Layers:

Layer: Emergency Assistance Request (6)

Name: Emergency Assistance Request

Display Field: FIRSTNAME

Type: Feature Layer

Geometry Type: esriGeometryPoint

Description:

Service Item Id: fed88657c647411194d85ca7642e95c2

Copyright Text:

Default Visibility: true

MaxRecordCount: 2000

Supported Query Formats: JSON, geoJSON, PBF

Min Scale: 0

Max Scale: 0

Supports Advanced Queries: true

Supports Statistics: true

Can Scale Symbols: false

Use Standardized Queries: true

Supports ValidateSQL: true

Supports Calculate: true

Supports Datum Transformation: true

Extent:
XMin: -1.0776678235297194E7
YMin: 5880577.6513308
XMax: -1.0549296137000754E7
YMax: 6029329.237200366
Spatial Reference: 102100  (3857)



Drawing Info:
Renderer:
Simple Renderer:
Symbol:
Label: N/A
Description: N/A
Transparency: 0
Labeling Info:
Advanced Query Capabilities:
Supports Statistics: true
Supports OrderBy: true
Supports Distinct: true
Supports Pagination: true
Supports TrueCurve: true
Supports Returning Query Extent: true
Supports Query With Distance: true
Supports Sql Expression: true
Supports Query With ResultType: true
Supports Returning Geometry Centroid: false
Supports Binning LOD: false
Supports Query With LOD Spatial Reference: false
Supports Percentile Statistics: true
Supports Having Clause: true
Supports Count Distinct: true
Supports Time Relation: false
Supports Sql Format: false
Supports Query Analytic: true
Supports Query With Current User: true


HasZ: false

HasM: false

Has Attachments: false

HTML Popup Type: esriServerHTMLPopupTypeAsHTMLText

Type ID Field:

