Common use of Preferred Spoken Language Clause in Contracts

Preferred Spoken Language.  English  Spanish  Russian  Chinese  Vietnamese  Other Preferred Written Language  English  Spanish  Russian  Chinese  Vietnamese  Other Racial Identity  White/Caucasian  American Indian/Alaskan Native  Asian  Black/African American  Native Hawaiian/Pacific Islander  Other  Decline to State Ethnic Identity  Of Hispanic or Latino Origin  Not Of Hispanic or Latino Origin  Decline to State  Add  Remove  Spouse  Domestic Partner Gender:  Male  Female First Name MI Last Name Social Security Number Date of Birth Existing Patient  Yes  No Primary Care Physician ID# Medical Group  Add  Remove  Child, up to age 26 Gender:  Male  Female First Name MI Last Name Social Security Number Date of Birth Existing Patient  Yes  No Primary Care Physician ID# Medical Group  Add  Remove  Child, up to age 26 Gender:  Male  Female First Name MI Last Name Social Security Number Date of Birth Existing Patient  Yes  No Primary Care Physician ID# Medical Group  Add  Remove  Child, up to age 26 Gender:  Male  Female First Name MI Last Name Social Security Number Date of Birth Existing Patient  Yes  No Primary Care Physician ID# Medical Group PERSON RESPONSIBLE  Check if same as applicant First Name MI Last Name Xxxxxxxxxxxx Xxxxxxx Xxx./Xxxx# Xxxx, Xxxxx, Zip Home Phone  Day  Evening Work Phone  Day  Evening Preferred Spoken Language  English  Spanish  Russian  Chinese  Vietnamese  Other

Preferred Spoken Language.  English  Spanish  Russian  Chinese  Vietnamese  Other Preferred Written Language  English  Spanish  Russian  Chinese  Vietnamese  Other Racial Identity  White/Caucasian  American Indian/Alaskan Native  Asian  Black/African American  Native Hawaiian/Pacific Islander  Other  Decline to State Ethnic Identity  Of Hispanic or Latino Origin  Not Of Hispanic or Latino Origin  Decline to State  Add  Remove  Spouse  Domestic Partner Gender:  Male  Female  Unspecified First Name MI Last Name Social Security Number Date of Birth Existing Patient  Yes  No Primary Care Physician ID# Medical Group  Add  Remove  Child, up to age 26 Gender:  Male  Female  Unspecified First Name MI Last Name Social Security Number Date of Birth Existing Patient  Yes  No Primary Care Physician ID# Medical Group  Add  Remove  Child, up to age 26 Gender:  Male  Female  Unspecified First Name MI Last Name Social Security Number Date of Birth Existing Patient  Yes  No Primary Care Physician ID# Medical Group  Add  Remove  Child, up to age 26 Gender:  Male  Female  Unspecified First Name MI Last Name Social Security Number Date of Birth Existing Patient  Yes  No Primary Care Physician ID# Medical Group PERSON RESPONSIBLE  Check if same as applicant First Name MI Last Name Xxxxxxxxxxxx Xxxxxxx Xxx./Xxxx# Xxxx, Xxxxx, Zip Home Phone  Day  Evening Work Phone  Day  Evening Preferred Spoken Language  English  Spanish  Russian  Chinese  Vietnamese  Other

Preferred Spoken Language.  English  Spanish  Russian  Chinese  Vietnamese  Other Preferred Written Language  English  Spanish  Russian  Chinese  Vietnamese  Other Racial Identity  White/Caucasian  American Indian/Alaskan Native  Asian  Black/African American  Native Hawaiian/Pacific Islander  Other  Decline to State Ethnic Identity  Of Hispanic or Latino Origin  Not Of Hispanic or Latino Origin  Decline to State  Add  Remove  Spouse  Domestic Partner Gender:  Male  Female First Name MI Last Name Social Security Number Date of Birth Existing Patient  Yes  No Primary Care Physician ID# Medical Group  Add  Remove  Child, up to age 26 Gender:  Male  Female First Name MI Last Name Social Security Number Date of Birth Existing Patient  Yes  No Primary Care Physician ID# Medical Group  Add  Remove  Child, up to age 26 Gender:  Male  Female First Name MI Last Name Social Security Number Date of Birth Existing Patient  Yes  No Primary Care Physician ID# Medical Group  Add  Remove  Child, up to age 26 Gender:  Male  Female First Name MI Last Name Social Security Number Date of Birth Existing Patient  Yes  No Primary Care Physician ID# Medical Group PERSON RESPONSIBLE  Check if same as applicant First Name MI Last Name Xxxxxxxxxxxx Xxxxxxx Relationship Address 0000 0xx Xxxxxx Xxx./Xxxx# Xxxx, Xxxxx, Zip Home Phone  Day  Evening Work Phone  Day  Evening Preferred Spoken Language  English  Spanish  Russian  Chinese  Vietnamese  Other