When you register for your appointment, we will always ask you your name and date of birth. We do this for your safety – to make sure your doctor or nurse has the correct information. Several staff may check your name and date of birth during your visit. 

We also will ask about who you are - your preferred spoken language, race, ethnicity, whether you identify as Hispanic/Latino or Spanish, and your gender identity and sexual orientation because they can be important factors in your health. Asking these and other questions will make us better health care partners and providers. 

Because We Care About Your Health, We Ask:

• Are you Hispanic, Latino/a or Spanish origin?  
• ​What is your race?  
• What is your ethnicity?  
• What is your preferred spoken language?  
• What is your chosen name?*  
• What are your pronouns?  
• What is your sexual orientation?
• What is your current gender identity?  
• What sex were you assigned at birth on your original birth certificate?  
• Have you been diagnosed by a provider with an intersex condition?

* We may need to use your legal name or sex assigned at birth on some forms or labels for insurance purposes.

Your Information Is Safe

Sometimes it can be uncomfortable to answer personal questions. Your information is always confidential, is protected by law, and is only used to provide better care. We put your confidential answers into your medical record and you are welcome to change your answers at any time – just let us know!

If you do not know how to answer a question, please ask a staff member for help. You are also welcome to discuss these questions with your doctor or nurse.