Taliyah Gumilar calls the office to make an appointment with a doctor, but there is no Taliyah Gumilar in the electronic health record (EHR) system. Since new patient appointments are only scheduled on Wednesdays, the first available appointment is not for another 3 weeks. Taliyah is okay with that but requests to be called in sooner if someone cancels. What information do you need to collect to make a new patient appointment for Taliyah? (Select all that apply.)