What is


REALD is the name of the demographics form created by the Oregon Health Authority (OHA). It stands for Race, Ethnicity, Language, and Disability. (What happened with that "a," am I right?) OHA asks us to collect this information with every COVID related encounter in an effort to better track and understand how the COVID pandemic is affecting communities differently.

Whether you're bringing your child for a COVID test or a COVID vaccine, we will ask you for your REALD demographic information. We only need to collect this information once per year, so once it's on file for your child, we won't keep asking. You may ALWAYS refuse to fill out the form. We don't need this information to provide healthcare to your child and we will respect that choice.

The Form

There are three ways to fill out and send this form. We have physical copies at the clinic, we have a fill-able pdf you enter the information into and then send us electronically, and you can send a special REALD portal message through our patient portal.