Download Coordinated Care Plan (CCP) User Guide

v2-5
Information Field
Given name
Preferred name
What it tries to capture
The patient’s given name
The name by which the patient
prefers to be identified
Surname
The patient’s surname or family
Free text
name
The patient’s identified gender
Choose from the drop-down list
Description
The patient identifies as a male
The patient identifies as a female
The patient identifies as a transgender male
The patient identifies as a transgender female
The patient identifies as a gender other than the ones listed
The patient declined to answer
The patient’s date of birth
A date in the format
YYYY-MM-DD
The name of the Health Link
Free text
from which the patient’s CCP
was created
The address of the patient’s
Free text
primary residence
The city of the patient’s primary Free text
residence
The province of the patient’s
Standard two-letter format
primary residence
The postal code of the patient’s
Standard six-character format
primary residence
Whether or not the patient has
Choose from the drop-down list
OHIP coverage
Description
The patient has OHIP insurance
The patient does not have any insurance for core services
Gender
Option
Male
Female
Transgender male
Transgender female
Other
Decline to answer
Date of birth
Health Link
Address
City
Province
Postal code
OHIP insured
Option
Yes
No – uninsured
How to fill it out
Free text
Free text
Examples and key questions
Michael
Mike
Do you prefer to be called by a
different name?
Jones
1965-10-15
Barrie Community
123 Main Street
Ottawa
ON
A1A1A1
5