Instructions: Please fill out this form to the best of your comfort level. No answers are required, and if you choose to self-identify, we will take this as in indication to reach out and follow-up with you. We do request, you list any/all oppressed identities (such as race, culture, gender, sexual orientation, abledness, citizenship, socio-economic status, etc.) as we are always collecting and analyzing data to increase inclusiveness and social justice practices at National Jewish Health.

The purpose of this form is to collect DEI-related information from any and all staff National Jewish Health. We will only use this information as a way to learn and to increase inclusivity and social justice practices at National Jewish. No punitive action will be taken as a result of this form.

In addition, we hope you also use this form as a safe space to ask all those tough DEI questions you have always wanted to ask, but never knew how. Here is the place! 

IMPORTANT: We are NOT the safety or customer service department. If you are or have experienced any act of violence, are the victim of a crime, or are reporting anything that goes against NJH’s Code of Conduct, please reach out to the appropriate department FIRST through RedCap. This form operates as a way to increase DEI practices and inclusivity at National Jewish and should NOT be used for reporting crimes or violations.

In the DEI & Leadership Department, we acknowledge that:

-No one has all the answers (especially us)

-In difference, there is strength

-DEI work is never done

-DEI is ever-evolving and changing, and as a result, so is our relationship with it

-We are all learners in DEI and must constantly strive to learn from one another

We constantly strive towards positive DEI change and never intend to harm or insult purposefully. However, due to the systemic nature of racism and oppression, sometimes we are unaware of when our biases get in the way of DEI work. Therefore, it is vital for us to know when we do accidentally engage in macro or microaggressions. So, please use this form as a way to also communicate when our unconscious biases get in the way of this good work.