Navigating Systems Intake: Updating Documents
This intake form is for members of the 2SLGBTQ+ community to request assistance with name change and/or updating identifying documents. Please complete as much information as you are able to. All information will be kept confidential.
Your Information
Preferred/Chosen Name
*
First Name
Last Name
Legal Name (if different)
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
Zip Code
*
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Demographic Information
What is your age range?
Please Select
Under 17
18-24
25-29
30-39
40-49
50-59
60+
How do you identify your sexual orientation?
Please Select
Lesbian
Gay
Bisexual
Heterosexual
Asexual
Pansexual
Queer
Prefer not to answer
Identity not listed
How do you identify your gender identity and/or gender expression? Select all that apply.
Cis-Man
Cis-Woman
Trans-Man
Trans-Woman
Non-binary
Two-Spirit
Gender Fluid
Gender Queer
Agender
Intersex
Prefer not to answer
Identity not listed
How do you identify your race and/or ethnicity? Select all that apply.
American Indian or Alaskan Native
Asian
Black or African American
Hispanic or Latinx
Middle Eastern or North African
Native Hawaiian or Pacific Islander
White or European American
Prefer not to answer
Identity not listed
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Services Requested
What services would you like assistance with? Select all that apply.
*
Legal name change
Updating name across documents
Updating gender marker (M/F/X)
Application Processes
Other service, please specify:
More specifically, how can we assist you? Select all that apply.
Help understanding forms (MI Sex Designation Form, etc.)
Help ordering certified court copies
Financial assistance for fees
Transportation assistance
Interpreter services (ASL, language)
Court accompaniment / advocacy (someone to attend with you)
Emotional support / peer support during the process
Accountability to ensure it is completed accurately
Access to technology (computer, printer, scanner, internet)
Other, please specify:
What documents would you like to update or apply for new? Select all that apply.
Social Security Records
Michigan Birth Certificate
Passport
Driver's License/State ID
Enhanced or REAL ID
Voter Registration
Other, please specify:
Reason(s) for updates:
If you want to avoid mentioning transition we recommend something like “I want to be known legally as I am by my family and friends”
Documentation Checklist
What documentation do you currently have available? Select all that apply.
MI Birth Certificate
Social Security Card
Passport (current or expired)
Current Driver's License/State ID
Proof of Address (utility bill, lease, etc.)
Court Order for Name Change (certified copy)
Other, please specify:
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Accessibility & Safety
Do you need accessibility accommodation?
No
If yes, please describe:
Do you have safety/privacy concerns?
No
If yes, please describe:
Follow-up Preferences
Preferred Contact:
*
Phone
Text
Email
Other, please specify:
Can we leave a voicemail or text?
Yes
No
Preferred time to contact:
Consent & Confidentiality
I consent to receive support regarding identity document changes:
*
Please Select
Yes
No
I understand my information will be kept confidential:
*
Please Select
Yes
No
Today's Date
*
-
Month
-
Day
Year
Date
Signature
*
Submit
Should be Empty: