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Or feel free to print them at home, sign them and bring them to your appointment","forms.other.ways-save-title":"Download and Save","forms.overview-button-next":"Next","forms.overview-button-review":"Review and Sign","forms.overview-form-completed":"Previously completed on {date}","forms.overview-link-other-ways":"Download forms","forms.overview-page-title-no-forms":"No Forms to Complete","forms.overview-page-title":"Forms for Your Visit","forms.overview-paragraph-no-forms":"You have no forms to complete at this time. Required forms and any additional information will be collected on the day of your appointment.","forms.overview-paragraph":"Please review and sign each form listed below.","forms.render-link-cancel":"Return to overview","getting.started-button":"Next","getting.started-list-four":"","getting.started-list-header":"Using this application, you can:","getting.started-list-one":"","getting.started-list-three":"Simplify Your Visit","getting.started-list-two":"Sign Required Forms","getting.started-paragraph":"Our goal is to make the check in process as simple as possible, and save you time on the day of your appointment.","getting.started-returned-list-four":"","getting.started-returned-list-one":"","getting.started-returned-list-three":"Check-In Ahead of Time","getting.started-returned-list-two":"Review & Sign Required Forms","getting.started-sub-header":"Thanks for choosing online pre-registration and check-in.","getting.started-welcome-back-with-name":"Welcome Back, {name}!","getting.started-welcome-back":"Welcome Back!","getting.started-welcome-with-name":"Welcome!","getting.started-welcome":"Welcome!","help.find.my.location-action-android":"Android","help.find.my.location-action-ios":"iPhone & iPad","help.find.my.location-android-step-one-li-four":"Open the Experian Health link in your browser and refresh the page.","help.find.my.location-android-step-one-li-one":"On your Android phone or tablet, go to the Settings app.","help.find.my.location-android-step-one-li-three":"Turn the switch on.","help.find.my.location-android-step-one-li-two-bold-text":"Location.","help.find.my.location-android-step-one-li-two-line-two":"(Depending on your device, this may be found elsewhere.)","help.find.my.location-android-step-one-li-two":"Under \"Personal,\" tap {boldText}","help.find.my.location-android-step-one-paragraph-bold-text":"Allow.","help.find.my.location-android-step-one-paragraph-two":"If you still get an error when you open the link, follow the instructions below.","help.find.my.location-android-step-one-paragraph":"If you don't see an error after you open the Experian Health link, select \"Allow Location\" and tap {boldText}","help.find.my.location-android-step-two-li-five-bullet-one":"If you see \"Location access is turned off for this device,\" tap the blue words > on the next screen, turn on location access.","help.find.my.location-android-step-two-li-five-bullet-two-bold-text-one":"Blocked","help.find.my.location-android-step-two-li-five-bullet-two-bold-text-two":"Clear & reset.","help.find.my.location-android-step-two-li-five-bullet-two":"If you see \"blocked\" under \"Location\" tap {boldTextOne} > tap the Experian Health site > {boldTextTwo}","help.find.my.location-android-step-two-li-five":"Tap location > turn it on.","help.find.my.location-android-step-two-li-four-bold-text":"Site settings.","help.find.my.location-android-step-two-li-four":"Under \"Advanced\", tap {boldText}","help.find.my.location-android-step-two-li-one":"On your Android phone or tablet, open the Chrome app.","help.find.my.location-android-step-two-li-six":"Open Experian Health link in your mobile browser and refresh the page.","help.find.my.location-android-step-two-li-three-bold-text":"Settings.","help.find.my.location-android-step-two-li-three":"Tap {boldText}","help.find.my.location-android-step-two-li-two":"In the top right, tap More.","help.find.my.location-button-back":"Go Back","help.find.my.location-heading":"Help Find My Location","help.find.my.location-ios-step-one-li-one":"On your iPhone or iPad, open your Settings