Ambassadors are clinicians who educate other clinicians and community members on climate and health.  
A brief Q&A to help us to get to know our Ambassadors!
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Email *
First Name *
Last Name *
Contact Number *
What is your clinical practice?
What is your age range?
Clear selection
What is your highest educational level?
Clear selection
Are you based in Florida? *
What are you hoping to gain from becoming an Ambassador with FCCA?
What is your willingness to engage in advocacy on the intersection of health and climate change? (Check all that apply) *
Required
Are you joining as an Organizational Ambassador *
Required
Name of Organization
Organization Address
A copy of your responses will be emailed to the address you provided.
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