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Depression & Anxiety Specialty Clinic of Chicago 3047 N. Lincoln Ave., Suite 400 Chicago, Illinois 60657 (773) 4945505 www.dascchicago.comPATIENT INFORMATION DEMOGRAPHICS Legal Name: Chosen Name:
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Legal name chosen name is the official name of an individual or entity that is used for legal and business purposes.
Individuals or entities who are looking to establish their official name for legal and business purposes are required to file legal name chosen name.
To fill out legal name chosen name, one must provide their desired official name and submit any necessary documentation to the appropriate government agency.
The purpose of legal name chosen name is to establish an individual or entity's official name for legal and business transactions.
The information required on legal name chosen name typically includes the individual or entity's desired official name, any aliases, and supporting documentation.
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