app.","help.find.my.location-ios-step-one-li-three-bold-text":"While Using the App","help.find.my.location-ios-step-one-li-three":"Under \"Allow Location Access,\" tap {boldText}","help.find.my.location-ios-step-one-li-two-bold-text":"Privacy > Location Services > Safari Websites.","help.find.my.location-ios-step-one-li-two":"Tap {boldText}","help.find.my.location-ios-step-two-li-eight-allow":"Allow","help.find.my.location-ios-step-two-li-eight-ok":"OK.","help.find.my.location-ios-step-two-li-eight":"To give Safari access to your location, tap {Allow} or {OK}","help.find.my.location-ios-step-two-li-five-bold-text":"Reset Settings.","help.find.my.location-ios-step-two-li-five":"You'll see a message that says \"This will reset your location and privacy settings to factory defaults.\" Tap {boldText}","help.find.my.location-ios-step-two-li-four":"If asked, enter your password","help.find.my.location-ios-step-two-li-one":"On your iPhone or iPad, open your Settings app.","help.find.my.location-ios-step-two-li-seven-bold-text":"Experian Health link","help.find.my.location-ios-step-two-li-seven":"Open your {boldText}","help.find.my.location-ios-step-two-li-six-bold-text":"Safari.","help.find.my.location-ios-step-two-li-six":"Open {boldText}","help.find.my.location-ios-step-two-li-three-bold-text":"Reset Location & Privacy.","help.find.my.location-ios-step-two-li-three":"Tap {boldText}","help.find.my.location-ios-step-two-li-two-bold-text":"General > Reset.","help.find.my.location-ios-step-two-li-two":"Tap {boldText}","help.find.my.location-other-browsers-paragraph":"If you're using an internet browser other than Chrome, look for instructions on that browser's website.","help.find.my.location-other-browsers":"Other browsers","help.find.my.location-paragraph":"You'll need to turn on location services on your device in order to check in remotely.","help.find.my.location-step-one-heading":"Step 1: Turn on your location","help.find.my.location-step-two-browser-chrome":"Chrome","help.find.my.location-step-two-browser-safari":"Safari","help.find.my.location-step-two-heading":"Step 2: Give current location access on your browser","id.error-button":"Try Again","id.error-correct":"Correct","id.error-expired-id-page-title":"ID Has Expired","id.error-expired-id-paragraph":"The ID detected has expired and is no longer valid.","id.error-incorrect":"Incorrect","id.error-no-match-alerts-header":"Info from your ID:","id.error-no-match-button":"Call Provider","id.error-no-match-paragraph":"We're sorry, but some information collected from your ID does not match the records for this appointment. If you believe this to be in error, please contact us at {telephone}.","id.error-no-match-title":"Information Mismatch","id.error-page-title":"Unable to Read ID","id.error-reason-default-list-five":"Make sure there are no glare and shadows on the ID","id.error-reason-default-list-four":"Make sure all edges of the ID are visible","id.error-reason-default-list-one":"Place ID close to device","id.error-reason-default-list-three":"Hold device steady","id.error-reason-default-list-two":"Ensure sufficient light","id.error-reason-phone-incompatible-list-one":"Make sure the photo has good quality","id.error-reason-phone-incompatible-list-three":"If you are using the camera on the back of your phone, your phone may be incompatible with this application","id.error-reason-phone-incompatible-list-two":"If you are using the camera on the front of your phone, try using the camera on the back of your phone","id.info-address1":"Street Address 1","id.info-address2":"Street Address 2","id.info-button-cancel":"Cancel","id.info-button-edit":"Edit Info","id.info-button-save":"Update","id.info-button-submit":"Next","id.info-city":"City","id.info-date-of-birth":"Date Of Birth","id.info-first-name":"First Name","id.info-input-address1":"Street Address","id.info-input-city":"City","id.info-input-dateOfBirth":"Date of Birth","id.info-input-firstName":"First Name","id.info-input-lastName":"Last Name","id.info-input-state-choose":"Choose State","id.info-input-state":"State","id.info-input-zip":"Postal Code","id.info-last-name":"Last