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Application Elective in Transgender Medicine Lyon Martin Health Services Personal Information: Name (please print) Current address Permanent address Home phone Cell phone Email Title: MS (year); NPS
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Obtain the necessary forms from the Lyon-Martin Health Services website or by contacting their office.
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Fill out the personal information section of the form, including your name, date of birth, address, and contact information.
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Provide details about your medical history, including any previous diagnoses, medications, surgeries, and allergies.
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Lyon-Martin Health Services is designed to support and provide healthcare services to the following individuals:
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- LGBTQ+ community members who may require specialized care or feel more comfortable accessing care from providers who understand their unique needs.
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- Individuals in need of primary care services, especially those facing barriers to accessing healthcare due to their gender identity, sexual orientation, or socioeconomic status.

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