In accordance with the American Recovery and Reinvestment Act of 2009 and the Health Information Technology for Economic and Clinical Health Act (HITECH ACT), Pullman Family Medicine will now be maintaining and collecting Federal data on race and ethnicity.
The categories below are the minimum categories for data on race and ethnicity in accordance with the federal government guidelines. The categories are social-political constructs that should not be interpreted as being scientific or anthropological in nature. The standards have been developed to provide a common language for uniformity and comparability in the collection and use of data on race and ethnicity by the Federal government. The categorical designations below will not impact the quality of care or any clinical or administrative practices at Pullman Family Medicine; they are only for the purposes of federal data collection.
Please include the patients name and date of birth and mark ONE of the categories listed below. A non-designation will be recorded as “Patient Declined” for record keeping purposes: