• Health Equity Hero Nomination Form

    Please fill the form below to nominate an individual who has dedicated their career and work to advancing health equity and creating real, lasting impact to the lives of marginalized patient populations. You are welcome to nominate yourself. Chosen nominees will be considered for our Health Equity Heroes Series on individuals who have championed health equity.
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  • Nominator:

    Person submitting the nomination. If self-nomination, please skip this section.
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  • Nominee Information

    Please indicate details about your nomination
  • Should be Empty:
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