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Make sense of any

Patient Facesheet

Generate accurate and consistent data from any document, any layout.

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Patient Intake Intelligence

Map facesheets to EHR at scale

Turn scanned, faxed, or electronic facesheets into structured fields. Automate registration, eligibility prechecks, and pre-visit planning with high-accuracy document processing. Extract legal name, DOB, sex, address, phones, email, insurance carrier, plan, member ID, group, subscriber, coverage dates, copay, guarantor, employer, emergency contact, PCP, allergies, medications, problems, and consent checkboxes with signatures. Validate addresses, normalize payer names, and handle variable layouts and handwriting for front-desk and EHR workflows.

Facesheet.pdf

Viewer

JSON

document Type

Patient Facesheet

document Id

FS-2025-0910-01987

status

Final

patient Name

Taylor Morgan

patient Dob

1987-04-05

patient Sex

F

patient Mrn

M1234567

patient Ssn

XXX-XX-4321

patient Address Line1

55 N Central Ave

patient City

Phoenix

patient State

AZ

patient Postal Code

85004

patient Country

US

patient Phone Mobile

+1-602-555-0120

patient Phone Home

+1-602-555-0177

patient Email

[taylor.morgan@example.com](mailto:taylor.morgan@example.com)

race

White

ethnicity

Not Hispanic or Latino

preferred Language

en

marital Status

Married

employer Name

Sunrise Retail Group

employer Phone

+1-602-555-0142

pcp Name

Samuel Ortiz, MD

pcp Npi

1477583996

pcp Phone

+1-415-555-0133

emergency Contact Name

Jordan Morgan

emergency Contact Relationship

Spouse

emergency Contact Phone

+1-602-555-0188

guarantor Name

Taylor Morgan

guarantor Relationship

Self

guarantor Address Line1

55 N Central Ave

guarantor City

Phoenix

guarantor State

AZ

guarantor Postal Code

85004

guarantor Phone

+1-602-555-0120

Insurance

1 item

sequence

payerName

planName

memberId

groupNumber

subscriberName

subscriberDob

relationship

effectiveDate

terminationDate

payerPhone

copayOfficeVisit

Primary

BlueCross BlueShield

PPO 500

ZEP123456789

GRP-4451

Taylor Morgan

1987-04-05

Self

2025-01-01

+1-800-555-0100

25

Allergies

2 items

substance

reaction

severity

Penicillin

Rash

mild

Peanuts

Hives

moderate

Medications

2 items

name

dose

route

frequency

Lisinopril

10 mg

PO

daily

Metformin

500 mg

PO

BID

Problems

2 items

icd10

name

I10

Essential hypertension

E11.9

Type 2 diabetes mellitus without complications

preferred Pharmacy

name: City Pharmacy, phone: +1-602-555-0190, addressLine1: 121 W Monroe St, city: Phoenix, state: AZ, postalCode: 85003

consents

hipaaNoticeAcknowledged: true, assignmentOfBenefits: true, consentToTreat: true, financialResponsibilityAccepted: true, signaturePresent: true, signedAt: 2025-09-10T08:55:00-04:00

pages

1

notes

Checkboxes and signatures captured as discrete booleans. HL7 ADT and FHIR mappings available.

