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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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How to fill out sexuality and gender identity

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Understand and respect the distinction between sexuality and gender identity.
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Who needs sexuality and gender identity?
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Healthcare providers to provide inclusive and appropriate care.
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Policy-makers to inform decision-making and resource allocation for diverse populations.
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What is sexuality and gender identity?
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.
Who is required to file sexuality and gender identity?
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.
How to fill out sexuality and gender identity?
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.
What is the purpose of sexuality and gender identity?
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.
What information must be reported on sexuality and gender identity?
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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