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Climate Health Now Healthcare Sustainability Fellowship Pre-Application_2025
Have you always wanted to make your workplace more sustainable but felt like you needed help? We will provide all the coaching to help you complete a sustainability project – and we’ll see you through the whole process from beginning to end. Please check out this document for additional information about this one or two year fellowship:
https://tinyurl.com/4ens3zpm
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Pre-applications are due October 15, and will be followed by a round of full applications. Selected fellows will begin their projects in January 2025.
Information for person completing this form
First Name
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Last Name
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Email
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Phone Number
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State/Province
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Which of the following best describes your role in the health community? To read more about how Climate Health Now defines the health community, please read this: https://docs.google.com/document/d/12QzVhW0Eq5eZ59LhMTzgUP_GmxYfGTUr27ryK4hjxxo/edit
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Acupuncturist
Athletic trainer
Audiologist
Chiropractor
Clinic lab technologist or technician
Dental hygienist
Dentist
Dietitian or nutritionist
Doula
Emergency Medical Technician or Paramedic
Genetic counselor
Healthcare administrator
Home health care aide
Massage therapist
Medical assistant or licensed vocational nurse
Mental health professional
Midwife
Nursing assistant
Occupational therapist
Optometrist
Pharmacist
Phlebotomist
Physical therapist
Physician assistant
Physician or surgeon
Podiatrist
Public health
Radiology technician (e.g., sonographer, radiation therapist, nuclear medicine, cardiovascular or MRI technician)
Registered nurse, nurse practitioner, nurse anesthetist, certified nurse midwife
Respiratory therapist
Speech therapist
Surgical assistant or technologist
Social worker
Pharmaceutical / Medical device industry
Health insurance industry
Traditional healer / indigenous medicine practitioner
Patient advocates / Members of patient advocacy groups
Religious leader / healer
Health educator
Other type of health care worker / member of health community
I'm not a member of the health community
What is the name of the hospital, clinic, or healthcare system where you plan to complete your project?
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Information about teammates
Name of teammate 1
Email address of teammate 1
Name of teammate 2
Email address of teammate 2
Name of teammate 3
Email address of teammate 3
Name of teammate 4
Email address of teammate 4
About your proposed project
Title of your proposed project
What environmental problem will your project address (choose all that apply)?
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Energy - clean energy procurement
Energy - energy efficiency
Energy - medical imaging
Water use reduction
Sustainable food procurement
Operating room - anesthetic gasses
Operating room - general OR sustainability
Telehealth
Pharmacy sustainability
Transportation (includes commuting by staff, patient and visitor transit, and business travel)
Waste reduction - composting
Waste reduction - recycling
Waste reduction - conversion from single-use to reusable items
Waste reduction - device reprocessing
Waste reduction - efficient clinical practices
Waste reduction - other (please write in below)
Waste reduction - reduction of food waste
Waste reduction - regulated medical waste
Waste reduction - reuse and repurposing
Waste reduction - sustainable procurement
Waste reduction - water bottle filling stations
Optimizing clinical management to reduce unnecessary labs, medications, procedures, imaging studies, etc.
Other (please write in below)
If other, please write in here
What is the current practice at your workplace related to your proposed topic (e.g., we use single use gowns)?
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What is the intervention you are proposing (e.g., start using reusable gowns)?
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What are your initial thoughts on how baseline and outcome will be measured? This can be very simple!
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What is the change you expect to see with your intervention? - again, this can be very simple!
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Do you have any other comments, questions, or feedback you'd like to share with us at this time?