Fields:
• OBJECTID ( type: esriFieldTypeOID, alias: OBJECTID, editable: false, nullable: false, defaultValue: null, modelName: OBJECTID )
• FIRSTNAME ( type: esriFieldTypeString, alias: First Name, editable: true, nullable: true, length: 50, defaultValue: null, modelName: FIRSTNAME )
• LASTNAME ( type: esriFieldTypeString, alias: Last Name, editable: true, nullable: true, length: 50, defaultValue: null, modelName: LASTNAME )
• STADDR ( type: esriFieldTypeString, alias: Street Address, editable: true, nullable: true, length: 100, defaultValue: null, modelName: STADDR )
• CITY ( type: esriFieldTypeString, alias: City, editable: true, nullable: true, length: 50, defaultValue: null, modelName: CITY )
• STATEABBR ( type: esriFieldTypeString, alias: State Abbreviation, editable: true, nullable: true, length: 2, defaultValue: null, modelName: STATEABBR )
• ZIPCODE ( type: esriFieldTypeString, alias: Zip Code, editable: true, nullable: true, length: 5, defaultValue: null, modelName: ZIPCODE )
• DATEBIRTH ( type: esriFieldTypeDate, alias: Date of Birth, editable: true, nullable: true, length: 8, defaultValue: null, modelName: DATEBIRTH )
• CRTAGE ( type: esriFieldTypeSmallInteger, alias: Current Age, editable: true, nullable: true, defaultValue: null, modelName: CRTAGE )
• GENDER ( type: esriFieldTypeString, alias: Gender, editable: true, nullable: true, length: 10, defaultValue: null, modelName: GENDER , Coded Values: [Male: Male] , [Female: Female] )
• HEIGHT ( type: esriFieldTypeString, alias: Height, editable: true, nullable: true, length: 20, defaultValue: null, modelName: HEIGHT , Coded Values: [5' or less: 5' or less] , [5' to 6': 5' to 6'] , [6' or more: 6' or more] )
• WEIGHT ( type: esriFieldTypeString, alias: Weight, editable: true, nullable: true, length: 20, defaultValue: null, modelName: WEIGHT , Coded Values: [100 lbs or less: 100 lbs or less] , [100 lbs to 200 lbs: 100 lbs to 200 lbs] , [200 lbs or more: 200 lbs or more] )
• EMAIL ( type: esriFieldTypeString, alias: Email Address, editable: true, nullable: true, length: 100, defaultValue: null, modelName: EMAIL )
• PRIMPHONE ( type: esriFieldTypeString, alias: Primary Phone Number, editable: true, nullable: true, length: 20, defaultValue: null, modelName: PRIMPHONE )
• SECPHONE ( type: esriFieldTypeString, alias: Secondary Phone Number, editable: true, nullable: true, length: 20, defaultValue: null, modelName: SECPHONE )
• PHYSNAME ( type: esriFieldTypeString, alias: Physician Name, editable: true, nullable: true, length: 100, defaultValue: null, modelName: PHYSNAME )
• PHYSFACNAME ( type: esriFieldTypeString, alias: Physician Facility Name, editable: true, nullable: true, length: 50, defaultValue: null, modelName: PHYSFACNAME )
• POCNAME ( type: esriFieldTypeString, alias: Name of Person Providing the Information, editable: true, nullable: true, length: 100, defaultValue: null, modelName: POCNAME )
• ICENAME ( type: esriFieldTypeString, alias: Emergency Contact Name, editable: true, nullable: true, length: 100, defaultValue: null, modelName: ICENAME )
• ICERELATION ( type: esriFieldTypeString, alias: Emergency Contact Relation, editable: true, nullable: true, length: 20, defaultValue: null, modelName: ICERELATION )
• ICEPRIMPHONE ( type: esriFieldTypeString, alias: Emergency Contact Primary Phone, editable: true, nullable: true, length: 20, defaultValue: null, modelName: ICEPRIMPHONE )
• ICESECPHONE ( type: esriFieldTypeString, alias: Emergency Contact Secondary Phone, editable: true, nullable: true, length: 20, defaultValue: null, modelName: ICESECPHONE )
• ICEEMAIL ( type: esriFieldTypeString, alias: Emergency Contact Email, editable: true, nullable: true, length: 100, defaultValue: null, modelName: ICEEMAIL )
• OXYGEN ( type: esriFieldTypeString, alias: Does this individual require oxygen?, editable: true, nullable: true, length: 5, defaultValue: null, modelName: OXYGEN , Coded Values: [Yes: Yes] , [No: No] )
• WHEELCHAIR ( type: esriFieldTypeString, alias: Does the individual require the use of a wheelchair?, editable: true, nullable: true, length: 5, defaultValue: null, modelName: WHEELCHAIR , Coded Values: [Yes: Yes] , [No: No] )
• HOSPICE ( type: esriFieldTypeString, alias: Does the individual receive hospice care?, editable: true, nullable: true, length: 5, defaultValue: null, modelName: HOSPICE , Coded Values: [Yes: Yes] , [No: No] )
