Get the free Patient Name: Preference:
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Patient Name: ___ Preference:
FirstMiddle Initial/SHE / THEYLastPreferred Name: ___ DOB: ___SSN___Parent/Guardians Name (if a minor): ___ DOB: ___
FirstLastmiddle InitialPatient Mailing Address: ___APT#___
City___
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How to fill out patient name preference
How to fill out patient name preference
01
Ask the patient if they have a preferred name or title they would like to be addressed by.
02
Include the preferred name or title in the patient's records by updating their profile.
03
Ensure that all healthcare providers and staff members are aware of the patient's name preference and use it during interactions.
Who needs patient name preference?
01
Patients who have a specific name or title they prefer to be called by.
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What is patient name preference?
Patient name preference is the choice of name a patient wishes to be called during their medical care.
Who is required to file patient name preference?
Patients are required to file their name preference with their healthcare provider.
How to fill out patient name preference?
Patients can fill out their name preference on a form provided by their healthcare provider or verbally communicate it to their healthcare team.
What is the purpose of patient name preference?
The purpose of patient name preference is to respect the individual's personal identity and ensure they are addressed by their preferred name during medical treatment.
What information must be reported on patient name preference?
Patient name preference typically includes the name the patient wishes to be called by, any preferred pronouns, and any specific instructions on how they want to be addressed.
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