Patient Demographic Form - chiroonwheels 2025

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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.
What Does Patient Demographic Include? Name. Gender. Date of Birth. Ethnicity/race. Address. Social Security number. Contact Information. Drug/ allergies Information.
Demographics are characteristics used to categorize a group of people based on specific criteria, such as age, gender, income level, education, ethnicity, marital status, and employment. Demographic information helps researchers identify trends and patterns within a population.
Examples of demographic characteristics include age, race, gender, ethnicity, religion, income, education, home ownership, sexual orientation, marital status, family size, health and disability status, and psychiatric diagnosis.
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.