Name","id.info-page-description-edit":"We've collected the following information from your ID so you don't have to enter it again - just take a look and make sure the information is correct.","id.info-page-description-error":"There was an issue collecting your information. Please review to make sure the information is complete and accurate.","id.info-page-description":"We've collected the following information from your ID so you don't have to enter it again - just take a look and make sure the information is correct.","id.info-page-title":"Verify Information","id.info-state-ak":"Alaska","id.info-state-al":"Alabama","id.info-state-ar":"Arkansas","id.info-state-as":"American Samoa","id.info-state-az":"Arizona","id.info-state-ca":"California","id.info-state-co":"Colorado","id.info-state-ct":"Connecticut","id.info-state-dc":"District Of Columbia","id.info-state-de":"Delaware","id.info-state-fl":"Florida","id.info-state-fm":"Federated States of Micronesia","id.info-state-ga":"Georgia","id.info-state-gu":"Guam","id.info-state-hi":"Hawaii","id.info-state-ia":"Iowa","id.info-state-id":"Idaho","id.info-state-il":"Illinois","id.info-state-in":"Indiana","id.info-state-ks":"Kansas","id.info-state-ky":"Kentucky","id.info-state-la":"Louisiana","id.info-state-ma":"Massachusetts","id.info-state-md":"Maryland","id.info-state-me":"Maine","id.info-state-mh":"Marshall Islands","id.info-state-mi":"Michigan","id.info-state-mn":"Minnesota","id.info-state-mo":"Missouri","id.info-state-ms":"Mississippi","id.info-state-mt":"Montana","id.info-state-nc":"North Carolina","id.info-state-nd":"North Dakota","id.info-state-ne":"Nebraska","id.info-state-nh":"New Hampshire","id.info-state-nj":"New Jersey","id.info-state-nm":"New Mexico","id.info-state-np":"Northern Mariana Islands","id.info-state-nv":"Nevada","id.info-state-ny":"New York","id.info-state-oh":"Ohio","id.info-state-ok":"Oklahoma","id.info-state-or":"Oregon","id.info-state-pa":"Pennsylvania","id.info-state-pr":"Puerto Rico","id.info-state-pw":"Palau","id.info-state-ri":"Rhode Island","id.info-state-sc":"South Carolina","id.info-state-sd":"South Dakota","id.info-state-tn":"Tennessee","id.info-state-tx":"Texas","id.info-state-ut":"Utah","id.info-state-va":"Virginia","id.info-state-vi":"Virgin Islands","id.info-state-vt":"Vermont","id.info-state-wa":"Washington","id.info-state-wi":"Wisconsin","id.info-state-wv":"West Virginia","id.info-state-wy":"Wyoming","id.info-state":"State","id.info-zip":"Postal Code","input.field-placeholder-enter":"Enter {name}","input.field-placeholder-select":"Select a {name}","input.field-required":"* Required","insurance.areYouInsured":"Are You Insured?","insurance.auth-call-button":"Call {phoneNumber}","insurance.auth-declined-description":"This could possibly delay or cancel your appointment if not resolved","insurance.auth-declined-fix-header":"How to fix this","insurance.auth-declined-fix-paragraph-no-phone-number":"Most of the time, this can easily be resolved by calling the support team at {provider} and asking why there has been a delay in authorization.","insurance.auth-declined-fix-paragraph":"Most of the time, this can easily be resolved by calling the support team at {provider}","insurance.auth-declined-header":"Your Insurance Has Been Declined","insurance.auth-declined-say-header":"What to say","insurance.auth-declined-say-paragraph":"Call the office number listed below and ask why there has been a delay in authorization","insurance.auth-delayed-description":"This could possibly delay or cancel your appointment if not resolved","insurance.auth-delayed-fix-header":"How to fix this","insurance.auth-delayed-fix-paragraph-no-phone-number":"Most of the time, this can easily be resolved by calling the support team at {provider} and asking why there has been a delay in authorization.","insurance.auth-delayed-fix-paragraph":"Most of the time, this can easily be resolved by calling the support team at {provider}","insurance.auth-delayed-header":"Your Insurance has Delayed Authorization","insurance.auth-delayed-say-header":"What to say","insurance.auth-delayed-say-paragraph":"Call the office number listed