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Chart #:Patient Information Patient Name:Date: Last,FirstMI(Preferred Name)Email Address:Gender:Social Security #:Birth Date:Phone (Home):(Work):Ext:Marital Status: Cell Phone:Address: StreetApartment
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Understand and respect the distinction between sexuality and gender identity.
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Provide various options for sexual orientation and gender identity on forms.
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Encourage individuals to self-identify their sexuality and gender identity.
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Ensure confidentiality and privacy when collecting this information.
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Train staff on the importance of inclusivity and diversity when addressing sexuality and gender identity.

Who needs sexuality and gender identity?

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Healthcare providers to provide inclusive and appropriate care.
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Employers to create a welcoming and safe work environment for all employees.
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Educators to ensure inclusivity and support for students of all sexual orientations and gender identities.
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Policy-makers to inform decision-making and resource allocation for diverse populations.
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Sexuality refers to a person's sexual orientation, sexual preferences, and sexual behavior, while gender identity is an individual's personal sense of their own gender, which may or may not align with the sex assigned at birth.
Individuals seeking to disclose their sexual orientation and gender identity in various contexts, including legal, medical, or institutional frameworks, may be required to file such information.
To fill out sexuality and gender identity forms, individuals should select or write down their sexual orientation, gender identity, and any other relevant information as per the guidelines provided on the form.
The purpose is to ensure that individuals' sexual orientations and gender identities are recognized and respected, facilitating inclusive practices in various fields such as healthcare, education, and legal matters.
Information such as sexual orientation, gender identity, preferred pronouns, and any relevant personal history may need to be reported depending on the context.
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