Client

Client name - Last, First [Middle]* Date of birth - m/d/yyyy* Enrollment type (list)* Enrollment status* Location (list)*
Bulk3,Client4 FT In treatment San Francisco
Bulk3,Client5 08/15/1988 New San Francisco
Bulk3,Client6 08/15/1988 GT San Francisco
Bulk3,Client7 08/15/1988 FT In treatment
 Enrollment
Primary staff(list) Referral date - m/d/yyyy Ref received date - m/d/yyyy Tx start - m/d/yyyyy Tx end - m/d/yyyyy
03-27, test1
03-27, test1
03-27, test1
Referrer Other Stakeholder 1 Other Stakeholder 2
 Identifiers
Other Stakeholder 3 Enrollment ID PID CII Ref Num Email - a@address.com
 Client Contact
Phone - (111) 222-2222 Phone Type Address line 1 Address line 2 City State Zip
 Personal Details
Lives with (list) Gender (list) SSN (xxx-xx-xxxx) Driver license Marital status (list) Ethnicity (list)
 Emergency Contact
Height - 5' 5" Weight - 120 Employment (list) Name - [Last,] First [Middle] Relationship Email - a@address.com
 Emergency Contact
Phone (111) 222-2222 Phone Type Address line 1Address line 2City State Zip Name - [Last,] First [MiddleRelationship (list)
 Child 1
Date of birth - m/d/yyyAge - 23 Email - a@address.com Phone (111) 222-2222 Phone Type Name - [Last,] First [MiddleRelationship (list)
 Child 2
Date of birth - m/d/yyyAge - 23 Email - a@address.com Phone (111) 222-2222 Phone Type Name - [Last,] First [MiddleRelationship (list)
 Child 3
Date of birth - m/d/yyyAge - 23 Email - a@address.com Phone (111) 222-2222 Phone Type Name - [Last,] First [MiddleRelationship (list)
 Child 4
Date of birth - m/d/yyyAge - 23 Email - a@address.com Phone (111) 222-2222 Phone Type
Other
Quick note
Date of birth can not be blank.
Enrollment type can not be blank.
Enrollment status can not be blank.
Enrollment location can not be blank.
Guidance

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Bulk uploading clients
Male AL Single Phone Enrollments Referrer list Enrollment Statuses
Female AK Married Home AB123 Automation, Test QA - OP32 Discharged
Other AZ In Relationship Mobile GT In Treatment
AR Divorced Office ETA002 New
CA Widowed Other FT
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Locations Staffs Ethnicity Relationship Lives With Employment
San Francisco 03-27, test1 American Indian Aunt Alone Full time
Asian Boyfriend Both Parents Part time
Black Brother Boyfriend Training
Hispanic Cousin Brother School
Pacific Islander Coworker Father Volunteer
White Daughter Girlfriend Other
Father Grandparents
Fiance Homeless/Transient
Friend Mother
Girlfriend Other Family
Grandfather Roommate
Grandmother Senior Care Facility
Husband Sister
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Roommate Other
Sister
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Other
Child Relationship
Daughter
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Son
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Stepson
Other