below and ask why there has been a delay in authorization","insurance.auth-expired-description":"The deadline has expired for your insurance to send authorization","insurance.auth-expired-fix-header":"What do I do now?","insurance.auth-expired-fix-paragraph":"Unfortunately you will need to reschedule your appointment. Give us a call to see what can be done from our end.","insurance.auth-expired-header":"Deadline Expired for Insurance Authorization","insurance.auth-expired-say-header":"","insurance.auth-expired-say-paragraph":"","insurance.auth.approved-button":"Finish Getting Set Up","insurance.auth.approved-page-title":"Your Insurance Has Been Approved!","insurance.auth.declined-button":"Finish Getting Set Up","insurance.auth.delayed-button":"Finish Getting Set Up","insurance.auth.pending-button":"Finish Getting Set Up","insurance.auth.pending-description":"You will receive another update from us when your status changes.","insurance.auth.pending-page-title":"Your Insurance Status is Pending","insurance.card.not.approved-modal-button-done":"Got It","insurance.card.not.approved-modal-button-try-again":"Try Another Card","insurance.card.not.approved-modal-identifier-heading":"Invalid Card Identifier:","insurance.card.not.approved-modal-invalid-paragraph-multiple":"The insurance cards submitted are invalid or not yet approved. You will be unable to check-in without providing a valid insurance card. You may also choose to bring one with you to your appointment.","insurance.card.not.approved-modal-invalid-paragraph-single":"The insurance card submitted is invalid or not yet approved. You will be unable to check-in without providing a valid insurance card. You may also choose to bring one with you to your appointment.","insurance.card.not.approved-modal-invalid-title":"A Valid Insurance Card Has Not Yet Been Provided","insurance.card.not.approved-modal-paragraph":"One or more of the insurance cards you submitted is invalid or not yet approved. At least one card has been approved, so you will still be allowed to check-in.","insurance.card.not.approved-modal-policy":"Policy #: ","insurance.card.not.approved-modal-sr":"Insurance card help","insurance.card.not.approved-modal-title-multiple":"{number} Insurance Cards are Invalid","insurance.card.not.approved-modal-title-single":"{number} Insurance Card is Invalid","insurance.card.not.approved-multiple":"{number} Insurance cards were not approved","insurance.card.not.approved-single":"{number} Insurance card was not approved","insurance.error-button":"Try Again","insurance.error-correct":"Correct","insurance.error-expired-id-page-title":"Insurance Card Has Expired","insurance.error-expired-id-paragraph":"The insurance card detected has expired and is no longer valid.","insurance.error-incorrect":"Incorrect","insurance.error-page-title":"Unable to Read Card","insurance.error-reason-default-list-five":"Make sure there are no glare and shadows on the insurance card","insurance.error-reason-default-list-four":"Make sure all edges of the card are visible","insurance.error-reason-default-list-one":"Place insurance card close to device","insurance.error-reason-default-list-three":"Hold device steady","insurance.error-reason-default-list-two":"Ensure sufficient light","insurance.error.modal-button":"Enter Manually","insurance.error.modal-paragraph":"Sorry, we are unable to capture your insurance information from the camera on your device. In order to proceed, please enter your information manually.","insurance.error.modal-title":"Oops!","insurance.info-are-you-insured-no":"No","insurance.info-are-you-insured-yes":"Yes","insurance.info-are-you-insured":"Are You Insured?","insurance.info-company":"Company","insurance.info-effective-date":"Effective Date","insurance.info-group-number":"Group Number","insurance.info-member-id":"Member Id","insurance.info-relationship-to-subscriber":"Relationship to Subscriber","insurance.info-subscriber-date-of-birth":"Subscriber Date of Birth","insurance.info-subscriber-employer-name":"Subscriber Employer Name","insurance.info-subscriber-first-name":"Subscriber First Name","insurance.info-subscriber-last-name":"Subscriber