• DIALYSIS ( type: esriFieldTypeString, alias: Does the individual receive dialysis treatment?, editable: true, nullable: true, length: 5, defaultValue: null, modelName: DIALYSIS , Coded Values: [Yes: Yes] , [No: No] )
• SPECIALTRANSPORT ( type: esriFieldTypeString, alias: Does the individual require special transportation involving the use of a mechanical device (special vehicle lifts, etc.)?, editable: true, nullable: true, length: 5, defaultValue: null, modelName: SPECIALTRANSPORT , Coded Values: [Yes: Yes] , [No: No] )
• DIABETIC ( type: esriFieldTypeString, alias: Is the individual diabetic?, editable: true, nullable: true, length: 5, defaultValue: null, modelName: DIABETIC , Coded Values: [Yes: Yes] , [No: No] )
• INSULIN ( type: esriFieldTypeString, alias: Does the individual take insulin?, editable: true, nullable: true, length: 5, defaultValue: null, modelName: INSULIN , Coded Values: [Yes: Yes] , [No: No] )
• VISIONIMPAIR ( type: esriFieldTypeString, alias: Is the individual vision impaired?, editable: true, nullable: true, length: 5, defaultValue: null, modelName: VISIONIMPAIR , Coded Values: [Yes: Yes] , [No: No] )
• HEARINGIMPAIR ( type: esriFieldTypeString, alias: Is the individual hearing impaired?, editable: true, nullable: true, length: 5, defaultValue: null, modelName: HEARINGIMPAIR , Coded Values: [Yes: Yes] , [No: No] )
• PETCT ( type: esriFieldTypeSmallInteger, alias: How many pets live with the individual? If the pet is not a dog or cat, please describe the pet in the comment section below, editable: true, nullable: true, defaultValue: null, modelName: PETCT )
• HEALTHCOMMENT ( type: esriFieldTypeString, alias: Describe any additional health issues, editable: true, nullable: true, length: 3000, defaultValue: null, modelName: HEALTHCOMMENT )
• MOBILITYCOMMENT ( type: esriFieldTypeString, alias: Describe any mobility issues, editable: true, nullable: true, length: 3000, defaultValue: null, modelName: MOBILITYCOMMENT )
• CASEMGRNAME ( type: esriFieldTypeString, alias: Name of Case Manager or Home Nurse, editable: true, nullable: true, length: 100, defaultValue: null, modelName: CASEMGRNAME )
• CASEMGRAGENCY ( type: esriFieldTypeString, alias: Agency Name of Case Manager or Home Nurse, editable: true, nullable: true, length: 100, defaultValue: null, modelName: CASEMGRAGENCY )
• ADDCOMMENT ( type: esriFieldTypeString, alias: Include any additional comments and considerations, editable: true, nullable: true, length: 3000, defaultValue: null, modelName: ADDCOMMENT )
• RECDT ( type: esriFieldTypeDate, alias: Date Received, editable: true, nullable: true, length: 8, defaultValue: null, modelName: RECDT )
• STAFFNAME ( type: esriFieldTypeString, alias: Name of Staff Recording Information, editable: true, nullable: true, length: 100, defaultValue: null, modelName: STAFFNAME )
• STAFFCOMMENT ( type: esriFieldTypeString, alias: Internal Comments, editable: true, nullable: true, length: 3000, defaultValue: null, modelName: STAFFCOMMENT )
• VERIFYSTAFFNAME ( type: esriFieldTypeString, alias: Name of Staff Verifying Information, editable: true, nullable: true, length: 100, defaultValue: null, modelName: VERIFYSTAFFNAME )
• VERIFYDT ( type: esriFieldTypeDate, alias: Date Verified, editable: true, nullable: true, length: 8, defaultValue: null, modelName: VERIFYDT )
• STATUS ( type: esriFieldTypeString, alias: Status, editable: true, nullable: true, length: 20, defaultValue: null, modelName: STATUS , Coded Values: [Submitted: Submitted] , [Verified: Verified] , [Expired: Expired] )
• CREATEDON ( type: esriFieldTypeDate, alias: CREATEDON, editable: false, nullable: true, length: 8, defaultValue: null, modelName: CREATEDON )
Templates:
• Name: Emergency Assistance Request
  Description:
  Prototype:
  VERIFYDT: null
  CITY: null
  STATUS: Submitted
  FIRSTNAME: null
  LASTNAME: null
  STADDR: null
  STATEABBR: MN
  ZIPCODE: null
  DATEBIRTH: null
  CRTAGE: null
  GENDER: null
  HEIGHT: null
  WEIGHT: null
  EMAIL: null
  PRIMPHONE: null
  SECPHONE: null
  PHYSNAME: null
  PHYSFACNAME: null
  POCNAME: null
  ICENAME: null
  ICERELATION: null
  ICEPRIMPHONE: null
  ICESECPHONE: null
  ICEEMAIL: null
  OXYGEN: null
  WHEELCHAIR: null
  HOSPICE: null
  DIALYSIS: null
  SPECIALTRANSPORT: null
  DIABETIC: null
  INSULIN: null
  VISIONIMPAIR: null
  HEARINGIMPAIR: null
  PETCT: null
  HEALTHCOMMENT: null
  MOBILITYCOMMENT: null
  CASEMGRNAME: null
  CASEMGRAGENCY: null
  ADDCOMMENT: null
  RECDT: null
  STAFFNAME: null
  STAFFCOMMENT: null
  VERIFYSTAFFNAME: null
  
