Patient Setup

Configure a patient in AIR — new patient or new course for an existing patient

Patient Search

Search for an existing patient before creating a new one.

First Name *

Last Name *

Date of Birth *

Tiebreaker fields (optional — improves match accuracy)

SSN

Phone

Email

City

Checking for duplicates…

Patient Demographics

All fields blank — enter patient information.

Pre-filled from existing record. Edit as needed.

General

First Name *

Last Name *

Date of Birth *

Gender

SSN

Contact (all required by AIR)

Preferred Phone *

Email *

Address Line 1 *

Address Line 2

Postal Code *

City *

State *

Case / Course of Treatment

New Episode

Course # (auto)

Treatment Type *

Case Name (auto)

Course Start Date

Insurance

Primary insurance is required. Add Secondary/Tertiary if applicable.

Review & Submit

Patient

DOB: ·

Case

Treatment: · Start: