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TRANSport Client Intake Form
TRANSport will review your application based on the information you are able/willing to provide. The more you are willing to share, the quicker we are able to determine eligibility and your direct requirements.
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Email
*
Your email
1. Legal Name
*
Your answer
2. Preferred Name
*
Your answer
3. Preferred Pronouns
*
Your answer
4. Age*
*
Your answer
5. City, State, Country
*
Your answer
6. Name changes sometimes require a year of verifiable residency in the state you are applying for name change in. How long have you been a resident of your state?*
*
More than one year
Less than one year
7. Name changes require a state and sometimes national background check. Have you been convicted of a felony in the last 10 years?
*
Yes
No
8a. Are you needing a name change through the courts in North Dakota?*
*
Yes
No
8b. Are you needing a name change through the courts in Minnesota?*
*
Yes
No
9. Are you behind on child support and have had your passport suspended?*
*
Yes
No
10. Are you currently on a no fly list with the FAA?*
*
Yes
No
11a. Preferred Contact Methods email*
Your answer
11b. Preferred Contact Methods phone/text*
Your answer
11c. Preferred Contact Methods social*
Your answer
12. Family Ancestry (for researching possible renaturalization/repatriation)
*
Your answer
13. Any overseas contacts / friends / family in desired relocation country
*
Your answer
14. Which of the following documents do you have, correct information or not, as these will all be needed to process almost all paperwork and court orders?
*
Certified copy of birth certificate
Social Security Card
Current State ID or License
Valid US Passport
Expired US Passport
None
Required
15. Which of the Following Services are needed*
Legal name change
Gender Marker Change on State ID or License
Update Passport
Update State ID
Verifiable Medical Diagnosis
Verifiable Mental Health Diagnosis
Country Selection Assesment
Securing Medications for extended period (2 years)
Securing Hormone prescription refills (where legal)
Property shipping (not formalized yet)
None
16. Due to Gender Care Guidelines in foreign countries, you may not have access to GAHT or surgical treatments for several years. Have you considered that this will probably delay your transition goals?*
*
I have no further surgical goals
I have no further surgical goals in the next 5 years
I have planned or scheduled surgeries in the next 1 to 2 years
I have planned or scheduled surgeries in the next 6 months to 1 year
17. Due to Gender Care Guidelines in foreign countries, you may not have access to GAHT or surgical treatments for several years. Have you considered that this will probably delay your transition goals?*
*
I have no further use for hormonal treatments
I have no hormone medication goals in the next 5 years
I have stockpiled hormones for the next 6-12 months
I need help acquiring enough hormones to last the lapse in care from moving
18. Current Hormone regimen*
*
Intramuscular injection
Subcutaneous injection
oral
topical patches
topical gel
other
none
19. We expect anyone who is a client, to commit to help any future clients, successfully emigrate to their new home country. Are you willing to commit to helping future TRANSport clients inside your new home country?*
*
Yes
No
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