Request edit access
Speak Up Ortho submission
#SpeakUpOrtho is an initiative to increase awareness of bias, inequities, and harassment within orthopaedic surgery. Only by increasing awareness and acknowledging that the problem exists,  can the potential for culture change also exist. This is NOT a smear campaign. We wish to highlight the stories of those who otherwise do not feel as if they have a voice, while also sharing positive experiences in which we see our colleagues doing and saying the right thing. We hope to foster active bystander advocacy, which is so important for those in positions in which they feel powerless to speak up or take action. Thank you for being a part of this. Together, we speak up.
Sign in to Google to save your progress. Learn more
Submit how you yourself have overcome adversity or handled a difficult situation! Submit an incident where someone stood up for you and advocated for you!
Submit your story of how SpeakUpOrtho has had an impact on you, your residency, or your workplace!
If you would like to disclose your identity to the volunteers of SpeakUpOrtho ONLY, please include your information below (Name, Email, Phone, Social Media Handles).
REPORTING EXPERIENCE: Please tell us your experience when you tried to report an abusive behavior. Was the situation resolved? Did you face retaliation? Help us understand the process you experienced.
AWARENESS: Please tell us your story that you'd like to submit for use on the SpeakUpOrtho social platforms. All stories will remain anonymous, and any identifying details of personal identity or institution will be removed. By submitting this story, you consent to its anonymous publication by SpeakUpOrtho. Your submission may be shortened to fit the platform (i.e. twitter, facebook, instagram), while maintaining the integrity of the message.
ADVOCACY: Please share instances in which you have witnessed or have directly been a part of active bystander advocacy when there has been bias, harassment or abuse.
ACTION: Share your ideas for creating a better work environment so that we can use your recommendations to implement change.
Region You Are From:
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms