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HealthTrust Clinical Warrior Submissions

HealthTrust Clinical Warrior Submission

HealthTrust Clinical Warriors are clinicians (individuals or teams) working on the front lines demonstrating courage, sacrifice and a commitment to the improvement of human life in the war against COVID-19 through measurable efforts.

Thank you for submitting your colleagues. Fill out the form below. 

Please remember to include a photo!
Submitted by: *This question is required.
Submission type: *This question is required.
Team submission information: *This question is required.
Space Cell Team LeaderAdditional MemberAdditional MemberAdditional MemberAdditional Member
Name
Title
Facility Name
Email Address
Individual submission information: *This question is required.
Please provide a photo of the HealthTrust Clinical Warrior(s). *This can be a picture from your phone. *This question is required.