  Drawing Tool: esriFeatureEditToolPoint

Layer: Emergency Assistance (4)

Name: Emergency Assistance

Display Field: FIRSTNAME

Type: Feature Layer

Geometry Type: esriGeometryPoint

Description:

Service Item Id: fed88657c647411194d85ca7642e95c2

Copyright Text:

Default Visibility: true

MaxRecordCount: 2000

Supported Query Formats: JSON, geoJSON, PBF

Min Scale: 0

Max Scale: 0

Supports Advanced Queries: true

Supports Statistics: true

Can Scale Symbols: false

Use Standardized Queries: true

Supports ValidateSQL: true

Supports Calculate: true

Supports Datum Transformation: true

Extent:
XMin: -1.0776678235297194E7
YMin: 5880577.6513308
XMax: -1.0549296137000754E7
YMax: 6029329.237200366
Spatial Reference: 102100  (3857)



Drawing Info:
Renderer:
Unique Value Renderer:
Field 1: STATUS
Field 2: N/A
Field 3: N/A
Field Delimiter: ,
Default Symbol:
N/A
Default Label: N/A
UniqueValueInfos:
• Value: Expired
  Label: Expired
  Description: N/A
  Symbol:
  
• Value: Verified
  Label: Verified
  Description: N/A
  Symbol:
  
• Value: Submitted
  Label: Submitted
  Description: N/A
  Symbol:
  
Transparency: 0
Labeling Info:
Advanced Query Capabilities:
Supports Statistics: true
Supports OrderBy: true
Supports Distinct: true
Supports Pagination: true
Supports TrueCurve: true
Supports Returning Query Extent: true
Supports Query With Distance: true
Supports Sql Expression: true
Supports Query With ResultType: true
Supports Returning Geometry Centroid: false
Supports Binning LOD: false
Supports Query With LOD Spatial Reference: false
Supports Percentile Statistics: true
Supports Having Clause: true
Supports Count Distinct: true
Supports Time Relation: false
Supports Sql Format: false
Supports Query Analytic: true
Supports Query With Current User: true


