Urgent care

Fernhollow Corners Urgent Care · Urgent care · Asheville, NC

Ottilie Nakashima is the clinic manager at Fernhollow Corners Urgent Care, a walk-in clinic in Asheville, and she runs a public intake form that carries each newcomer from the first call, through a coverage check, to a booked first visit.

Healthcare IntakeForms3 tables · 4 views · 1 form · 2 dimension sets · 1 digest · 1 notification · 1 stage rule set · 1 agent

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Everyone waiting

New patients

Patient	Chart number	Date of birth	Phone	Email	Reason for the visit	How they found us
Ravenna Whitlock-Achebe	FC-1001	Jan 1, 1958	+1 828 555 0100	ravenna.whitlockachebe@fernhollowpatientmail.com	Chest cold or cough	Search results
Leopold Pelham-Ito	FC-1004	Apr 7, 1993	+1 828 555 0103	leopold.pelhamito@fernhollowpatientmail.com	Sprain or strain	Employer
Caspian Fenwick-Duarte	FC-1002	Feb 3, 1971	+1 828 555 0101	caspian.fenwickduarte@fernhollowpatientmail.com	Rash or skin problem	Insurance directory
Isadora Kalinowski-Boateng	FC-1003	Mar 5, 1985	+1 828 555 0102	isadora.kalinowskiboateng@fernhollowpatientmail.com	Sports physical	Friend or family
Tamsin Jessamy-Kowalski	FC-1022	Oct 16, 1995	+1 828 555 0121	tamsin.jessamykowalski@fernhollowpatientmail.com	Vaccination	Insurance directory
Percival Ivanhoe-Mensah	FC-1021	Sep 14, 1986	+1 828 555 0120	percival.ivanhoemensah@fernhollowpatientmail.com	Urinary symptoms	Search results
Ottoline Hargreaves-Ng	FC-1020	Aug 12, 1969	+1 828 555 0119	ottoline.hargreavesng@fernhollowpatientmail.com	Sprain or strain	Walk-by
Cornelius Galloway-Ibrahim	FC-1019	Jul 10, 1991	+1 828 555 0118	cornelius.gallowayibrahim@fernhollowpatientmail.com	Sports physical	Employer
Henrietta Fairbairn-Santos	FC-1018	Jun 8, 2004	+1 828 555 0117	henrietta.fairbairnsantos@fernhollowpatientmail.com	Rash or skin problem	Friend or family
Delphine Strickland-Tanaka	FC-1024	Dec 20, 1972	+1 828 555 0123	delphine.stricklandtanaka@fernhollowpatientmail.com	Work injury	Employer
Montague Everhart-Okafor	FC-1017	May 6, 1977	+1 828 555 0116	montague.everhartokafor@fernhollowpatientmail.com	Chest cold or cough	Insurance directory
Cordelia Dunmore-Yamada	FC-1016	Apr 4, 1984	+1 828 555 0115	cordelia.dunmoreyamada@fernhollowpatientmail.com	Work injury	Search results

18 more rows

Tables

New patients

30 sample rows · 17 columns

Everyone who has called, clicked or walked in for a first visit, from first contact to the day they are seen.

Patient	Chart number	Date of birth	Phone	Email	Reason for the visit	How they found us
Ravenna Whitlock-Achebe	FC-1001	Jan 1, 1958	+1 828 555 0100	ravenna.whitlockachebe@fernhollowpatientmail.com	Chest cold or cough	Search results
Leopold Pelham-Ito	FC-1004	Apr 7, 1993	+1 828 555 0103	leopold.pelhamito@fernhollowpatientmail.com	Sprain or strain	Employer
Caspian Fenwick-Duarte	FC-1002	Feb 3, 1971	+1 828 555 0101	caspian.fenwickduarte@fernhollowpatientmail.com	Rash or skin problem	Insurance directory
Isadora Kalinowski-Boateng	FC-1003	Mar 5, 1985	+1 828 555 0102	isadora.kalinowskiboateng@fernhollowpatientmail.com	Sports physical	Friend or family
Tamsin Jessamy-Kowalski	FC-1022	Oct 16, 1995	+1 828 555 0121	tamsin.jessamykowalski@fernhollowpatientmail.com	Vaccination	Insurance directory
Percival Ivanhoe-Mensah	FC-1021	Sep 14, 1986	+1 828 555 0120	percival.ivanhoemensah@fernhollowpatientmail.com	Urinary symptoms	Search results
Ottoline Hargreaves-Ng	FC-1020	Aug 12, 1969	+1 828 555 0119	ottoline.hargreavesng@fernhollowpatientmail.com	Sprain or strain	Walk-by
Cornelius Galloway-Ibrahim	FC-1019	Jul 10, 1991	+1 828 555 0118	cornelius.gallowayibrahim@fernhollowpatientmail.com	Sports physical	Employer
Henrietta Fairbairn-Santos	FC-1018	Jun 8, 2004	+1 828 555 0117	henrietta.fairbairnsantos@fernhollowpatientmail.com	Rash or skin problem	Friend or family
Delphine Strickland-Tanaka	FC-1024	Dec 20, 1972	+1 828 555 0123	delphine.stricklandtanaka@fernhollowpatientmail.com	Work injury	Employer
Montague Everhart-Okafor	FC-1017	May 6, 1977	+1 828 555 0116	montague.everhartokafor@fernhollowpatientmail.com	Chest cold or cough	Insurance directory
Cordelia Dunmore-Yamada	FC-1016	Apr 4, 1984	+1 828 555 0115	cordelia.dunmoreyamada@fernhollowpatientmail.com	Work injury	Search results

18 more rows

Coverage checks

18 sample rows · 6 columns

The phone or portal check that confirms what a new patient's plan will cover.

