Personal Demographics

Customer ID#

Why should I provide this information?

The Academy is committed to diversity and inclusion within our membership and ophthalmology. When you provide demographic information, including gender, race and ethnicity, these data contribute to understanding the composition of Academy members and ensure that leaders, presenters, programs and award recipients reflect that diversity.

As part of the Academy’s commitment to inclusion, you have the option of adding your pronouns and race and ethnicity in your Find an Ophthalmologist/ Member Profile. Providing any of the demographic information is voluntary. Responses will be visible only to administrative staff and will not be publicly shared without explicit consent of the user.

Gender Identity & Pronouns

Birth Year

Sexual Orientation

*This information is confidential. The Academy does not use or display individual demographic data without the explicit consent of the user.

Language Proficiency Other Than English