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PATIENT INFORMATION LAST NAMEFIRST ASOCIAL SECURITY #MIDDLE NAME / INITIALBIRTHDATE (MM/DD/YYY)PREVIOUS NAME / PREFERRED NAMEEMAIL Addressable Shenandoah Community Health recognizes a number of gender
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How to fill out preferred pronoun circle one

01
Locate the section on the form where preferred pronouns are requested.
02
Look for the instruction to circle one option that represents your preferred pronoun.
03
Decide which pronoun you prefer to be referred to as (eg. he/him, she/her, they/them).
04
Use a pen or pencil to carefully circle your chosen option.
05
Double check to make sure you have circled the correct pronoun before submitting the form.

Who needs preferred pronoun circle one?

01
Individuals who want to communicate their gender identity and preferred pronouns accurately.
02
Organizations or institutions that aim to create inclusive environments and respect individuals' identities.
03
Those who want to ensure they are addressed correctly in written or verbal communication.
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Preferred pronoun circle one is a section where individuals can indicate their preferred pronouns.
Anyone completing a form or document that includes a preferred pronoun circle one section is required to fill it out.
Individuals can fill out their preferred pronouns by selecting from options provided or by writing in their own preferred pronouns.
The purpose of preferred pronoun circle one is to respect individuals' gender identities and ensure appropriate pronoun usage.
The information reported on preferred pronoun circle one includes the individual's preferred pronouns.
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