please_provide_your_name
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Please provide your name., type: esriFieldTypeString
)
please_provide_your_email_addre
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Please provide your email address., type: esriFieldTypeString
)
please_provide_the_name_of_your
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Please provide the name of your facility., type: esriFieldTypeString
)
what_are_the_facilitys_normal_h
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: What are the facility's normal hours of operation Monday - Friday?, type: esriFieldTypeString
)
is_your_facility_open_saturdays
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Is your facility open Saturdays & Sundays? If so, please provide your operating hours?, type: esriFieldTypeString
)
does_your_facility_have_on_call
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Does your facility have on-call personnel that can help respond to immediate needs/crisis?, type: esriFieldTypeString
, Coded Values:
[Yes: Yes]
, [No: No]
)
are_there_any_financial_assista
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Are there any financial assistance programs or policies in place to help patients who cannot afford their medical bills?, type: esriFieldTypeString
)
what_type_of_care_does_your_fac
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: What type of care does your facility provide?, type: esriFieldTypeString
, Coded Values:
[Inpatient: Inpatient]
, [Outpatient: Outpatient]
, [Inpatient & Outpatient: Inpatient & Outpatient]
)
what_types_of_mentalbehavioral
(
nullable: true, editable: true, defaultValue: null, length: 1000, alias: What types of mental/behavioral health services does your facility offer?, type: esriFieldTypeString
)
what_types_of_mentalbehav_other
(
nullable: true, editable: true, defaultValue: , length: 255, alias: Other - What types of mental/behavioral health services does your facility offer?, type: esriFieldTypeString
)
what_types_of_patients_do_you_t
(
nullable: true, editable: true, defaultValue: null, length: 1000, alias: What types of patients do you treat?, type: esriFieldTypeString
)