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PATIENT INFORMATION Mr. Mrs. Miss. Ms. Dr. ADULT CHILD Name Last First Initial Prefer to be Called: Address: Street (Apt.#) (City) (Postal Code) Home Phone: Work Phone: Email: Date of Birth: Cell:
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How to fill out prefer to be called

01
Start by opening the 'Prefer to be called' form.
02
Enter your personal information in the designated fields.
03
Indicate your preferred name or title that you would like others to call you.
04
Provide any additional instructions or preferences related to your preferred name.
05
Double-check all the information you have entered for accuracy.
06
Submit the form and wait for the confirmation or acknowledgment from the relevant party.

Who needs prefer to be called?

01
Any individual who has a preferred name or title that differs from their legal name can fill out the 'Prefer to be called' form.
02
This form is particularly useful for transgender individuals, people with gender-neutral names, individuals who have changed their names, or those who simply prefer to be called by a different name or title.
03
It can also be used by non-binary individuals, people with nicknames, or individuals who hold certain titles or honors and wish to be addressed accordingly.
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Prefer to be called is a personal preference for how an individual prefers to be addressed.
Prefer to be called is typically self-reported by individuals.
To fill out prefer to be called, individuals can simply state their preferred name or title.
The purpose of prefer to be called is to ensure individuals are addressed in a way that is respectful and preferred by them.
The only information reported on prefer to be called is the individual's preferred name or title.
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