{ "documentType": "Patient Facesheet", "documentId": "FS-2025-0910-01987", "status": "Final", "patientName": "Taylor Morgan", "patientDob": "1987-04-05", "patientSex": "F", "patientMrn": "M1234567", "patientSsn": "XXX-XX-4321", "patientAddressLine1": "55 N Central Ave", "patientCity": "Phoenix", "patientState": "AZ", "patientPostalCode": "85004", "patientCountry": "US", "patientPhoneMobile": "+1-602-555-0120", "patientPhoneHome": "+1-602-555-0177", "patientEmail": "[taylor.morgan@example.com](mailto:taylor.morgan@example.com)", "race": "White", "ethnicity": "Not Hispanic or Latino", "preferredLanguage": "en", "maritalStatus": "Married", "employerName": "Sunrise Retail Group", "employerPhone": "+1-602-555-0142", "pcpName": "Samuel Ortiz, MD", "pcpNpi": "1477583996", "pcpPhone": "+1-415-555-0133", "emergencyContactName": "Jordan Morgan", "emergencyContactRelationship": "Spouse", "emergencyContactPhone": "+1-602-555-0188", "guarantorName": "Taylor Morgan", "guarantorRelationship": "Self", "guarantorAddressLine1": "55 N Central Ave", "guarantorCity": "Phoenix", "guarantorState": "AZ", "guarantorPostalCode": "85004", "guarantorPhone": "+1-602-555-0120", "insurance": [ { "sequence": "Primary", "payerName": "BlueCross BlueShield", "planName": "PPO 500", "memberId": "ZEP123456789", "groupNumber": "GRP-4451", "subscriberName": "Taylor Morgan", "subscriberDob": "1987-04-05", "relationship": "Self", "effectiveDate": "2025-01-01", "terminationDate": null, "payerPhone": "+1-800-555-0100", "copayOfficeVisit": 25 } ], "allergies": [ { "substance": "Penicillin", "reaction": "Rash", "severity": "mild"}, { "substance": "Peanuts", "reaction": "Hives", "severity": "moderate"} ], "medications": [ { "name": "Lisinopril", "dose": "10 mg", "route": "PO", "frequency": "daily"}, { "name": "Metformin", "dose": "500 mg", "route": "PO", "frequency": "BID"} ], "problems": [ { "icd10": "I10", "name": "Essential hypertension"}, { "icd10": "E11.9", "name": "Type 2 diabetes mellitus without complications"} ], "preferredPharmacy": { "name": "City Pharmacy", "phone": "+1-602-555-0190", "addressLine1": "121 W Monroe St", "city": "Phoenix", "state": "AZ", "postalCode": "85003"}, "consents": { "hipaaNoticeAcknowledged": true, "assignmentOfBenefits": true, "consentToTreat": true, "financialResponsibilityAccepted": true, "signaturePresent": true, "signedAt": "2025-09-10T08:55:00-04:00"}, "pages": 1, "notes": "Checkboxes and signatures captured as discrete booleans. HL7 ADT and FHIR mappings available."}

Facesheet.pdf

Viewer

JSON

document Type

Patient Facesheet

document Id

FS-2025-0910-01987

status

Final

patient Name

Taylor Morgan

patient Dob

1987-04-05

patient Sex

F

patient Mrn

M1234567

patient Ssn

XXX-XX-4321

patient Address Line1

55 N Central Ave

patient City

Phoenix

patient State

AZ

patient Postal Code

85004

patient Country

US

patient Phone Mobile

+1-602-555-0120

patient Phone Home

+1-602-555-0177

patient Email

[taylor.morgan@example.com](mailto:taylor.morgan@example.com)

race

White

ethnicity

Not Hispanic or Latino

preferred Language

en

marital Status

Married

employer Name

Sunrise Retail Group

employer Phone

+1-602-555-0142

pcp Name

Samuel Ortiz, MD

pcp Npi

1477583996

pcp Phone

+1-415-555-0133

emergency Contact Name

Jordan Morgan

emergency Contact Relationship

Spouse

emergency Contact Phone

+1-602-555-0188

guarantor Name

Taylor Morgan

guarantor Relationship

Self

guarantor Address Line1

55 N Central Ave

guarantor City

Phoenix

guarantor State

AZ

guarantor Postal Code

85004

guarantor Phone

+1-602-555-0120

Insurance

1 item

sequence

payerName

planName

memberId

groupNumber

subscriberName

subscriberDob

relationship

effectiveDate

terminationDate

payerPhone

copayOfficeVisit

Primary

BlueCross BlueShield

PPO 500

ZEP123456789

GRP-4451

Taylor Morgan

1987-04-05

Self

2025-01-01

+1-800-555-0100

25

Allergies

2 items

substance

reaction

severity

Penicillin

Rash

mild

Peanuts

Hives

moderate

Medications

2 items

name

dose

route

frequency

Lisinopril

10 mg

PO

daily

Metformin

500 mg

PO

BID

Problems

2 items

icd10

name

I10

Essential hypertension

E11.9

Type 2 diabetes mellitus without complications

preferred Pharmacy

name: City Pharmacy, phone: +1-602-555-0190, addressLine1: 121 W Monroe St, city: Phoenix, state: AZ, postalCode: 85003

