Membership

Action Coalition Member Engagement and Contact Form

Thank you for your commitment to building a healthier America through nursing! We are thrilled that you are joining the Nursing Action Coalition of Florida and helping us work at the local level to promote health equity and well-being.

Please confirm your interest and alignment with the Future of Nursing: Campaign for Action priorities. Make your selection below and return the completed form to Nursing Action Coalition of Florida, Jan Adams, at nursingactioncoalition@gmail.com

Yes, I will engage as an Action Coalition member with the Nursing Action Coalition of Florida to:

Foster and unleash the power of equity-minded nurses to advance health equity and disrupt structural racism.
Strengthen, grow, and diversify nursing at all levels.
Increase equitable access to care by nurses.
Strengthen, diversify, and engage the Campaign stakeholder network to implement Future of Nursing 2020-2030 National Academy of Medicine recommendations.

To help us update our records, please fill in your contact information below.

First name:

Last name:

Credentials:

Title:

Organization:

Street Address: City: State: ZIP code:

Phone number:

Email address:

Signature:

Date

Your Team Choice(s):

#3 Nurse Health and Well Being
#6 Social Determinants of Health
#7 Strengthening Nursing Education
#8 Emergency Preparedness