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Patient Registration Form Patient Information Patient Name (Last, First, M.I.): Birth Date: / / Social Security Number: Sex (Circle One): Male / Female Race (Circle One): Asian/African American/American
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What is race circle one asianafrican?
Race Circle One Asianafrican is a classification used in some forms to identify individuals of both Asian and African descent.
Who is required to file race circle one asianafrican?
Individuals who identify as both Asian and African descent are required to file Race Circle One Asianafrican.
How to fill out race circle one asianafrican?
To fill out Race Circle One Asianafrican, simply mark the appropriate circle that corresponds to both Asian and African descent.
What is the purpose of race circle one asianafrican?
The purpose of Race Circle One Asianafrican is to accurately capture individuals who are of Asian and African descent for demographic and statistical purposes.
What information must be reported on race circle one asianafrican?
On Race Circle One Asianafrican, individuals must report their identification as both Asian and African descent.
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