consents

hipaaNoticeAcknowledged: true, assignmentOfBenefits: true, consentToTreat: true, financialResponsibilityAccepted: true, signaturePresent: true, signedAt: 2025-09-10T08:55:00-04:00

pages

1

notes

Checkboxes and signatures captured as discrete booleans. HL7 ADT and FHIR mappings available.

{ "documentType": "Patient Facesheet", "documentId": "FS-2025-0910-01987", "status": "Final", "patientName": "Taylor Morgan", "patientDob": "1987-04-05", "patientSex": "F", "patientMrn": "M1234567", "patientSsn": "XXX-XX-4321", "patientAddressLine1": "55 N Central Ave", "patientCity": "Phoenix", "patientState": "AZ", "patientPostalCode": "85004", "patientCountry": "US", "patientPhoneMobile": "+1-602-555-0120", "patientPhoneHome": "+1-602-555-0177", "patientEmail": "[taylor.morgan@example.com](mailto:taylor.morgan@example.com)", "race": "White", "ethnicity": "Not Hispanic or Latino", "preferredLanguage": "en", "maritalStatus": "Married", "employerName": "Sunrise Retail Group", "employerPhone": "+1-602-555-0142", "pcpName": "Samuel Ortiz, MD", "pcpNpi": "1477583996", "pcpPhone": "+1-415-555-0133", "emergencyContactName": "Jordan Morgan", "emergencyContactRelationship": "Spouse", "emergencyContactPhone": "+1-602-555-0188", "guarantorName": "Taylor Morgan", "guarantorRelationship": "Self", "guarantorAddressLine1": "55 N Central Ave", "guarantorCity": "Phoenix", "guarantorState": "AZ", "guarantorPostalCode": "85004", "guarantorPhone": "+1-602-555-0120", "insurance": [ { "sequence": "Primary", "payerName": "BlueCross BlueShield", "planName": "PPO 500", "memberId": "ZEP123456789", "groupNumber": "GRP-4451", "subscriberName": "Taylor Morgan", "subscriberDob": "1987-04-05", "relationship": "Self", "effectiveDate": "2025-01-01", "terminationDate": null, "payerPhone": "+1-800-555-0100", "copayOfficeVisit": 25 } ], "allergies": [ { "substance": "Penicillin", "reaction": "Rash", "severity": "mild"}, { "substance": "Peanuts", "reaction": "Hives", "severity": "moderate"} ], "medications": [ { "name": "Lisinopril", "dose": "10 mg", "route": "PO", "frequency": "daily"}, { "name": "Metformin", "dose": "500 mg", "route": "PO", "frequency": "BID"} ], "problems": [ { "icd10": "I10", "name": "Essential hypertension"}, { "icd10": "E11.9", "name": "Type 2 diabetes mellitus without complications"} ], "preferredPharmacy": { "name": "City Pharmacy", "phone": "+1-602-555-0190", "addressLine1": "121 W Monroe St", "city": "Phoenix", "state": "AZ", "postalCode": "85003"}, "consents": { "hipaaNoticeAcknowledged": true, "assignmentOfBenefits": true, "consentToTreat": true, "financialResponsibilityAccepted": true, "signaturePresent": true, "signedAt": "2025-09-10T08:55:00-04:00"}, "pages": 1, "notes": "Checkboxes and signatures captured as discrete booleans. HL7 ADT and FHIR mappings available."}

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FeatureDocuPipeTextractGoogle OCRGPT
OCR printed text
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OCR handwriting
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Crossed out text
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Highlight information source on document
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