Address information is displayed from latest Enrollment or Maintenance item. To update the information, edit the allowable field(s).

Address Type

• Primary Physical – This cannot be a Post Office Box and is the actual practice location

• Other Physical – Other satellite locations

• Pay-To/1099 – The address that payments, tax and other financial documents will be sent

• Mailing – General address for any other correspondence

• Select all Address Types that are applicable

• If the address is not the same for the address types, then select the type that does apply and add that information to the grid

• Only one address may be entered for the following address types: Pay-To/1099 and Mailing/Correspondence

• Multiple addresses may be entered for Other Physical address type

• Upon completion of the first address type, if other addresses need to be added, then select the applicable address type and complete the required fields

Contact Name

• This is a required field to direct information and communications to the appropriate individual

Address Line 1

• Add the address information in this field

• P.O. Box addresses cannot be used for the physical address

Address Line 2

• This is an optional field and can be used to add additional information about the address i.e. Suite numbers, etc.

City

• Populate the appropriate city for the applicable address

State

• State defaults to Kentucky but is editable

• Select the appropriate state from the drop down box

Zip Code

• Enter the appropriate zip code for the applicable address entered

Zip + 4

• If known, enter the appropriate +4 Zip code.  During the validation process of the entered address, this can be confirmed and added automatically

County

• Enter the corresponding county for the applicable address entered

• If  state is not Kentucky, the default county should be “Out of State”

• This is a required field for ALL physical addresses

Phone Number

• Enter the phone number that corresponds to the applicable address entered

Extension

• If applicable, enter the phone extension associated with the phone number previously entered

Fax Number

• Enter the fax number for the applicable address entered

Once all information has been added to the fields, click Validate Address to confirm the address

Select the address match, and click Choose and Continue to add the address to the grid

Click “Discard” to not save the record and the information entered will be deleted

Special Characters:

• The following Special Characters cannot be used in the situations below. Field properties will not allow the following characters in the box:

 For First Name, Business Name, Other name (if any):    | + \ '

 For Last Name field:    | + \ ', and numbers are not allowed

 For Comment Boxes:     <  >  ^  ~ ` + | \ / ¬ £

 For Address fields:    | + ! @ # $ ^ * ( ) ? / \ " < > & : ; _

• If you copy and paste an excluded special character, an error message will display after clicking Save & Next

• Remove excluded characters from pasted information or uploaded text in the document

Save & Next:

• When finished, click Save & Next to save the information and proceed to the next page

• Click Back to go to the previous screen without saving

• Click Exit to return to the dashboard without saving

• Note that if the information is not saved, you will lose the data on the current page