Mandatory data fields are identified with an asterisk in the Catalyst application.
- Address Effective Date
- Admission Date
- Admission ID
- Admission Site Number
- Agency Address
- Agency Name
- City
- Client Site Number
- Client Type
- Complete Postal Code
- County
- Currently Prescribed Medication for a Mental Health Problem
- Currently Receiving Treatment for a Mental Health, Emotional, Behavioural or Psychological Problem from a Community Mental Health Program or Professional
- Date of Birth
- Date of Outgoing Referral
- Date of Referral to the Agency (Referred On)
- Diagnosed With a Mental Health Problem by a Qualified Mental Health Professional in Prior 12 Months
- Diagnosed With a Mental Health Problem by a Qualified Mental Health Professional within Lifetime
- Direct Service Time (Total Hours)
- Discharge Date
- Educational Status
- Employment Status
- Ethnicity
- First Name
- Frequency of client gambling activity at specific gambling locations in Prior 12 Months
- Frequency of Specified Gambling Activities in Prior 12 Months
- Frequency of Use of Primary Problem Substance in Prior 30 Days
- Gambling Activities in Prior 12 Months
- Gambling Problem Identified
- Gambling Treatment Plan Status
- Gender
- Hearing Problems
- Hospitalized for a Mental Health Problem in prior 12 Months
- Hospitalized for a Mental Health Problem within Lifetime
- Income Source
- Indirect Service Time (Total Hours)
- In which language are you most comfortable receiving your healthcare services?
- In which of Canada’s Official Languages are you most comfortable receiving your healthcare services?
- Last Name
- Last Name at Birth
- Legal Status
- Length of Stay (Service)
- Length of Time Since Last Gambling Activity
- Mandatory/Required Treatment
- Mobility Problems
- Number of Overnight Hospitalizations in Prior 12 Months for Physical Problems
- Number of Years Life Negatively Affected by Gambling Behaviour
- Percentage of Time Spent Gambling by Jurisdiction
- Pregnancy Status
- Prescribed Medication for a Mental Health Problem in Prior 12 Months
- Prescribed Medication for a Mental Health Problem within Lifetime
- Prescribed Methadone or Other Opioid Substitute
- Primary Problem Substance
- Program End Date
- Program End Time
- Program Name
- Program Site Number
- Program Start Date
- Program Start Time
- Provincial Service Category of Outgoing Referral
- Reason for Discharge
- Reason for Non-completion of Gambling Data Form
- Reason for Program Termination
- Reason for Seeking Help With Gambling Behaviour
- Received Treatment for a Mental Health, Emotional, Behavioural or Psychological Problem from a Community Mental Health Program or Professional in Prior 12 Months
- Referral Source
- Relationship Status
- Sequence of Gambling Problem Identification
- Service Type of Outgoing Referral
- Status of Non-medical Intravenous Drug Use
- Substances Used in Prior 12 Months
- Top Three Specified Gambling Activities
- Top Three Specified Locations of Gambling
- Vision Problems
- What is your mother tongue?
- Young Offender Status
