Pre-filled Patient Information
For certain forms, you can have patient information automatically filled in when patients verify their identity.
Which Information Can Be Pre-filled?
Only these three fields can be automatically filled: Patient First Name Patient Last Name Patient Date of Birth.
How to Set This Up
Step 1: Create a form with any Form Type (this feature works with all form types).
Step 2: Add text fields for patient information with these exact property names:
For First Name
1. Add a Text Field.
2. Label: 'Patient First Name'.
3. Go to API tab.
4. Property Name: type patientFirstName (exactly as shown).
5. Go to Display tab.
6. Turn ON 'Disabled' (so users can't change it).
7. Save.
For Last Name
1. Add a Text Field.
2. Label: 'Patient Last Name'.
3. Go to API tab.
4. Property Name: type patientLastName (exactly as shown).
5. Go to Display tab.
6. Turn ON 'Disabled'.
7. Save.
For Date of Birth
1. Add a Text Field.
2. Label: 'Patient Date of Birth'.
3. Go to Display tab.
4. Placeholder: 'MM/DD/YYYY'.
5. Input Mask: 99/99/9999.
6. Turn ON 'Disabled'.
7. Go to API tab.
8. Property Name: type patientDOB (exactly as shown).
9. Save.
Important: The property names must be spelled exactly as shown above for the pre-fill feature to work.
Using the Same Patient Info Multiple Times
Why do this? Sometimes you need the patient's information to appear in different sections of your form (for example, at the top for identification and again at the bottom for signature). Instead of asking patients to type their name twice, you can make it auto-copy from the first field. The steps for this are listed below.
1. Create your first field normally: Follow the setup steps in the section above (use property names like
patientFirstName , patientLastName , or patientDOB ). These fields will automatically pre-fill with patient information when patients verify their identity.
2. For the second instance of the same information, create a new second field with a different property name:
Examples:
First Name: First field = patientFirstName > Second field = patientFirstNameSection2
Last Name: First field = patientLastName > Second field = patientLastNameSection2
Date of Birth: First field = patientDOB > Second field = patientDOBSection2
3. Configure the second field to auto-copy from the first:
1. Add a Text Field to your form.
2. Go to API tab > Set Property Name (e.g., patientFirstNameSection2 )
3. Go to Data tab > In "Calculated Value" box, type the formula:
For First Name: value = data.patientFirstName;
For Last Name: value = data.patientLastName;
For Date of Birth: value = data.patientDOB;
4. Go to Display tab > Turn ON 'Disabled' (this prevents users from manually editing this field, ensuring it
always matches the original field).
5. Click Save.
Result: The second field will automatically display the same information as the first field.
***Pre-fill from Cloud9 only works once the patient has been matched to an existing Cloud9 record.
To return to the main Form Creation article, Click Here.
As always, if you have any further questions please do not hesitate to reach out to Cloud 9 Support by emailing us at cloud9support@planetdds.com, or chatting us online using the chat bubble on the lower right at https://cloud9support.planetdds.com/hc/en-us, or giving us a call during our business hours of 8:00 AM EST to 8:00 PM EST at the 1.800.394.6050 option 2.