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Complete Care Medicine Registration/Update Form Today\'s Date:Patient Information Male FemalePatient\'s Name: LastFirstRace: American Indian Asocial Security Numerate of BirthMINative HawaiianBlack
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Individuals who identify as American Indian or have American Indian heritage.
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Race American Indian refers to individuals who identify as American Indian or Alaska Native.
Individuals who identify as American Indian or Alaska Native are required to report their race as American Indian.
To fill out race American Indian, individuals simply need to check the box indicating American Indian or Alaska Native as their race.
The purpose of reporting race American Indian is to ensure accurate demographic data and representation of this population group.
Individuals must report whether they identify as American Indian or Alaska Native.
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