School of Engineering Technology Applied Database 1 COP 4708 Project Assignment # 1 PATIENT INFORMATION Thank you for choosing our office! In order to serve you properly, we need the following inormation. Please print. All information will be Introduction: Date Mile Home phone A physician office (private practice) approached you in.an.effort to convert their paperwork process into a health information database. The physician provided a copy of the paperwork used in the office to collect patient information. The physician also explained the need to secure patient information and discussed the required level of access for each employee but did not provide a list. The physician stated that additional information will be provided upon request. The physician would like to add to patient records results from labs and imaging. In addition, the physician would like to link with a list of pharmacies in the area and send patient prescription electronically. As a database expert you will be developing patient database and all required tables using relational database approach. 2p MinorSingle Married Divenced Wiskwed Seprated Check appropriate box Patient's parent's employer Business address Spouse or parent'sme Cty ale Work phone patient is a student, name of schoolcolege Whom may we thank for eferring you Penuce to conact in case of emergeny lntie o' anokal emenpncy, ithe patert is ot school age 15+,Risallright to-treat in my ence. Parent or gaardian signatare Responsible Parly Requirement: ol penson nesponsible for this account Relationhip to patient Home phone Driver's license Bithdate 1. Analyze the provided forms below identifying the entities that should be tracked in the 2. Identify the fields (attributes) associated with each entity, listing possible candidate keys 3. Based on your analysis and the given forms identify all possible functional dependencles Work phone s this penon canently a paent at our office Insurance Information Name of in ithdte Name of employer Addres of eeploe rnince company m. Co. address How much i your deductible system [determinants). Relationship to patient Date employed Social Security Number Work phone remember that those functional dependencies will not only assist in creating the proper tables but also will assist in understanding relationships between tables). Create a separate entity to secure database with the list of required level access provided by the physician. Group # Union o 4. How much have you used Max, annaal beneit Do you have any additional insurance? Yes No Relatiorohip to patient Date employed Name el iured Forms and Documentation Provided: Sociul Security Numbr Work phone Name of employe Address of employer Isurance company Zp The following are coples of the paper forms used in the office. Use these form to complete the assignment requirements above Group Union or local # How much is your deductible? How much have you uned Mas. annual benefe I authorize relene o any information cencerning my for my chilJ's ath care, advice and breatement peovided for the purpose of esaluating and administering lais for insrance benelits Iabo hereby aathorize payment of insunance bencle otherwise payable to me deectly to the doctor Sighature of patient or parent d mino School of Engineering Technology Applied Database 1 COP 4708 Project Assignment # 1 PATIENT INFORMATION Thank you for choosing our office! In order to serve you properly, we need the following inormation. Please print. All information will be Introduction: Date Mile Home phone A physician office (private practice) approached you in.an.effort to convert their paperwork process into a health information database. The physician provided a copy of the paperwork used in the office to collect patient information. The physician also explained the need to secure patient information and discussed the required level of access for each employee but did not provide a list. The physician stated that additional information will be provided upon request. The physician would like to add to patient records results from labs and imaging. In addition, the physician would like to link with a list of pharmacies in the area and send patient prescription electronically. As a database expert you will be developing patient database and all required tables using relational database approach. 2p MinorSingle Married Divenced Wiskwed Seprated Check appropriate box Patient's parent's employer Business address Spouse or parent'sme Cty ale Work phone patient is a student, name of schoolcolege Whom may we thank for eferring you Penuce to conact in case of emergeny lntie o' anokal emenpncy, ithe patert is ot school age 15+,Risallright to-treat in my ence. Parent or gaardian signatare Responsible Parly Requirement: ol penson nesponsible for this account Relationhip to patient Home phone Driver's license Bithdate 1. Analyze the provided forms below identifying the entities that should be tracked in the 2. Identify the fields (attributes) associated with each entity, listing possible candidate keys 3. Based on your analysis and the given forms identify all possible functional dependencles Work phone s this penon canently a paent at our office Insurance Information Name of in ithdte Name of employer Addres of eeploe rnince company m. Co. address How much i your deductible system [determinants). Relationship to patient Date employed Social Security Number Work phone remember that those functional dependencies will not only assist in creating the proper tables but also will assist in understanding relationships between tables). Create a separate entity to secure database with the list of required level access provided by the physician. Group # Union o 4. How much have you used Max, annaal beneit Do you have any additional insurance? Yes No Relatiorohip to patient Date employed Name el iured Forms and Documentation Provided: Sociul Security Numbr Work phone Name of employe Address of employer Isurance company Zp The following are coples of the paper forms used in the office. Use these form to complete the assignment requirements above Group Union or local # How much is your deductible? How much have you uned Mas. annual benefe I authorize relene o any information cencerning my for my chilJ's ath care, advice and breatement peovided for the purpose of esaluating and administering lais for insrance benelits Iabo hereby aathorize payment of insunance bencle otherwise payable to me deectly to the doctor Sighature of patient or parent d mino