Demographic and biographic data includes basic characteristics about the patient, such as their name, contact information, birthdate, age, gender and preferred pronouns, allergies, languages spoken and preferred language, relationship status, occupation, and resuscitation status. [1] See Table 2.4a for sample focused questions used to gather demographic and biological data.
Table 2.4a Demographic and Biological Data
| Data | Focused Interview Questions |
|---|---|
| Name |
Contact Information
What do you prefer to be called?
What is your address?
What is your phone number?
Whom can we contact in an emergency?
What is their relationship to you?
*Avoid questions that imply expected behaviors, such as:
Where do you work or go to school?
Do you have any advance directives on file with a hospital or provider, such as a “Living Will” or “Power of Attorney for Health Care”?
See Table 2.4b for a sample demographic form used during a complete health history.
Table 2.4b Sample Demographic Form [2]
Demographic Information Form
Emergency Contact Name:
Sex: Male / Female / Another Option
Gender You Self-Identify With:
Interpreter needed: Yes No
Information from: Patient / Other
Patient Accompanied: Yes / No
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