How Do You Describe Yourself?

We collect additional information on the background of all our patients. We would like you to tell us more about yourself so that we may review the treatment that all patients receive and make sure everyone gets the highest quality care. Your responses are not shared othside of the hospital and your information will remain private.

#1 What is your race?

NOTE: If you select Asian, Black, or Native Hawaiian or Pacific Islander see Question #1A to select your background

#1A. WHAT IS YOUR BACKGROUND?

#2 Are you SPANISH/HISPANIC/LATINO?

NOTE: If you select "I AM SPANISH/HISPANIC/LATINO". see Questiokn #2A to select your background.

How Do You Describe Yourself?

#1 What is your race?

#1A. WHAT IS YOUR BACKGROUND?

#2 Are you SPANISH/HISPANIC/LATINO?

#2A. WHAT IS YOUR BACKGROUND?