Template Merge Fields
| Template Field Name | Description |
| PATIENT_ADDRESS_LINE_1 | |
| PATIENT_ADDRESS_LINE_2 | |
| PATIENT_ADDRESS_LINE_3 | |
| PATIENT_ADDRESS_LINE_4 | |
| PATIENT_ADDRESS_LINE_5 | |
| PATIENT_ADDRESS_LINE_6 | |
| PATIENT_ID | |
| PATIENT_FIRST_NAME | |
| PATIENT_INITIAL | |
| PATIENT_LAST_NAME | |
| PATIENT_TITLE | |
| PATIENT_HOME_TELEPHONE | |
| PATIENT_WORK_TELEPHONE | |
| PATIENT_ADDRESSED_AS | |
| PATIENT_SALUTATION | |
| PATIENT_PJS | |
| PATIENT_PJS_FULL | |
| PATIENT_MOBILE | |
| PATIENT_EMAIL | |
| PATIENT_DOB | |
| REFERRER_ADDRESS_LINE_1 | |
| REFERRER_ADDRESS_LINE_2 | |
| REFERRER_ADDRESS_LINE_3 | |
| REFERRER_ADDRESS_LINE_4 | |
| REFERRER_ADDRESS_LINE_5 | |
| REFERRER_ADDRESS_LINE_6 | |
| REFERRER_FIRST_NAME | |
| REFERRER_INITIAL | |
| REFERRER_LAST_NAME | |
| REFERRER_TITLE | |
| REFERRER_JD | |
| REFERRER_ORG | |
| PROVIDER_TITLE | |
| PROVIDER_INITIAL | |
| PROVIDER_FIRST_NAME | |
| PROVIDER_LAST_NAME | |
| AF_DATE | |
| AF_SKEL_CLASS | |
| AF_SKEL_SEVERITY | |
| AF_FMPA | |
| AF_LAFH | |
| AF_CHIN_POINT | |
| AF_CHIN_VAL | |
| AF_NASO_LAB | |
| AF_LIPS | |
| AF_LIP_LINE | |
| AF_IS_AT_REST | |
| AF_IS_SMILE | |
| AF_ORAL_HYG | |
| AF_TMISSING | |
| AF_DPROGNOSIS | |
| AF_CPITN | |
| AF_IRELATIONSHIP | |
| AF_OVERJET | |
| AF_OVERBITE | |
| AF_OVERBITE_ASS | |
| AF_OPENBITE | |
| AF_OPENBITE_VAL | |
| AF_MR_LEFT | |
| AF_MR_RIGHT | |
| AF_CR_LEFT | |
| AF_CR_RIGHT | |
| AF_CL_UPPER | |
| AF_CL_UPPER_VAL | |
| AF_CL_LOWER | |
| AF_CL_LOWER_VAL | |
| AF_CROSSBITES | |
| AF_DISPLACE | |
| AF_DISPLACE_VAL | |
| AF_CROWD_ULS | |
| AF_CROWD_LLS | |
| AF_CROWD_UBS | |
| AF_CROWD_LBS | |
| AF_IOTN_DHC | |
| AF_IOTN_DHC_ASS | |
| AF_IOTN_AC | |
| AF_DEV_STAGE | |
| AF_OIR_OPG | |
| AF_OIR_CEPH | |
| AF_OIR_VT | |
| AF_OIR_PHOTO | |
| AF_OIR_SM | |
| AF_OTHER | |
| CREATED_ON | |
| CREATED_FIRST_NAME | |
| CREATED_INITIAL | |
| CREATED_LAST_NAME | |
| CREATED_TITLE | |
| COND_NAME | |
| COND_SEVERITY | |
| COND_DESCRIPTION | |
| COND_ACTION | |
| COND_NOTE | |
| TODAYS_DATE |