PATIENT DEMOGRAPHIC FORM new patients only 2025

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What Does Patient Demographic Include? Name. Gender. Date of Birth. Ethnicity/race. Address. Social Security number. Contact Information. Drug/ allergies Information.
Patient demographic forms are forms used by healthcare providers to collect information about a patients identity, contact information, and medical history. This information is used to create a patients medical record and to help providers deliver quality healthcare services.
Patient demographic data refers to all of the non-clinical data about a patient, including: name, date of birth, address, phone number, email address, sex, race, etc.
In the simplest of terms, patient demographics describe a patients most basic information. It encompasses a wide range of information, including their age, gender, race, ethnicity, income, name, allergies, occupation, address, contact details, insurance information, and medical history.
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