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Let's Keep In Touch
Yes, I want Texas Health Mansfield to send me information about its various services via phone, email or direct mail.
If you are having a medical emergency, please call 911.
Area_of_Interest__c
Area of Interest - Area_of_Interest__c - Case
Type
Type - Case
Subject
Subject - Subject - Case
RequestReason__c
Request Reason - RequestReason__c - Case
Case - Status
Status - Status - Case
Campus_Submitted__c
Campus Submitted - Campus_Submitted__c - Case
Case Origin
Case Origin - Origin - Case
Line__c
Line - Line__c - Case
ReferralPath__c
ReferralPath - ReferralPath__c - Case
ReferralValue__c
ReferralValue - ReferralValue__c - Case
Referral_Source__c
Referral Source - Referral_Source__c - Campaign
Campaign__c
Campaign - Campaign__c - Case
Campaign Member - Status
Status - Status - CampaignMember
LeadSource
Lead Source - LeadSource - Contact
Email_Opt_In_Description__c
Email Opt In Description - Email_Opt_In_Description__c - Contact
Campaign Name
This hidden field has been added by Attribution to CRM Plugin to store Campaign Name in this Form's submission table
Campaign Source
This hidden field has been added by Attribution to CRM Plugin to store Campaign Source in this Form's submission table
Campaign Content
This hidden field has been added by Attribution to CRM Plugin to store Campaign Content in this Form's submission table
Campaign Medium
This hidden field has been added by Attribution to CRM Plugin to store Campaign Medium in this Form's submission table
Campaign Term
This hidden field has been added by Attribution to CRM Plugin to store Campaign Term in this Form's submission table
Requested_Physician_Name__c
Preferred Physician - Requested_Physician_Name__c - Case
NPI__c
Most_Recent_Lead_Source__c
Most Recent Lead Source - Most_Recent_Lead_Source__c - Contact
Guide_Choice__c
Guide Choice - Guide_Choice__c - Case
HRA__c
HRA - HRA__c - Case
GCLID (Google Click Identifier)
This hidden field has been added by Attribution to CRM Plugin to store GCLID (Google Click Identifier) in this Form's submission table
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