Customizing Your PDFs

You can customize PDFs for use with CTM Forms, the Records section of Front Desk, and Provider All-in-One by adding form fields that merge from ChiroTouch.

ClosedUpload your PDF to the editing tool

  1. Go to http://www.pdfescape.com/account/
  2. Click the Start Using Unregistered button.
  3. Click Upload PDF to PDFescape.
  4. Click the Choose File button.
  5. Select the PDF you want to make editable.
  6. Click Open.
  7. Click the Upload button.

You can now add text fields, radio buttons, and check boxes to your form.

ClosedAdding Text Fields

  1. In the left panel, click the Form Field button. The Form Field Creation Tool dialog box appears.
  2. In the Form Field Creation Tool dialog box, select Text.
  3. Click the Select button.
  4. Click the PDF to place the text box in the PDF. You can resize the text box by dragging any of the corners. You can move the text box by clicking the middle of the text box and dragging it to a new location.
  5. (Optional) If you want the text field data to be merged from ChiroTouch, right-click the text box and select Object Properties.
    1. In the Form Field Properties dialog box, change the Name field to the name you want to merge with from ChiroTouch. (See Merge Field Values for a list of fields.)
    2. Click the OK button.

If you are adding a field that does not get populated by ChiroTouch, leave the default value in the name field.

ClosedAdding Radio Button Fields

A radio button is a field that allows only one of a group to be selected (for example: "Yes" or "No").

  1. In the left panel, click the Form Field button.
  2. In the Form Field Properties dialog box, select Radio.
  3. Click the Select button.
  4. Click the PDF to place the radio button in the PDF. You can resize the radio button by dragging any of the corners. You can move the radio button by clicking the middle of it and dragging it to a new location.
  5. (Optional) If you want the radio button data to be merged from ChiroTouch, right-click the radio button and select Object Properties.
    1. In the Form Field Properties dialog box, change the Name field to the name you want to merge with from ChiroTouch. (Customizing Your PDFs for a list of fields.)
    2. In the Export Value field, type the value you are expecting from ChiroTouch.
    3. E X A M P L E    
      In this example, the radio button will be filled in if the value of the PatSex property is Male.
    4. Click the OK button. In the example above, you would then repeat the steps to create a button with an Export Value of "Female" (with the same Name value of "PatSex").
  6. After each set of radio buttons you add, right-click anywhere in the document that is not a form field, in order to turn off the form field tool. Note that in each group of radio buttons, one will remain selected by default at all times. If you want to change which button is selected, click the button.

Add another set of radio buttons

Click the Form Field button and repeat the above steps. This will ensure that each group of buttons is named differently and stays separate from other radio buttons. In order to allow only one button in a group to be selected, the radio buttons must have the same Name field defined in the Form Field Properties dialog box.

Change the name of a radio button

Right-click the button and select Object Properties to edit the Name field.

ClosedAdding Check Box Fields

A check box field can allow one or many options to be selected. (For example, "Select all symptoms you are currently experiencing".)

  1. In the left panel, click the Form Field button.
  2. In the Form Field Properties dialog box, select Checkbox.
  3. Click the Select button.
  4. Click the PDF to place the check box in the PDF. You can resize the check box by dragging any of the corners. You can move the check box by clicking the middle of it and dragging it to a new location. The check boxes contain a check mark by default. Click the check box to remove the check mark.

There are no corresponding form fields in ChiroTouch that would merge with the check boxes, so you do not necessarily need to edit the Name field property of the check box.

ClosedSaving Your PDF

  1. In the left panel, click the green icon (NOT the blueSave icon).
  2. (In Internet Explorer) Once your PDF is ready, you will see this dialog box. Click the Download button.
  3. You will then be prompted to download the file.
  4. Save or move the file to the following folder on the server:
    • From the server computer, save the file to C:\Program Files (x86)\PSChiro\Database\PatFiles\Templates\PDFForms
    • From a workstation, save the file to [servername]\CTData\PatFiles\Templates\PDFForms

If you do not have a “Program Files (x86)” folder, use the Program Files folder instead.

Your PDF will now be available in your ChiroTouch system in the Patient Records section.

ClosedMerge Field Values

When making your PDF, use the values in the left column.

