JM Jaffe
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Surgery Questionnaire
See attached. The purpose of this form is to assess for readiness, as well as to obtain a thorough history for letters of support. surgery questionnaire.pdf
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Gender History Form
See attached Gender-Intake-form.pdf
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Trans-Inclusive Medical History Form
See attached History-Intake-Form-4.14.15.pdf
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WPATH Medical Necessity Statement
See attached WPATH Med Nec on 2008 Letterhead.pdf
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CA's Insurance Gender Non-Discrimination Act (IGNA)
See attached DMHC-Director-Letter-re-Gender-NonDiscrimination-Requirements.pdf AB 1586 FACT SHEET 8-15-05.pdf
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Affordable Care Act Section 1557 - DHHS
See attached HHS ACA Section 1557.pdf
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Trans-Inclusive Demographic Form Example
Attached is Lyon-Martin's current demographic form--given to all new patients and to those who need to update their information. Demographic Form Eng 9.2.16.pdf
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What are the Laws Protecting Gender Identity by State?
Check out the Interactive National Equality Map!
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Fenway's Trans Masculine Sexual Health Focus Group
Fenway Health is organizing a study on trans masculine sexual health for both community members and providers! Participate in the Study on Trans Masculine Sexual Health