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Bring The Patient Promise
to your Institution or Organization
If you would like to see if The Patient Promise could benefit the clinicians and patients at your institution or organization, please contact us using the form below. Institutions can range from large academic centers to middle-sized hospitals to even private practices. Organizations range from 100,000+ member groups like the American Medical Association to groups comprising only five members. We can provide material that can be distributed within your institution to motivate clinicians to add healthier lifestyle behaviors to their daily routines.
Name
*
First
Last
Email Address
*
Preferably your official institutional e-mail address (if applicable)
Role
*
Physician
Nurse
Dentist
Dietitian
Therapist
Other Clinician
Administrator
Patient
Student
Other (please describe below)
Choose all that apply. For example, nursing students may check "Student" and "Nurse"
Institution and/or Organization
*
This can be your academic institution, hospital, clinic, etc, as well as your organization (e.g. American Medical Association)
Message
*
Send
Share your Story or Advice
with The Patient Promise Community
The signers of The Patient Promise become part of a unique community of health-conscious clinicians. Please feel free to share a story or advice with the community by submitting the form below or posting directly to our
Facebook page
. Stories may include, for example, personal accounts of adopting healthy lifestyle behaviors (or stopping unhealthy behaviors such as smoking), standing against weight discrimination, or partnering with a patient to live healthier. Advice may include tips you have that may help colleagues to adopt healthier behaviors even with clinician schedules, or changes your institution has made to make it easier to live healthy (e.g. putting a healthy vending machine or stocked fruit basket in the on-call room).
Name
*
First
Last
Email Address
*
Preferably your official institutional e-mail address (if applicable)
Role
*
Physician
Nurse
Dentist
Dietitian
Therapist
Other Clinician
Administrator
Patient
Student
Other (please describe below)
Choose all that apply. For example, nursing students may check "Student" and "Nurse"
Institution and/or Organization
*
Story or Advice
*
Please indicate whether you have special instructions about sharing your story or advice on our mailing list or Facebook page.
Send