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Date: REGISTRATION FORMS SN: Name: Preferred Name (if any): Sex at Birth: Male Female Gender Identity: Transgender Male Transgender Female Other Decline to answer Sexual Orientation: Straight Lesbian/Gay
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Community health centers provide primary care services to underserved populations.
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Community health centers are required to file the report to comply with federal regulations.
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Community health centers must report on patient demographics, services provided, and financial information.
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Information such as patient visits, services provided, staffing, and financial data must be reported on community health centers.
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