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PATIENT REGISTRATIONInternal Use Only.mana.md PATIENT INFORMATION Please Inpatient Name Listener: M FFirstDate of Birth MiddleSocial Security # Address Apt. City State Zip Home Phone Mobile Misc Phone
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Start by obtaining a copy of the native Hawaiianoformr Pacific Islander form. This can usually be done by visiting the official website of the relevant organization providing the form.
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Native Hawaiian or Other Pacific Islander refers to a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
Individuals who identify as Native Hawaiian or Other Pacific Islander on official forms or surveys may be required to report this information.
To fill out Native Hawaiian or Other Pacific Islander, simply check the corresponding box or write in the information when requested.
The purpose of collecting Native Hawaiian or Other Pacific Islander data is to provide accurate demographic information for research, planning, and resource allocation.
Only the individual's self-identification as Native Hawaiian or Other Pacific Islander needs to be reported.
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