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Equity and Access Council - Join the Inclusion Group!
Please complete the survey to participate in the inclusion group(s). You are welcome to sign up for more than one inclusion group. Thank you!
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1.
Full Name
(Required.)
2.
Job Title/Role
*
3.
Facility/Site
(Required.)
*
4.
Email - Please enter your work email address.
(Required.)
*
5.
Which inclusion group(s) are you interested in?
(Required.)
African American and Caribbean American
Anti-Racism Advocates and Allies
Asian American Pacific Islander
Black Female Physicians
Black Male Physicians
Disabilities
Generational
Heritage and History
Hispanic/Latinx
Hispanic/Latinx Physicians
Jewish
LGBTQIA+
Muslim
Veterans
Women Mentorship
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6.
Are you interested in leading the inclusion group
(Required.)
Yes
No