Last Name","insurance.info-subscriber-relationship-child":"Child","insurance.info-subscriber-relationship-other":"Other","insurance.info-subscriber-relationship-self":"Self","insurance.info-subscriber-relationship-spouse":"Spouse","insurance.insuredNo":"No","insurance.insuredYes":"Yes","insurance.invalid-button-try-again":"Try Another Card","insurance.invalid-data-match-button-try-again":"Try Again","insurance.invalid-data-match-paragraph":"The patient name does not match the plan requested. Please make sure the name on the card matches the registering patient's name.","insurance.invalid-data-match":"Oops! There Was An Issue With Insurance","insurance.invalid-paragraph":"The insurance card provided is no longer valid. Please try using a different insurance card.","insurance.invalid-title":"Insurance Card is No Longer Valid","insurance.needed-button-confirm":"Confirm Insurance","insurance.needed-content-header":"Insurance information is needed","insurance.needed-page-title":"Your Appointment is Coming Up!","insurance.needed-paragraph":"Your procedure requires insurance authorization prior to your appointment","insurance.subscriber-dateOfBirth":"Subscriber Date of Birth","insurance.subscriber-employerName":"Subscriber Employer Name","insurance.subscriber-firstName":"Subscriber First Name","insurance.subscriber-lastName":"Subscriber Last Name","insurance.subscriber-relationship-child":"Child","insurance.subscriber-relationship-other":"Other","insurance.subscriber-relationship-self":"Self","insurance.subscriber-relationship-spouse":"Spouse","insurance.subscriber-relationship":"Relationship to Subscriber","insurance.subscriberId":"Subscriber ID","insurance.success-page-title":"Insurance Submitted Successfully!","insurance.success-paragraph":"You will receive another update from us when your insurance has been authorized for your procedure.","labelMissing":"Label Missing","language.selector-language":"Language: ","link.expired-paragraph":"Sorry, the link entered is either expired or no longer valid. You can no longer check-in for your appointment because the time has already passed.","link.expired-title":"This Link Has Expired or No Longer Exists","modal.window-make-changes-button-call":"Call","modal.window-make-changes-button-close":"Close","modal.window-make-changes-paragraph":"To cancel or make changes to your appointment, call ","modal.window-make-changes-title":"Want to make changes?","network.error.modal-button":"Try Again","network.error.modal-paragraph":"There seems to be a problem with your connection.","network.error.modal-title":"Could Not Connect to the Network","payment.fail-appointment-details":"Appointment Details","payment.fail-button":"Try Again","payment.fail-link":"No thanks, I'll pay at my visit","payment.fail-page-title":"Payment Failed","payment.fail-procedure-time":"{procedure} takes about {time} hours","payment.fail-reason":"Your credit card has been declined.","payment.receipt-button":"All Done","payment.receipt-confirmation-title":"Confirmation Number","payment.receipt-download":"Print a copy of your receipt","payment.receipt-page-title":"Payment Received","payment.receipt-print-confirmation":"Confirmation #","payment.receipt-print-copay-amount":"${amountPaid}","payment.receipt-print-date":"Date","payment.receipt-print-description-details":"{procedure} - {physician}","payment.receipt-print-facility-info":"Facility Information","payment.receipt-print-heading":"Co-Pay Payment Receipt","payment.receipt-print-method-details":"ending in ","payment.receipt-print-office-phone":"Office: {phoneNumber}","payment.receipt-print-patient-dob":"DOB: ","payment.receipt-print-patient-info":"Patient Information","payment.receipt-print-patient-name":"Name:","payment.receipt-print-patient-prn":"PRN: ","payment.receipt-print-patient-sex":"Sex: ","payment.receipt-print-table-amount":"AMOUNT PAID","payment.receipt-print-table-description":"DESCRIPTION","payment.receipt-print-table-method":"METHOD","payment.receipt-print-table-type-copay":"Co-Pay","payment.receipt-print-table-type":"TYPE","phone.number.footer-paragraph":"Having issues? Call ","phone.number.footer-phone-number":"1-888-234-2389","please.wait.modal-powered-by":"Powered by","please.wait.modal-title":"Please wait...","preview.id.image-back":"Back","preview.id.image-front":"Front","preview.id.image-page-title":"Here's a Preview of the {side} of Your ID","preview.id.image-retake":"Retake Photo","preview.id.image-use":"Use This Photo","preview.insurance.card-back":"Back","preview.insurance.card-front":"Front","preview.insurance.card-page-title":"Here's a Preview of the {side} of Your Insurance Card","preview.insurance.card-retake":"Retake Photo","preview.insurance.card-use":"Use This Photo","preview.selfie-page-title":"Here's a Preview of Your Selfie","preview.selfie-retake":"Retake Photo","preview.selfie-use":"Use This Photo","processing":"Processing...","progress.header-label-confirm":"Confirm","progress.header-label-forms":"Forms","progress.header-label-identity":"Identity","progress.header-label-insurance":"Insurance","provider-building-instructions":" ","provider-footer-content":" ","provider-parking-instructions":" ","provider-phone-number":"(888) 234-2389","rotate-image-button":"Rotate Image","scan.insurance.card-back":"Back","scan.insurance.card-button-cancel":"Cancel","scan.insurance.card-button-scan":"Scan Card","scan.insurance.card-button":"Scan {side} of Insurance Card","scan.insurance.card-front":"Front","scan.insurance.card-page-title-subtext":"","scan.insurance.card-page-title":"Upload a Clear Picture of the {side} of Your Insurance Card","scan.insurance.defer-link":"Enter your information manually","scan.insurance.defer-photo":"Are you uninsured or don't have your insurance card handy?","selfie.error-button":"Try Again","selfie.error-page-title":"Selfie Does Not Match","selfie.error-paragraph":"The selfie photo did not match the photo ID. Please make sure to follow instructions on the selfie screen.","session.expired-button-home":"Return Home","session.expired-paragraph":"For security purposes, your session has timed out after 15 minutes of inactivity","session.expired-signed-out-paragraph":"You have successfully been signed out of the application. You can follow the link in your text messages to return to this appointment.","session.expired-signed-out-title":"You Are Signed Out","session.expired-title":"Your Session Expired","skip.insurance-action":"Skip Insurance for Now","skip.insurance-paragraph":"Continue with registration anyway?","skip.insurance.modal-button-back":"Go Back","skip.insurance.modal-button-skip":"Skip","skip.insurance.modal-paragraph":"You can skip this, but you will need to present a valid insurance card in order to check-in for your appointment.","skip.insurance.modal-title":"Skip Adding Insurance Card?","splash.screen-powered-by":"Powered by","splash.screen-title":"Preparing your personalized registration experience...","system.messages-error-message-body":"Sorry, something went wrong. Please close this window and try again. If the issue persists, please try again later.","system.messages-error-message-button":"Close","system.messages-error-message-title":"Oops! An Error Occurred.","take.selfie-check-in-button":"Verify ID and Check In","take.selfie-check-in-header":"It's Almost Time for Your Appointment!","take.selfie-check-in-paragraph":"Check in ahead of time. Verify your ID by taking a quick selfie.","take.selfie-insurance-authorization-button":"Verify ID and Check In","take.selfie-insurance-authorization-header":"It's Almost Time for Your Appointment!","take.selfie-insurance-authorization-paragraph":"Check in ahead of time. Verify your ID by taking a quick selfie.","take.selfie-registration-button":"Take Selfie","take.selfie-registration-header":"Take a Selfie","take.selfie-registration-paragraph":"Help us verify you are the individual we're looking for by taking a picture of yourself!","time.for.appointment-button-help-find-location":"Help Find My Location","time.for.appointment-button-ride-share":"Request a ride","time.for.appointment-close-enough-button":"Check Me In Now!","time.for.appointment-close-enough-header":"You Are Close Enough to Check In!","time.for.appointment-close-enough-paragraph":"You can check