Survey on Racial Equality & NICU Families
WE NEED YOU.  Our team has aligned Neonatal Intensive Care Unit (NICU) and preemie-focused organizations many of which are African-American led to promote racial equality in the NICU. We are conducting a survey to capture the impact of racism's reach in our community - in the NICU, NICU discharge, and at home in the community of specialists.  

YOUR VOICE MATTERS MORE THAN EVER.  Why?  Because we will be taking this information speaking up to associations and various boards of certification for neonatology, pediatrics and more .  We want to request that they make a change to their continuing education requirements to require at least 2 hours of education about racism in the preemie community with direct insights from families who experienced direct and indirect racism through their preemie journey so that we reach all preemie professionals - newer professionals and the older ones, too.  Tell us your stories, tell us your frustrations.  We will use that to weave your voice into our strategies for change by adding it to our letters across the country and the world.

PRIVACY.  We realize this is a sensitive topic and want to assure you that your privacy will be maintained.  Providing your email address to us is only being used if we need to reach you to clarify your responses.  Feel free to remain anonymous.

FILL THIS OUT AND PLEASE SHARE!  

We can only make real change with real transparency and real numbers.  

It starts with each of us.  Let's do this!

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Neonatal Intensive Care Unit (NICU)
Were you on the receiving end of racist remarks, neglect, bias or actions by your NICU doctor(s), nurses or other team members? *
If you would like to provide us with a quote around what happened, please use the below space.  
Pediatric Intensive Care Unit (PICU)
Were you on the receiving end of racist remarks, neglect, bias or actions by your PICU doctor(s), nurses or other team members?   *
If you would like to provide us with a quote around what happened, please use the below space.  If your child was not in the PICU, please move onto the next question.  
Pediatrician & Specialists Post-NICU
Were you on the receiving end of racist remarks, neglect, bias or actions by your pediatric doctor(s), nurses or other team members?   *
If you would like to provide us with a quote around what happened, please use the below space.  
In any of the above settings, did you receive educational or other resources? *
If you said no to the above question and did not receive educational or other resources even though they existed, please advise which setting this occurred.  
If you would like to provide us with a quote around what happened in any or all settings, please use the below space.  
If you are in the United States, please tell us your state. *
If you are outside of the United States, please tell us your country.  
PLEASE SIGN the letters we are sending.  Please tell us how you want to have your story recognized.  Add your first name and/or last name, city and state or your initials and city and state.  If you are concerned about providing even that, you may put down "Anonymous" and your state.    Lastly, PLEASE SHARE THIS SURVEY WITH OTHER BLACK NICU FAMILIES PAST AND PRESENT.  Our success depends on YOU.  Thank you - Peace! *
A copy of your responses will be emailed to the address you provided.
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