#123forEquity Goals Update Form

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Thank you for taking the #123forEquity pledge! Please complete this form and provide a brief update about your organization's work to achieve each of the pledge goals. You can include actions you have taken, challenges you have faced, results from your efforts and lessons learned that may be helpful for other organizations.

* Organization Type:
* State:


* CEO Name:
* Primary Contact:
* Primary Contact E-Mail:
* Primary Contact Phone:

As a reminder, your organization's individual data will be kept confidential. However, if you are willing to share your organization's story with the field, please check how you would be interested in presenting it.
Case Example
Social Media

* Please enter goal updates below:
You can attach a supporting document, if applicable, at the bottom of the page.

Goal 1: Increase the collection, stratification and use of race, ethnicity, language preference and other sociodemographic data to improve quality and safety

Goal 2: Increase cultural competency training to ensure culturally responsive care

Goal 3: Advance diversity in leadership and governance to reflect the communities served

Goal 4: Improve and strengthen community partnerships

For personal assistance with the pledge, please contact Harriet McGee, executive assistant of the Institute for Diversity in Health Management, at hmcgee_tmp@aha.org or by phone at (312) 422-2630. For general questions, please email us at equityofcare@aha.org or call (312) 422-2630.

Attach your status update file:
Allowed file types: pdf, docx