PENNSYLVANIA, April 13 - that an individual or an individual's guardian has the option

not to answer an LGBTQ identifier on all blanks, forms,

documents and applications in a clear and conspicuous manner. A

third-party, including a health care provider or State employee,

shall not have the authority to act on behalf of an individual

for the purpose of opting not to answer an LGBTQ identifier. A

Commonwealth agency or entity shall include the option not to

answer an LGBTQ identifier on all blanks, forms, documents and

applications in substantially the following form:

You are not required to answer the LGBTQ identifier as a

condition of receiving a service or benefit from the

Commonwealth agency or entity or attaining or maintaining

employment with the Commonwealth agency or entity. The

Commonwealth agency or entity may not disclose your

answer to the LGBTQ identifier to the public in a manner

that will identify your personal information, including

your name, age, residence address, family members or

other similar information. The Commonwealth agency or

entity may not use your answer to the LGBTQ identifier as

the basis to discriminate against you regarding the

provision of a service or benefit from the Commonwealth

agency or entity or attaining or maintaining employment

with the Commonwealth agency or entity.

(d) Form.--A Commonwealth agency or entity shall design an

LGBTQ identifier as follows:

(1) The LGBTQ identifier shall not infringe or threaten

to infringe on an individual's mental or physical well-being.

(2) The LGBTQ identifier shall include a designation for

nonbinary individuals.

(3) The LGBTQ identifier shall be consistent with the

20210SB0436PN0589 - 4 -

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