Get the free Gender Affirming Care Attestation Request Form

Complete the Gender Affirming Care Attestation Form for Maryland members under 18 to request medication and consent for treatment, ensuring compliance with state laws.

How to fill out gender affirming care attestation

How to fill out gender affirming care attestation

1. Read the instructions for the gender affirming care attestation carefully.
2. Gather all necessary documents that support your request for care.
3. Clearly indicate your preferred name and pronouns on the form.
4. Provide personal information such as your birthdate, address, and contact information.
5. Detail any past medical history related to gender affirming care.
6. Include specific requests related to the type of care you are seeking.
7. Sign and date the attestation to confirm your acceptance of the terms.
8. Submit the completed form to the designated healthcare provider or institution.

Who needs gender affirming care attestation?

1. Individuals seeking hormone therapy or surgery related to gender transition.
2. Transgender individuals requiring mental health support related to gender identity.
3. People who have been diagnosed with gender dysphoria by a qualified healthcare provider.
4. Anyone looking to engage in support groups or community resources for gender affirmation.

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What is gender affirming care attestation?

Gender affirming care attestation is a formal document or declaration that verifies the provision of healthcare services that align with a person's gender identity, supporting the ongoing health and well-being of transgender and non-binary individuals.

Who is required to file gender affirming care attestation?

Healthcare providers and organizations that offer gender affirming care services are typically required to file gender affirming care attestation.

How to fill out gender affirming care attestation?

To fill out a gender affirming care attestation, providers should include information about the services offered, details about the patients receiving care, and ensure all required signatures and documentation are completed as per the guidelines.

What is the purpose of gender affirming care attestation?

The purpose of gender affirming care attestation is to ensure accountability and track the provision of necessary healthcare services that affirm an individual's gender identity, enabling better access and support for the LGBTQ+ community.

What information must be reported on gender affirming care attestation?

Information that must be reported may include patient demographics, types of services provided, dates of service, and any other specific details relevant to the care received by the individual.