Please take a moment to answer our Race, Ethnicity, Language, and Disability questions before your upcoming visit. We encourage you to share this information but it is 100% optional.
State law now requires us to ask about REALD information. Your answers help us make sure that you and others receive the best possible care. Your participation plays an important part in public health and helps us make sure that you and others receive the best possible care.
We share this information with Public Health Authorities such as Oregon Health Authority (OHA).
Here is how you can share your RealD data:
1) Open the link in the table below for your preferred language for reading and writing
2) FIll out the questions on behalf of yourself or your child
3) that's it! We will compile your response and share it with the relevant state reporting agencies
4) If your preferred language is not available or you need the forms in another format such as braille or large print, please contact the OHA Office of Equity & Inclusion at 971-673-3390.
|What language do you read and write in?||Here's the form in your language:|
|Chinese - Simplified||Link|