in for your appointment now. We will see you at {time}!","time.for.appointment-location-prompt-button":"Allow Location","time.for.appointment-location-prompt-header":"Your Appointment Is Today","time.for.appointment-location-prompt-paragraph":"By clicking on the allow location button, you can check in for your service from your smart device once you are on site. If you do not click on the allow location button, you will need to present to admitting to check in for your appointment.","time.for.appointment-not-close-button":"Update Location","time.for.appointment-not-close-header":"Sorry, You Are Not Close Enough to Check In Yet","time.for.appointment-not-close-paragraph":"You are about {length} {unit} away from {provider}. When you arrive on site, you will be able to check in.","time.for.appointment-page-header":"It's Almost Time for Your Appointment!","try.again.error.modal-button":"Try Again","try.again.error.modal-paragraph":"Sorry, something went wrong. Please try again. If the issue persists you may need to try again later.","try.again.error.modal-title":"Oops!","validation.error-message-cc":"{name} must be {len} digits.","validation.error-message-char-length":"{name} must be at least {len} characters.","validation.error-message-date-format-2":"Please check again and enter a valid {name}.","validation.error-message-date-format-mm-yy":"{name} must be in a valid format (MM/YY).","validation.error-message-date-format":"{name} must be in a valid format.","validation.error-message-date-future":"{name} cannot be in the future.","validation.error-message-date":"This card is beyond its {name}.","validation.error-message-default":"{name} is a required field.","validation.error-message-max-char-length":"{name} cannot exceed {len} characters.","validation.error-message-no-field-name":"This is a required field.","validation.error-message-zip-format":"{name} format must be valid (12345 or 12345-1234).","verify.insurance-action-cancel-add-card":"Cancel adding additional cards","verify.insurance-action-rescan":"Re-scan insurance card","verify.insurance-action-scan-insurance":"Scan insurance card instead","verify.insurance-add-another-modal-add":"Add","verify.insurance-add-another-modal-done":"Done","verify.insurance-add-another-modal-heading":"Card Successfully Submitted!","verify.insurance-add-another-modal-paragraph":"Select \"Add\" if you want to scan another insurance card or select \"Done\" to move on to the next step.","verify.insurance-button-add":"Add another insurance card","verify.insurance-button-cancel":"Cancel","verify.insurance-button-edit":"Edit Info","verify.insurance-button-save-and-continue":"Save & Continue","verify.insurance-button-save":"Update","verify.insurance-button-submit":"Next","verify.insurance-input-field-company":"Company","verify.insurance-input-field-effective-date-optional":"Optional","verify.insurance-input-field-effectiveDate":"Effective Date","verify.insurance-input-field-groupNumber":"Group Number","verify.insurance-input-field-insurance-number":"Insurance Number","verify.insurance-input-field-policyNumber":"Policy Number","verify.insurance-page-title-add":"Enter Insurance Information","verify.insurance-page-title-edit":"Verify Information","custom.demographics-country-code-canada":"Canada","custom.demographics-country-code-mexico":"Mexico","custom.demographics-country-code-other":"Other","custom.demographics-country-code-usa":"USA","custom.demographics-field-name-country-code":"Country Code","custom.demographics-field-name-interpreter":"Interpreter Needed?","custom.demographics-field-name-mobile-consent":"Mobile Consent","custom.demographics-field-name-patient-email-address":"Patient Email Address","custom.demographics-field-name-patient-primary-language":"Patient Primary Language","custom.demographics-field-name-relationship-to-patient":"Emergency Contact Relationship to Patient","custom.demographics-field-name-religion":"Religion","custom.demographics-marital-status-divorced":"Divorced","custom.demographics-marital-status-life-partner":"Life