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Patient and Physician Attitudes and Behaviors Associated
Feb 4, 2004 No other demographic and condition characteristics (age, income, education, health status, current usage of prescription drugs, gender and
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PATIENT DEMOGRAPHIC FORM (new patients only)
Marital Status. □ N/A (Child) □ Single □ Married □ Divorced □ Widowed. □ Separated. Religion (optional). Ethnicity (optional) e-mail address. Financially.
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Whats the big deal about patient demographic data?
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,
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