HasZ: false

HasM: false

Has Attachments: false

HTML Popup Type: esriServerHTMLPopupTypeAsHTMLText

Type ID Field: STATUS

Fields:
• OBJECTID ( type: esriFieldTypeOID, alias: OBJECTID, editable: false, nullable: false, defaultValue: null, modelName: OBJECTID )
• FIRSTNAME ( type: esriFieldTypeString, alias: First Name, editable: true, nullable: true, length: 50, defaultValue: null, modelName: FIRSTNAME )
• LASTNAME ( type: esriFieldTypeString, alias: Last Name, editable: true, nullable: true, length: 50, defaultValue: null, modelName: LASTNAME )
• STADDR ( type: esriFieldTypeString, alias: Street Address, editable: true, nullable: true, length: 100, defaultValue: null, modelName: STADDR )
• CITY ( type: esriFieldTypeString, alias: City, editable: true, nullable: true, length: 50, defaultValue: null, modelName: CITY )
• STATEABBR ( type: esriFieldTypeString, alias: State Abbreviation, editable: true, nullable: true, length: 2, defaultValue: null, modelName: STATEABBR )
• ZIPCODE ( type: esriFieldTypeString, alias: Zip Code, editable: true, nullable: true, length: 5, defaultValue: null, modelName: ZIPCODE )
• DATEBIRTH ( type: esriFieldTypeDate, alias: Date of Birth, editable: true, nullable: true, length: 8, defaultValue: null, modelName: DATEBIRTH )
• CRTAGE ( type: esriFieldTypeSmallInteger, alias: Current Age, editable: true, nullable: true, defaultValue: null, modelName: CRTAGE )
• GENDER ( type: esriFieldTypeString, alias: Gender, editable: true, nullable: true, length: 10, defaultValue: null, modelName: GENDER , Coded Values: [Male: Male] , [Female: Female] )
• HEIGHT ( type: esriFieldTypeString, alias: Height, editable: true, nullable: true, length: 20, defaultValue: null, modelName: HEIGHT , Coded Values: [5' or less: 5' or less] , [5' to 6': 5' to 6'] , [6' or more: 6' or more] )
• WEIGHT ( type: esriFieldTypeString, alias: Weight, editable: true, nullable: true, length: 20, defaultValue: null, modelName: WEIGHT , Coded Values: [100 lbs or less: 100 lbs or less] , [100 lbs to 200 lbs: 100 lbs to 200 lbs] , [200 lbs or more: 200 lbs or more] )
• EMAIL ( type: esriFieldTypeString, alias: Email Address, editable: true, nullable: true, length: 100, defaultValue: null, modelName: EMAIL )
• PRIMPHONE ( type: esriFieldTypeString, alias: Primary Phone Number, editable: true, nullable: true, length: 20, defaultValue: null, modelName: PRIMPHONE )
• SECPHONE ( type: esriFieldTypeString, alias: Secondary Phone Number, editable: true, nullable: true, length: 20, defaultValue: null, modelName: SECPHONE )
• PHYSNAME ( type: esriFieldTypeString, alias: Physician Name, editable: true, nullable: true, length: 100, defaultValue: null, modelName: PHYSNAME )
• PHYSFACNAME ( type: esriFieldTypeString, alias: Physician Facility Name, editable: true, nullable: true, length: 50, defaultValue: null, modelName: PHYSFACNAME )
• POCNAME ( type: esriFieldTypeString, alias: Name of Person Providing the Information, editable: true, nullable: true, length: 100, defaultValue: null, modelName: POCNAME )
• ICENAME ( type: esriFieldTypeString, alias: Emergency Contact Name, editable: true, nullable: true, length: 100, defaultValue: null, modelName: ICENAME )
• ICERELATION ( type: esriFieldTypeString, alias: Emergency Contact Relation, editable: true, nullable: true, length: 20, defaultValue: null, modelName: ICERELATION )
• ICEPRIMPHONE ( type: esriFieldTypeString, alias: Emergency Contact Primary Phone, editable: true, nullable: true, length: 20, defaultValue: null, modelName: ICEPRIMPHONE )
• ICESECPHONE ( type: esriFieldTypeString, alias: Emergency Contact Secondary Phone, editable: true, nullable: true, length: 20, defaultValue: null, modelName: ICESECPHONE )
• ICEEMAIL ( type: esriFieldTypeString, alias: Emergency Contact Email, editable: true, nullable: true, length: 100, defaultValue: null, modelName: ICEEMAIL )
• OXYGEN ( type: esriFieldTypeString, alias: Does this individual require oxygen?, editable: true, nullable: true, length: 5, defaultValue: null, modelName: OXYGEN , Coded Values: [Yes: Yes] , [No: No] )
• WHEELCHAIR ( type: esriFieldTypeString, alias: Does the individual require the use of a wheelchair?, editable: true, nullable: true, length: 5, defaultValue: null, modelName: WHEELCHAIR , Coded Values: [Yes: Yes] , [No: No] )
• HOSPICE ( type: esriFieldTypeString, alias: Does the individual receive hospice care?, editable: true, nullable: true, length: 5, defaultValue: null, modelName: HOSPICE , Coded Values: [Yes: Yes] , [No: No] )
• DIALYSIS ( type: esriFieldTypeString, alias: Does the individual receive dialysis treatment?, editable: true, nullable: true, length: 5, defaultValue: null, modelName: DIALYSIS , Coded Values: [Yes: Yes] , [No: No] )
