# | Name | Location | Type | Details | Index | Description |
---|---|---|---|---|---|---|
.01 | address change dt/tm(+) | 0;1 | DATE-TIME | B | This field will hold the date and time of the last Address Update. | |
1 | patient(+) | 0;2 | POINTER | 2 | C | This is the Patient associated with this address update. |
2 | address change user | 0;3 | POINTER | 200 | The name of the user who has changed this patient's primary address. | |
3 | address change source | 0;4 | SET OF CODES | HEC:HEC VAMC:VAMC HBSC:HBSC NCOA:NCOA BVA:BVA VAIN:VAINS USPS:USPS | This field will hold the source of the last address change. | |
3.5 | address change site | 0;5 | POINTER | 4 | ||
4 | prior address change dt/tm | 1;1 | DATE-TIME | This field will hold the date and time of the prior address update. | ||
5 | prior address change user | 1;2 | POINTER | 200 | The name of the prior user who changed this patient's primary address. | |
6 | prior address change site | 1;3 | POINTER | 4 | This field will hold the prior Site that changed this patient's address. This field is only populated when the PRIOR ADDRESS SOURCE is listed as VAMC. | |
7 | prior address change source | 1;4 | SET OF CODES | HEC:HEC VAMC:VAMC HBSC:HBSC NCOA:NCOA BVA:BVA VAIN:VAINS USPS:USPS | This field will hold the source of the prior address change. | |
8 | prior phone number [residence] | 1;5 | FREE TEXT | Enter the telephone number [4-20 characters] to this patient's prior place of residence. | ||
9 | prior street address [line 1] | 1;6 | FREE TEXT | This is the first line of this patient's prior residence street address [3-35 characters]. | ||
10 | prior street address [line 2] | 1;7 | FREE TEXT | Enter the second line of this patient's prior residence street address [3-30 characters] if the space provided in 'street address' was not sufficient. | ||
11 | prior city | 1;8 | FREE TEXT | Enter the prior city in which this patient resided [2-15 characters]. If the space provided is not sufficient please abbreviate the city to the best of your ability. | ||
12 | prior county | 1;9 | FREE TEXT | This is the prior county in which this patient resided [3-30 characters]. | ||
13 | prior state | 1;10 | POINTER | 5 | Select from the available listing the prior state in which this patient resided. | |
14 | prior zip+4 | 1;11 | FREE TEXT | Answer with either the 5 digit format (e.g. 12345) or the nine digit format (e.g. 12345-6789 or 123456789) for the prior zip code. | ||
15 | prior province | 1;12 | FREE TEXT | Enter the province [1-20 characters] to this patient's prior place of residence. | ||
16 | prior postal code | 1;13 | FREE TEXT | Enter the postal code [1-10 characters] to this patient's prior place of residence. | ||
17 | prior country | 1;14 | POINTER | 779.004 | This field will hold the value of Country in the prior address. | |
18 | prior bad address indicator | 1;15 | SET OF CODES | 1:UNDELIVERABLE 2:HOMELESS 3:OTHER 4:ADDRESS NOT FOUND | This field will hold the prior Bad Address Indicator. | |
19 | prior street address [line 3] | 2;1 | FREE TEXT | Enter the third line of this applicant's residence street address [3-30 characters] if the space provided in 'street address' and 'street address 2' was not sufficient. |
Not Referenced