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ADULT PATIENT INFORMATION Page 1
Name:
(Last Name)
Date of Birth:(First Name)
Birth Sex:Male(Middle Name)Female Gender Identity:
(Optional)Marital Status:SingleMarriedSeparatedDivorcedWidowedDEMOGRAPHIC
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How to fill out name pronouns sexual orientation
01
Start with your name, write down how you would like to be addressed by others.
02
Specify your pronouns, such as he/him, she/her, or they/them.
03
Include your sexual orientation, if you feel comfortable sharing it.
Who needs name pronouns sexual orientation?
01
Anyone who wants to be respectfully addressed according to their preferences needs to fill out their name, pronouns, and sexual orientation.
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What is name pronouns sexual orientation?
Name, pronouns, and sexual orientation refer to personal identifiers and preferences related to an individual's name, preferred pronouns, and sexual orientation.
Who is required to file name pronouns sexual orientation?
Individuals may be required to provide information on their name, pronouns, and sexual orientation depending on the context or situation where this information is needed.
How to fill out name pronouns sexual orientation?
To fill out information regarding name, pronouns, and sexual orientation, individuals can simply provide their accurate and updated details when requested.
What is the purpose of name pronouns sexual orientation?
The purpose of collecting information on name, pronouns, and sexual orientation is to ensure inclusivity and respect for individuals' identities and preferences in various settings.
What information must be reported on name pronouns sexual orientation?
Information to be reported may include an individual's chosen name, pronouns they prefer to be addressed by, and their sexual orientation if relevant to the context.
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