truForm & WinOMScs Integration Fields

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Instructions below ONLY apply to truForm with Carestream (WinOMscs) Integration.

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 fields integrate into your PMS!
  1. Patient Information
  2. Responsible Party
  3. Spouse or Other Guarantor Information
  4. School and Insurance Information
  5. Insurance Information (Primary/Secondary Dental and Medical)
  6. Health History
  7. Health History Personal Information
  8. Women Only
  9. Medications
  10. Allergies
  11. Family History
  12. Injury Information

PATIENT INFORMATION

*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.  [See Example]

*IF YOU ARE USING A CUSTOM FORM: Patient Address/ City/ State / Zip must be split out into its own fields in order to integrate correctly.  [See Example]

*IF YOU ARE USING A CUSTOM FORM:  Dentist/Doctor/Referred By/Nearest Relative Names on the form must be split out into first name last name in order to integrate correctly.  [See Example]
  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).  [See Example]
  1. Emergency Full Name
  2. Home Phone
  3. Work Phone

DOES NOT INTEGRATE:

  1. Emergency contact relation

 

RESPONSIBLE PARTY INFORMATION

*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.  [See Example]

*IF YOU ARE USING A CUSTOM FORM: Patient Address/ City/ State / Zip must be split out into its own fields in order to integrate correctly.  [See Example]
  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

 

This entire section will not integrate:

SPOUSE OR OTHER GUARANTOR INFORMATION

 

SCHOOL AND INSURANCE INFORMATION
*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.  [See Example]
  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 INFORMATION

*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.   [See Example]

*IF YOU ARE USING A CUSTOM FORM: All Address/ City/ State / Zip must be split out into its own fields in order to integrate correctly.  [See Example]

*IF YOU ARE USING A CUSTOM FORM: Insured Name on the form must be split out into first name last name in order to integrate correctly.  [See Example]

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 (QUESTIONS 1 - 68 on PDF)

*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. If so, how much a day
  36. Do you use chewing tobacco
  37. Blood transfusion
  38. Blood disorder such as anemia
    *    Comes over as anemia
  39. Bruise easily
  40. Bleeding tendency / abnormal bleed
    *Comes over as bleeding tendency
  41. 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 (QUESTIONS 69-72 on PDF)
  1. Is there a possibility of pregnancy
  2. Expected delivery date
  1. Are you nursing
  2. Are you taking birth control pills

 

MEDICATIONS (QUESTIONS 73 - 80 on PDF)
  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. [SEE HERE FOR FULL DETAILS]:  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 (QUESTIONS 81 - 95 on PDF)
  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 INFORMATION
  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

 

HEALTH HISTORY PERSONAL INFORMATION
  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
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