I still don't know how I can collect this. Is it okay just to look at them and guess? What if they are 8% African American and consider themselves such, although there skin is whiter than mine? I really don't think I can ask my overworked receptions to ask this. Patients already get mad when asked if other demographic info has change and are reluctant to have a picture at times. Perhaps just handing them a little card with a check box to give the doctor when he comes in. It looks like they have the option to refuse, but if they refuse do you lose credit for it?