• SPECIALTRANSPORT ( type: esriFieldTypeString, alias: Does the individual require special transportation involving the use of a mechanical device (special vehicle lifts, etc.)?, editable: true, nullable: true, length: 5, defaultValue: null, modelName: SPECIALTRANSPORT , Coded Values: [Yes: Yes] , [No: No] )
• DIABETIC ( type: esriFieldTypeString, alias: Is the individual diabetic?, editable: true, nullable: true, length: 5, defaultValue: null, modelName: DIABETIC , Coded Values: [Yes: Yes] , [No: No] )
• INSULIN ( type: esriFieldTypeString, alias: Does the individual take insulin?, editable: true, nullable: true, length: 5, defaultValue: null, modelName: INSULIN , Coded Values: [Yes: Yes] , [No: No] )
• VISIONIMPAIR ( type: esriFieldTypeString, alias: Is the individual vision impaired?, editable: true, nullable: true, length: 5, defaultValue: null, modelName: VISIONIMPAIR , Coded Values: [Yes: Yes] , [No: No] )
• HEARINGIMPAIR ( type: esriFieldTypeString, alias: Is the individual hearing impaired?, editable: true, nullable: true, length: 5, defaultValue: null, modelName: HEARINGIMPAIR , Coded Values: [Yes: Yes] , [No: No] )
• PETCT ( type: esriFieldTypeSmallInteger, alias: How many pets live with the individual? If the pet is not a dog or cat, please describe the pet in the comment section below, editable: true, nullable: true, defaultValue: null, modelName: PETCT )
• HEALTHCOMMENT ( type: esriFieldTypeString, alias: Describe any additional health issues, editable: true, nullable: true, length: 3000, defaultValue: null, modelName: HEALTHCOMMENT )
• MOBILITYCOMMENT ( type: esriFieldTypeString, alias: Describe any mobility issues, editable: true, nullable: true, length: 3000, defaultValue: null, modelName: MOBILITYCOMMENT )
• CASEMGRNAME ( type: esriFieldTypeString, alias: Name of Case Manager or Home Nurse, editable: true, nullable: true, length: 100, defaultValue: null, modelName: CASEMGRNAME )
• CASEMGRAGENCY ( type: esriFieldTypeString, alias: Agency Name of Case Manager or Home Nurse, editable: true, nullable: true, length: 100, defaultValue: null, modelName: CASEMGRAGENCY )
• ADDCOMMENT ( type: esriFieldTypeString, alias: Include any additional comments and considerations, editable: true, nullable: true, length: 3000, defaultValue: null, modelName: ADDCOMMENT )
• RECDT ( type: esriFieldTypeDate, alias: Date Received, editable: true, nullable: true, length: 8, defaultValue: null, modelName: RECDT )
• STAFFNAME ( type: esriFieldTypeString, alias: Name of Staff Recording Information, editable: true, nullable: true, length: 100, defaultValue: null, modelName: STAFFNAME )
• STAFFCOMMENT ( type: esriFieldTypeString, alias: Internal Comments, editable: true, nullable: true, length: 3000, defaultValue: null, modelName: STAFFCOMMENT )
• VERIFYSTAFFNAME ( type: esriFieldTypeString, alias: Name of Staff Verifying Information, editable: true, nullable: true, length: 100, defaultValue: null, modelName: VERIFYSTAFFNAME )
• VERIFYDT ( type: esriFieldTypeDate, alias: Date Verified, editable: true, nullable: true, length: 8, defaultValue: null, modelName: VERIFYDT )
• STATUS ( type: esriFieldTypeString, alias: Status, editable: true, nullable: true, length: 20, defaultValue: null, modelName: STATUS , Coded Values: [Submitted: Submitted] , [Verified: Verified] , [Expired: Expired] )
• CREATEDON ( type: esriFieldTypeDate, alias: CREATEDON, editable: false, nullable: true, length: 8, defaultValue: null, modelName: CREATEDON )
Types:
ID: Expired
Name: Expired
Domains:
• GENDER:
  Inherited
• HEIGHT:
  Inherited
• WEIGHT:
  Inherited
• OXYGEN:
  Inherited
• WHEELCHAIR:
  Inherited
• HOSPICE:
  Inherited
• DIALYSIS:
  Inherited
• SPECIALTRANSPORT:
  Inherited
• DIABETIC:
  Inherited
• INSULIN:
  Inherited
• VISIONIMPAIR:
  Inherited
• HEARINGIMPAIR:
  Inherited
• STATUS:
  Inherited
Templates:
• Name: Expired
  Description:
  Prototype:
  VERIFYDT: null
  CITY: null
  STATUS: Expired
  FIRSTNAME: null
  LASTNAME: null
  STADDR: null
  STATEABBR: MN
  ZIPCODE: null
  DATEBIRTH: null
  CRTAGE: null
  GENDER: null
  HEIGHT: null
  WEIGHT: null
  EMAIL: null
  PRIMPHONE: null
  SECPHONE: null
  PHYSNAME: null
  PHYSFACNAME: null
  POCNAME: null
  ICENAME: null
  ICERELATION: null
  ICEPRIMPHONE: null
  ICESECPHONE: null
  ICEEMAIL: null
  OXYGEN: null
  WHEELCHAIR: null
  HOSPICE: null
  DIALYSIS: null
  SPECIALTRANSPORT: null
  DIABETIC: null
  INSULIN: null
  VISIONIMPAIR: null
  HEARINGIMPAIR: null
  PETCT: null
  HEALTHCOMMENT: null
  MOBILITYCOMMENT: null
  CASEMGRNAME: null
  CASEMGRAGENCY: null
  ADDCOMMENT: null
  RECDT: null
  STAFFNAME: null
  STAFFCOMMENT: null
  VERIFYSTAFFNAME: null
  
