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Confidential Patient Information Today's Date/Signature of Patient/ Mr. Patient Title: (check one) Mrs. Ms. Miss Dr. First Name Nick Nameless NameMiddle Name Prof. Rev. SuffixPrimary Care Physician: Who
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Sex check one male is a form used to identify individuals who are male.
Any individual who identifies as male must fill out sex check one male.
To fill out sex check one male, simply mark the box labeled 'male' on the form.
The purpose of sex check one male is to collect data on individuals who identify as male.
On sex check one male, individuals must report their gender identity as male.
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