Take the Patients Over Profits pledge!
Please fill out this form to take the first step in affirming the "Patients Over Profits" pledge.

The pledge states:

"CEOs and lobbyists for Big Pharma, corporate insurers, and private hospitals have formed a front group called Partnership for America’s Healthcare Future that wants to exploit our healthcare system to make money off of keeping us sick.

I pledge to put patients over profits and not take contributions over $200 from the executives, lobbyists, and PACs affiliated with the corporate health care industry, including private insurers, pharma corporations, and private hospitals who are organizing to take over our health care system."

By taking this pledge, the candidate or elected official agrees that they will not knowingly accept any contributions over $200 from the executives, lobbyists, or PACs affiliated with the hospital, insurance, and pharma corporations that have chosen to bankroll an effort to halt any attempts at health care reform. These corporations, which directly profit off of the pain, suffering, and, in the worst cases, death of patients, use those same profits to purchase political influence in an attempt to defend a wasteful system that is failing tens of millions of people. This pledge does not apply to rank-and-file workers who are employed by these corporations.

Please see the last question on this form regarding the additional verification that is required to take the pledge.

If you have any questions about the information found here, please email info@patientsoverprofits.org or visit www.patientsoverprofits.org 
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Name of pledge signer *
Office/Office Sought *
Current Office (if applicable)
Staff name + title (if you do not have staff, please list your own name) *
Staff mobile # (if you do not have staff, please list your own mobile #) *
Staff email (if you do not have staff, please list your own email) *
URL of the posted pledge verification (can be social media or website): *
Pledge verification: *
To verify that you have signed the pledge, please include a link in response to the above question that features the pledge language on an official social media account, website OR email a photo of the signer signing a copy of the pledge to info@patientsoverprofits.org (see examples below). A printable version of the pledge is available here (http://bit.ly/35Zohfw) to physically sign. 
Example #1 of a verification:
Example #2 of a verification:
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