General Fields

 

PatReferPhyslD

Referring Physician lD

PatTxPlan

Treatment Plan

PatTxPlanEnd

Tx Plan End

PatTxPlanStart

Tx Plan Start

PatTxPlanNotes

Tx Plan Notes

PatCurrDx

Current Dx

PatInitDx

Initial Dx

PatAccountBalance

PatientBalance+AccountBalance

Today

Today's Date

 

 

Office Fields

 

OfficeName

Office Name

OfficeAddr

Address

OfficeBillingName

Billing Name

OfficeBillingAddr

Billing Address

OfficeBillingStreet

Billing Address (street address only)

OfficeBillingCity

Biliing Address (city only)

OfficeBillingState

Billing Address (state only)

OfficeBillingZip

Billing Address (zip code only)

OfficePhone

Phone

OfficeFax

Fax

 

 

Provider Fields

 

ProvFName

First Name

ProvMidInit

Middle Name

ProvLName

Last Name

ProvFullName

FullName

ProvLicNo

License No.

ProvMedicarelD

Medicare lD

ProvPIN

Provider Pin

ProvSSN

SSN

ProvTIN

TIN

 

 

Patient Fields

 

PatPriEmail

Primary Email

PatPriPhone

Primary Phone

PatFName

First Name

PatMName

Middle Name

PatMNameInt

Middle Name(first initial only)

PatLName

Last Name

PatFullName

Full Name

PatFullNameLFM

Full Name(Last,First Middle)

PatAddress

Address

PatCity

City

PatState

State

PatZip

Zip

PatAcctNo

Account No

PatChartNo

Chart No

PatCaseType

Case Type

PatBalance

Patient Balance

PatBirthDate

BirthDate

PatBirthDateMonth

BirthDate (month only, text "January", "February", etc)

PatBirthDateMonthDig

BirthDate (month only, number "01", "02", etc)

PatBirthDateDay

BirthDate (day only, number "01", "02", etc)

PatBirthDateYear4Dig

BirthDate (year only, 4-digit number "1995", "1996", etc)

PatBirthDateYear2Dig

BirthDate (year only, 2-digit number "95", "96", etc)

PatAge

Age

PatSex

Sex

PatMarStatus

Marital Status

PatSSN

SSN

PatOccupation

Occupation

PatEmplName

Employer Name

PatEmplAddr

Employer Address

PatEmplCity

Employer City

PatEmplState

Employer State

PatEmplZip

Employer Zip

PatEmploymentStatus

Employment Status

PatAttyFirm

Attorney Firm

PatAttyName

Attorney Name

PatAttyAddr

Attorney Address

PatAttyEmail

Attorney Email

PatAttyPhone

Attorney Phone

PatAttyFax

Attorney Fax

PatAttyNotes

Attorney Notes

PatCondAuto

Condition Auto

PatCondAutoState

Auto State

PatCondEmploy

Cond Employment

PatCondOther

Cond Other

PatUnableWorkFrom

Unable Work From Date

PatUnableWorkTo

Unable Work To Date

PatFacilityAddress

Facility Address

PatOrigInjDate

Original Injury Date

PatInjuryDate

Injury Date

PatHospFromDate

Hospital From Date

PatHospToDate

Hospital To Date

PatInitVisit

Initial Visit

PatLastVisit

Last Visit

PatNextVisit

Next Visit

PatReferBy

Referred By

PatReferPatName

Referred Patient Name

PatReferByName

Refer By Name

PatReferByDate

Refer By Date

PatReferByLoc

Refer By Loc

PatReferPhysName

Referring Phys

PatReferPhyslD

Referring Phys lD

PatTxPlan

Treatment Plan

PatTxPlanEnd

TxPlan End

PatTxPlanStart

TxPlan Start

PatTxPlanNotes

TxPlan Notes

PatCurrDx

Current Dx

PatInitDx

Initial Dx

PatAccountBalance

PatientBalance+AccountBalance

 

 

Insurance Primary

 

