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Patient Information (Please print)Full Legal Name: Lactate of Birth:FirstMiddle SS#: Month/Day/Complete YearPreferred Name: Sex: Male Female Ethnicity:Hispanic/LatinoPrimary Care Physician: Preferred
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What is biracial?
Biracial means having parents of two different races.
Who is required to file biracial?
Individuals who identify as biracial or have parents of two different races may choose to file for biracial status.
How to fill out biracial?
To fill out a biracial form, individuals can indicate their mixed-race heritage by selecting multiple racial categories or writing in a custom category.
What is the purpose of biracial?
The purpose of biracial identification is to accurately reflect an individual's mixed-race heritage and provide representation for diverse racial backgrounds.
What information must be reported on biracial?
On a biracial form, individuals may be asked to provide information about their racial background, heritage, and cultural identity.
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