Partner","custom.demographics-marital-status-married":"Married","custom.demographics-marital-status-separated":"Separated","custom.demographics-marital-status-single":"Single","custom.demographics-marital-status-unknown":"Unknown","custom.demographics-marital-status-widow":"Widow","custom.demographics-patient-ethnicity-hispanic-latino":"Hispanic/Latino","custom.demographics-patient-ethnicity-non-hispanic-latino":"Non Hispanic/Latino","custom.demographics-patient-gender-female":"Female","custom.demographics-patient-gender-male":"Male","custom.demographics-patient-gender-unknown":"Unknown","custom.demographics-patient-language-arabic":"Arabic","custom.demographics-patient-language-chinese":"Chinese","custom.demographics-patient-language-english":"English","custom.demographics-patient-language-sign-language":"Sign Language","custom.demographics-patient-language-spanish":"Spanish","custom.demographics-patient-language-vietnamese":"Vietnamese","custom.demographics-patient-race-alaska-native":"Alaska Native","custom.demographics-patient-race-american-indian":"American/Indian","custom.demographics-patient-race-asian":"Asian","custom.demographics-patient-race-black-african-american":"Black/African American","custom.demographics-patient-race-middle-eastern":"Middle Eastern Indian","custom.demographics-patient-race-native-hawaiian-pacific":"Native Hawaiian or Other Pacific Island","custom.demographics-patient-race-other":"Other","custom.demographics-patient-race-prefer-not-to-answer":"Prefer Not To Answer","custom.demographics-patient-race-white":"White","custom.demographics-relationship-friend":"Friend","custom.demographics-relationship-other":"Other","custom.demographics-relationship-parent":"Parent","custom.demographics-relationship-partner":"Partner","custom.demographics-relationship-relative":"Relative - Other","custom.demographics-relationship-sibling":"Sibling","custom.demographics-relationship-spouse":"Spouse","patient-religion-baptist":"Baptist","patient-religion-catholic":"Catholic","patient-religion-christian":"Christian","patient-religion-latter-day-saints":"Latter Day Saints","patient-religion-lutheran":"Lutheran","patient-religion-no-denomination":"No Denomination","patient-religion-no-preference":"No Preference","patient-religion-other-pacific":"Native Hawaiian or Other Pacific Island","patient-religion-protestant":"Protestant","patient-religion-refused":"Refused","pdf.editable-field-category-hie":"Health Information Exchange / CommonWell Opt In/Out Form","pdf.editable-field-hie-opt-in":"Option 1 – Participate in the Health Information Exchange and CommonWell: I wish to share my information with the Health Information Exchange and CommonWell.","pdf.editable-field-hie-opt-out":"Option 2 – I do not wish to participate in the Health Information Exchange and Commonwell: I do not want any Banner information visible in the Health Information Exchange and Commonwell effective with today’s visit and forward. (Unless I elect option 1 at a later date.)","pdf.editable-field-label-checkbox-hie":"If you opt in, your healthcare providers will be able to access your health information through the Health Information Exchange or CommonWell, even in an emergency. If you opt out, your healthcare providers will not be able to access your health information through the Health Information Exchange or CommonWell, even in an emergency. If you are the legally authorized representative and are filling out this form for that person, the reference to “you”, “I” and “my” in this form refer to the person for whom you are authorized to consent.","pdf.editable-field-name-checkbox-hie":"Opt In/Out of the Health Information Exchange and CommonWell"}{"appointment":{"appointmentDate":"2021-08-30T09:03:00-04:00","assignedPatientLocation":"UPW","hospitalServiceCode":"","patientAccountNumber":"3278893PAN","physicianName":"Katie Mcnkmcip, Name","providerAddress1":"37000 N Gantzel Road,","providerAddress2":"","providerCity":"Queen Creek","providerContactNumber":"480-394-4311","providerName":"Banner Health System - Test Client","providerState":"AZ","providerZip":"85140","timeZoneName":""},"patient":{"address1":"1230 N Spring St","address2":"Apt 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