InsCoName

InsCoName

InsCoAddr

Company Address

InsCoCity

Company City

InsCoState

Company State

InsCoZip

Company Zip

InsCoPhone

Company Phone No

InsCoFax

Company Fax No

InsAdjusterName

Adjuster

InsAdjusterPhone

Adjuster Phone No

InsEffDate

Effective Date

InsTermDate

Termination Date

InsInsuredIDNo

Insuredd lD No

InsCoverageType

Insurance Coverage Type

InsCopay

Copay

InsPercent

Ins Percent Covered

InsDeductible

Deductible

InsDeductibleRemaing

Deductible Remaining

InsVisitMax

Visit Max

InsAnnualMaxAmt

Annual Max Amount

InsAnnualAmt

Annual Amount

InsAnnualMaxVisits

Annual Max Visits

InsAnnualVisits

Annual Visits

InsAuthEndDate

Authorization End Date

InsAuthStartDate

Authorization Start Date

InsAuthVisits

Authorization Visits

InsAuthVisitsUsed

Authorization Visits Used

InsInsuredName

Insuredd Name

InsInsuredAddr

Insuredd Address

InsInsureddCity

Insured City

InsInsuredState

Insured State

InsInsuredZip

Insured Zip

InsInsuredPhone

Insured Phone

InsInsuredBirthDate

Insured Birth Date

InsInsuredSex

Insured Sex

InsInsuredEmpSchool

Insured Emp School

InsInsuredPlanProg

Insured Plan Program

InsRelationship

Relationship

InsOthInsuredName

Other Insured Name

InsOthInsuredBirthDate

Other Insured BirthDate

InsOthInsuredSex

Other Insured Sex

InsOthInsuredEmpSchool

Other Insured Emp School

InsOthInsuredPlanProg

Other Insured Plan Program

InsOthInsuredPolGrpNum

Other Insured Pol GrpNum

InsInsuredMedicaidResubCode

Medicaid Resub Code

InsOrigRefNo

Original Ref No

InsPriorAuthNo

Prior Auth No

InsLastPmtAmt

Last Ins Pmt Amt

InsLatPmtDate

LastIns Pmt Date

InsBalance

Account Balance

 

 

Insurance Secondary

 

Ins2CoName

Ins Company Name

Ins2CoAddr

Company Address

Ins2CoCity

Company Citv

Ins2CoState

Company State

Ins2CoZip

Company Zip

Ins2CoPhone

Company PhoneNo

Ins2CoFax

Company FaxNo

Ins2AdjusterName

Adjuster

Ins2AdjusterPhone

Adjuster Phone No

Ins2EffDate

EffectiveDate

Ins2TermDate

Termination Date

Ins21nsuredIDNo

Insured ID No

Ins2CoverageType

Coverage Type

Ins2Copay

Copay

Ins2Percent

InsPercent

Ins2Deductible

Deductible

Ins2DeductibleRemaing

Deductible Remaining

Ins2VisitMax

Visit Max

Ins2AnnualMaxAmt

Annual Max Amount

Ins2AnnualAmt

Annual Amount

Ins2AnnualMaxVisits

Annual Max Visits

Ins2AnnualVisits

Annual Visits

Ins2AuthEndDate

Authorization End Date

Ins2AuthStartDate

Authorization Start Date

Ins2AuthVisits

Authorization Visits

Ins2AuthVisitsUsed

Authorization Visits Used

Ins2InsuredName

Insured Name

Ins2InsuredAddr

Insured Address

Ins2InsuredCity

Insured City

Ins2InsuredState

Insured State

Ins2InsuredZip

Insured Zip

Ins2InsuredPhone

Insured Phone

Ins2InsuredBirthDate

Insured BirthDate

Ins2InsuredSex

Insured Sex

Ins2InsuredEmpSchool

Insured Emp School

Ins2InsuredPIanProg

Insured Plan Program

Ins2Relationship

Relationship

Ins2OthinsuredName

OtherInsured Name

Ins2OthinsuredBirthDate

OtherInsured BirthDate

Ins2OthinsuredSex

OtherInsured Sex

Ins2OthinsuredEmpSchooi

OtherInsured Emp School

Ins2OthinsuredPIanProg

OtherInsured Plan Program

Ins2OthinsuredPoIGrpNum

OtherInsured Pol Grp Num

Ins2InsuredMedicaidResubCode

Medicaid Resub Code

Ins2OrigRefNo

OrigRefNo

Ins2PriorAulhNo

Prior Auth No

Ins2LastPmtAmt

Last Ins Pmt Amt

Ins2LastPmtDate

Last Ins Pmt Date

Ins2Balance

Account Balance