Updating Sex, Gender, Preferred Name, and Pronouns in the MIT Health Electronic Medical Record

Changes made in the Registrar or HR systems do not automatically update MIT Health's electronic medical record. Use this form to update your gender, pronouns, or preferred name in MIT Health’s electronic medical record.

Entering your legal name will assist us in locating your record so we can make the appropriate changes.

Enter how you would like to be referred to when we contact you. (Note: To update your preferred name in the MIT Health electronic medical record, update the information below.)

Enter your MIT Health Medical Record Number (MRN), if known.

Enter an email where we can contact you with questions.

Enter a phone number where we can contact you with questions.

Phone

Sex

MIT Health uses information from the MIT Registrar and MIT Human Resources systems to initially define the sex information in the electronic medical record. Any changes made in the Registrar or HR systems after the initial upload to MIT Health will not automatically update MIT Health's electronic medical record.


Note: The sex you have selected in your MIT Health medical record must match the information in your health insurance record. Any mismatches could lead to incorrectly denied insurance claims.

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Sex Assigned at Birth

If your updated sex is not your sex assigned at birth, please select the information that best matches your sex assigned at birth.


This information is used in important clinical processes, including determining the normal ranges of laboratory test results and making preventative care recommendations.

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Gender

The gender information provides MIT Health clinicians with additional context regarding your identity. It does not impact any specific clinical or insurance processes.

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Preferred Name

The preferred name information assists MIT Health staff in referring to patients in the way that best matches their expectations. It does not impact any specific clinical or insurance processes.

Pronouns

The pronoun information assists MIT Health staff in referring to patients in the way that best matches their expectations. It does not impact any specific clinical or insurance processes.

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Acknowledgements

I acknowledge that the sex information I have selected matches the information in my health insurance records and that any mismatches may impact the successful processing of insurance claims.

  • For students enrolled in the MIT Student Insurance Plan (SHIP), the sex information must match the information in the MIT Registrar's system.
  • For employees enrolled in an MIT-sponsored insurance plan, the sex information must match the information in the MIT Human Resource system.
  • For individuals enrolled in other insurance, contact your insurer and confirm that the information in their system matches your selection.


I acknowledge that MIT Health cannot update the electronic medical records of any other health care providers and I am responsible for making those updates directly with those providers.


I acknowledge that an MIT Health team member may contact me by phone to discuss my requested changes and the potential impacts of those changes. If MIT Health is unable to contact me, they may not be able to process my requested changes.


I acknowledge that changes may take up to ten (10) business days to process and that MIT Health will contact me to confirm the completion of any requested changes or if the requested changes cannot be made.

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