Check	Patient	Checked on	Insurance	Coverage	Checked by
Coverage check, chart FC-1022	Tamsin Jessamy-Kowalski	Oct 1, 7:10 PM	State Medicaid	Needs a call	Calliope Vandenberg-Mensah
Coverage check, chart FC-1021	Percival Ivanhoe-Mensah	Sep 30, 7:10 PM	Ostrander Mutual Care	Active	Calliope Vandenberg-Mensah
Coverage check, chart FC-1020	Ottoline Hargreaves-Ng	Sep 29, 7:10 PM	Self-pay	Not applicable	Calliope Vandenberg-Mensah
Coverage check, chart FC-1019	Cornelius Galloway-Ibrahim	Sep 28, 7:10 PM	Linwood Choice Health	Active	Calliope Vandenberg-Mensah
Coverage check, chart FC-1018	Henrietta Fairbairn-Santos	Sep 27, 7:10 PM	Marrowfield Health Plan	Active	Calliope Vandenberg-Mensah
Coverage check, chart FC-1024	Delphine Strickland-Tanaka	Sep 27, 7:10 PM	Linwood Choice Health	Active	Calliope Vandenberg-Mensah
Coverage check, chart FC-1017	Montague Everhart-Okafor	Sep 26, 7:10 PM	State Medicaid	Active	Calliope Vandenberg-Mensah
Coverage check, chart FC-1016	Cordelia Dunmore-Yamada	Sep 25, 7:10 PM	Ostrander Mutual Care	Active	Calliope Vandenberg-Mensah
Coverage check, chart FC-1015	Lysander Castellano-Ridley	Sep 24, 7:10 PM	Self-pay	Not applicable	Calliope Vandenberg-Mensah
Coverage check, chart FC-1023	Ignatius Kingsley-Abara	Sep 24, 7:10 PM	Marrowfield Health Plan	Active	Calliope Vandenberg-Mensah
Coverage check, chart FC-1014	Seraphine Abernethy-Oduya	Sep 23, 7:10 PM	Linwood Choice Health	Active	Calliope Vandenberg-Mensah
Coverage check, chart FC-1013	Barnaby Corbett-Park	Sep 22, 7:10 PM	Marrowfield Health Plan	Active	Calliope Vandenberg-Mensah

6 more rows

Also included

Forms waiting on a coverage checkDigest
Intake stagesStage rules
Form receivedNotificationTells the insurance coordinator the moment a new patient sends their form.

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Ardith Solheim-Banda	KH-10401	Mar 14, 1946
Cornelius Whitlock-Abara	KH-10402	Nov 2, 1951
Theodora Brandt-Nakamura	KH-10403	Jul 21, 1943
Everett Kowalczyk-Ruiz	KH-10404	Jan 30, 1958

Ainsworth: adult therapy	BH-4100	Marguerite Ainsworth-Delacroix
Bellweather: teen therapy	BH-4107	Tobias Bellweather
Castellanos: couples counseling	BH-4114	Ximena Castellanos-Reyes
Dunmore: medication evaluation	BH-4121	Wilhelmina Dunmore

Corinne Abernathy-Voss	HDG-41200	Feb 17, 1986
Hamid Zahradnik-Dunn	HDG-41207	Sep 3, 1979
Linnea Bergstrom	HDG-41214	Nov 26, 1992
Odell Fitzgerald-Park	HDG-41221	May 14, 1968

Ludovica Ashgrove-Okoye	Mar 14, 1991	(608) 555-0150
Tobiah Wynnstay	Nov 2, 1978	(608) 555-0151
Marisela Whitlow-Ndiaye	Jun 25, 2001	(608) 555-0152
Cuthbert Oyelaran-Fry	Sep 9, 1962	(608) 555-0153

Winola Brandvik-Seabrook	(843) 555-0120	winola.brandvikseabrook@lowcountrymailbox.net
Cassius Delacroix-Oyelowo	(843) 555-0121	cassius.delacroixoyelowo@lowcountrymailbox.net
Marisol Tamayo-Keane	(843) 555-0122	marisol.tamayokeane@lowcountrymailbox.net
Winifred Ashgrove	(843) 555-0123	winifred.ashgrove@lowcountrymailbox.net

Kilbride — fasting lipid panel	Fasting lipid panel	Yes
Mackenzie — complete blood count	Complete blood count	No
Vickery — prenatal panel	Prenatal panel	No
Yankowski — metabolic panel	Metabolic panel	Yes

Everyone waiting

Tables

New patients

Coverage checks

Also included

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