  Drawing Tool: esriFeatureEditToolPoint

---

ID: Verified
Name: Verified
Domains:
• GENDER:
  Inherited
• HEIGHT:
  Inherited
• WEIGHT:
  Inherited
• OXYGEN:
  Inherited
• WHEELCHAIR:
  Inherited
• HOSPICE:
  Inherited
• DIALYSIS:
  Inherited
• SPECIALTRANSPORT:
  Inherited
• DIABETIC:
  Inherited
• INSULIN:
  Inherited
• VISIONIMPAIR:
  Inherited
• HEARINGIMPAIR:
  Inherited
• STATUS:
  Inherited
Templates:
• Name: Verified
  Description:
  Prototype:
  VERIFYDT: null
  CITY: null
  STATUS: Verified
  FIRSTNAME: null
  LASTNAME: null
  STADDR: null
  STATEABBR: MN
  ZIPCODE: null
  DATEBIRTH: null
  CRTAGE: null
  GENDER: null
  HEIGHT: null
  WEIGHT: null
  EMAIL: null
  PRIMPHONE: null
  SECPHONE: null
  PHYSNAME: null
  PHYSFACNAME: null
  POCNAME: null
  ICENAME: null
  ICERELATION: null
  ICEPRIMPHONE: null
  ICESECPHONE: null
  ICEEMAIL: null
  OXYGEN: null
  WHEELCHAIR: null
  HOSPICE: null
  DIALYSIS: null
  SPECIALTRANSPORT: null
  DIABETIC: null
  INSULIN: null
  VISIONIMPAIR: null
  HEARINGIMPAIR: null
  PETCT: null
  HEALTHCOMMENT: null
  MOBILITYCOMMENT: null
  CASEMGRNAME: null
  CASEMGRAGENCY: null
  ADDCOMMENT: null
  RECDT: null
  STAFFNAME: null
  STAFFCOMMENT: null
  VERIFYSTAFFNAME: null
  
  Drawing Tool: esriFeatureEditToolPoint

---

ID: Submitted
Name: Submitted
Domains:
• GENDER:
  Inherited
• HEIGHT:
  Inherited
• WEIGHT:
  Inherited
• OXYGEN:
  Inherited
• WHEELCHAIR:
  Inherited
• HOSPICE:
  Inherited
• DIALYSIS:
  Inherited
• SPECIALTRANSPORT:
  Inherited
• DIABETIC:
  Inherited
• INSULIN:
  Inherited
• VISIONIMPAIR:
  Inherited
• HEARINGIMPAIR:
  Inherited
• STATUS:
  Inherited
Templates:
• Name: Submitted
  Description:
  Prototype:
  VERIFYDT: null
  CITY: null
  STATUS: Submitted
  FIRSTNAME: null
  LASTNAME: null
  STADDR: null
  STATEABBR: MN
  ZIPCODE: null
  DATEBIRTH: null
  CRTAGE: null
  GENDER: null
  HEIGHT: null
  WEIGHT: null
  EMAIL: null
  PRIMPHONE: null
  SECPHONE: null
  PHYSNAME: null
  PHYSFACNAME: null
  POCNAME: null
  ICENAME: null
  ICERELATION: null
  ICEPRIMPHONE: null
  ICESECPHONE: null
  ICEEMAIL: null
  OXYGEN: null
  WHEELCHAIR: null
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  HEARINGIMPAIR: null
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  STAFFNAME: null
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  Drawing Tool: esriFeatureEditToolPoint

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