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Filling out the Adult Trauma Prevention Program demographic form is a straightforward process that helps facilitate your participation in the program. This guide provides step-by-step instructions to ensure you complete the form accurately and effectively.

Follow the steps to complete the demographic form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling out your name in the designated fields for first and last name.
3. Enter your date of birth in the provided field.
4. In the 'County of Incident' section, specify the county where the incident occurred.
5. Select your gender by checking the appropriate box for either Male or Female.
6. Complete the email field with your valid email address.
7. Fill out your address in the street, city, state, and zip code sections.
8. Indicate your phone number in the specified field.
9. Circle the corresponding option for the number of offenses you have.
10. Indicate your primary language by checking either English or Spanish.
11. Provide your driver's license number in the designated space.
12. Specify your employment status by marking either YES or NO.
13. Indicate whether you have children by selecting YES or NO.
14. Circle YES or NO for whether you are a smoker.
15. For 'Method of Referral', check one box and fill in the corresponding name, county, email, and phone if applicable.
16. Select a reason for attendance by checking the appropriate box, and provide details if you selected 'Other'.
17. Leave the 'DO NOT WRITE BELOW THIS LINE' section as it is.
18. Fill in the program date as specified.
19. Complete the payment information section including payment plan options and amounts as applicable.
20. Initial in the designated space provided.
21. Review all entries for accuracy, save your changes, and then download, print, or share the completed form as needed.

Complete your demographic form online today to expedite your participation in the program.