnancy
    2. Expected delivery date
    1. Are you nursing
    2. Are you taking birth control pills

  • Medications

    1. Any kind of medication, drug, pills
    2. Blood thinners (Coumadin, Plavix, Aspirin, Vitamin E, Ginko biloba, Aggrenox, Xarelto, Eliquis, Fish oil)
    3. Have you ever taken diet pills
    4. Any natural product, herbal supplement or homeopathic remedy
    5. Tranquilizers, sleeping pills, anti-depressants, and/or narcotics on a regular basis. If so, please list:

    DOES NOT INTEGRATE:    

    1. Are you taking, or have you ever taken, bone density meds. RANKL inhibitors or bisphosphonates such as Prolia, Fosamax, Boniva, Actonel, IV-Zometa, Aredia, Reclast, Xgeva, or Evista in the past 12 years
    2. If you are under the care of a physician for pain management, or recovering from drug addiction please select the medication you are currently taking:
        1. Other
        2. Treating Doctor Name
    3. Please list any medications you are currently taking:
      **Please note each medication they free type will come over as either a ALERT or a PROGRESS NOTE, from here you will have to click the green plus sign to add/retype or copy each medication manually within your patients chart in WinOMScs. (1-20 medications)

  • Allergies

    1. Local anesthetic (numbing meds.)
    2. Penicillin
    3. Other antibiotics
    4. Sulfa drugs
    5. Sodium pentothal / Valium /other tranquilizers
    6. Aspirin
    7. Codeine or other narcotics
    8. Latex
    9. Soy
    10. Eggs / yolk
    11. Sulfites
    1. Please list any other medication or antibiotic you are allergic to:
      1. Medication/Antibiotic #1
      2. Medication/Antibiotic #2
      3. Medication/Antibiotic #3
      4. Medication/Antibiotic #4
      5. Medication/Antibiotic #5
      6. Medication/Antibiotic #6
      7. Medication/Antibiotic #7
      8. Medication/Antibiotic #8
      9. Medication/Antibiotic #9
      10. Medication/Antibiotic #10

    DOES NOT INTEGRATE:    

    1. Amoxicillin
    2. Do you have any known allergies
    3. Please list any allergies other than drug allergies:

  • Family History

    1. Family History of Cancer
    2. Family History of Diabetes
    1. Family History of Heart Disease
    2. Family History of Anesthetic Problems

  • Injury Info

    1. Date of injury
    2. Type of accident- auto/work/other
    3. Insurance Company Handling Claim
    1. Claim Number
    2. Attorney or Adjustor
    3. Attorney Phone

  • Personal Info

    1. Is there any condition concerning your health that the Doctor should be told about
    2. If Yes, why
    1. Do you wish to speak to the Dr. privately about anything