RECOMMENDED STAFF SCRIPT FOR COLLECTING RACE, ETHNICITY & TRIBAL AFFILIATION DATA

Why we are collecting race, ethnicity and tribal affiliation data:

Always provide patients with the rationale for why we are collecting race, ethnicity and tribal affiliation data: "We want to make sure that all of our patients get the best care possible. We would like you to tell us your racial and ethnic background and tribe, if any, so that we can review the treatment that all patients receive and make sure that everyone gets the highest quality of care."

How to ask questions about patient race, ethnicity and tribal affiliation:

• First, ask ethnicity: "Do you consider yourself Hispanic or Latino?"
• Next, ask race: "Which category or categories best describe your race?"
  
  
  • Yes
  • No
  • Declined
  • Unknown



• Next, ask race: "Which category or categories best describe your race?"
  
  
  • American Indian or Alaska Native
  • Asian
  • Black or African American
  • Native Hawaiian or Other Pacific Islander
  • White
  • Declined
  • Unknown
  • Other Race



• If the patient describes his/her race as American Indian or Alaska Native, then ask tribal affiliation: "What is (are) your tribe(s) or pueblo(s)?"
  
  
  • Acoma Pueblo
  • Cochiti Pueblo
  • Isleta Pueblo
  • Jemez Pueblo
  • Jicarilla Apache Nation
  • Kewa/Santo Domingo Pueblo
  • Laguna Pueblo
  • Mescalero Apache Nation
  • Nambe Pueblo
  • Navajo Nation
  • Ohkay Owingeh Pueblo
  • Picuris Pueblo
  • Pojoaque Pueblo
  • San Felipe Pueblo
  • San Ildefonso Pueblo
  • Sandia Pueblo
  • Santa Ana Pueblo
  • Santa Clara Pueblo
  • Taos Pueblo
  • Tesuque Pueblo
  • Zia Pueblo
  • Zuni Pueblo
  • Other Tribal Affiliation
  • Declined
  • Unknown

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Aligning Forces for Quality/Improving Health and Health Care Across Albuquerque, an Initiative of the Albuquerque Coalition for Healthcare Quality and for Robert Wood Johnson Foundation