New State of Oregon Report R e q u i r e m e n t s
Which category best describes your race?
o
American Indian or Alaskan Native
A person having origins in any of the original peoples of North and South America
o
Asian
A p e r s o n having origins in any peoples of the Far East, Southeast Asia, or the Indian islands, Thailand
& Vietnam.
o
Black or African American
A person having origins in any of the black racial groups of Africa
o
Native Hawaiian or Other Pacific Islander
A person having origins in any other original peoples of Hawaii, Guam, Samoa, or other PacificIslands
o
White
A person having origins in any of the original peoples of Europe, the Middle East or North Africa
o
Patient refused
This category is an indication that the person did NOT want to respond to the question and should not
be asked again during the same visit or during a subsequent visit.
o
Other
This category is an indication that the person could not respond to the question and can be asked
again during the same visit or during a subsequent visit.
o
Unknown
This category should only be used when the patient or caregiver is unable to provide an answer.
New State of Oregon Reporting Requirements
Ethnicity
Which category best describes you?
o
Hispanic
A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin,
regardless of race.
o
Non-Hispanic or Latino
o
Patient refused
This category is an indication that the person did NOT want to respond to the question and should not be
asked again during the same visit or during a subsequent visit.
o
Unknown
This category should only be used when the patient or caregiver is unable to provide an answer.