Request for Diversity, Equity, & Inclusion (DEI) team workshop, 1-on-1 coaching, literature circle, or other intervention

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Instructions: Please complete this form to submit a request to the DEI & Leadership Development Team. We will respond within 3-5 business days.

*Please note that based on the complexity of the request and due to the novelty of the DEI & Leadership department, it may take some time to develop custom workshops.

*DEI is an ever-changing, ever-evolving field. No one has all the answers, not even us. As such, we may be unable to fulfill all requests at this time. However, even if you think a request is beyond our scope, we are always looking for ways to improve. We view all requests from a growth mindset as a way to learn and further develop DEI & Leadership practices at National Jewish Health.

Requester’s Name (first and last): *

Requester’s Preferred Pronouns

Email Address
*

Team/Department and Role
*

Number of anticipated attendees and audience type (supervisors, direct reports, etc…)
*

Type of support needed
*

1-on-1 DEI Coaching

Custom DEI Workshop (we will reach out to get the specifics)

Collaboration (thought partner, co-facilitation, utilizing Discomfort Dialogue)

Restorative Justice Circle or Healing Circle (best for conflicts)

DEI or Leadership Literature Circle (guided book club, we will reach out for specifics)

Pre-Built Workshop 1 (Leveraging Discomfort Dialogue to get comfortable talking about race)

Pre-Built Workshop 2 (Examining our unconscious (or implicit) biases)

Pre-Built Workshop 3 (Power, privilege, oppression, and intersectionality)

Pre-Built Workshop 4 (Racial and ethnic disparities and their root causes)

Pre-Built Workshop 5 (Leveraging Distributed Leadership- Best practices for shared decision making)

Other:

Briefly describe what you hope to accomplish *

Date(s) for support. (We will do our best to accommodate based on our availability and resources)

Delivery Type
*

In-Person

Virtual

Hybrid (this is not recommended unless absolutely necessary as facilitation becomes an issue, and it is not effective)

Anything else that would be helpful for us to know?
*

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