NHS rainbow badges pledge form https://www.chelwest.nhs.uk/about-us/organisation/our-way-of-working/equality-diversity/nhs-rainbow-badges-pledge-form https://www.chelwest.nhs.uk/++resource++plone-logo.svg NHS rainbow badges pledge form User email: Please leave this blank!!! By choosing to wear this badge, you are sending a message that “you can talk to me” about issues of gender and sexuality. You aren’t expected to solve all issues and concerns but you are a friendly ear and will know how to direct those you speak with to support available. By completing this form I confirm that: wearing a badge gives a positive message of inclusion and means I have a responsibility to be someone who is a friendly ear for LGBT+ young people and families I have read the information on the NHS rainbow badges page and explored the support materials for young people I understand what to do if I think a situation requires escalation I am a staff member, contractor, volunteer or governor at Chelsea and Westminster Hospital NHS Foundation Trust Full name I have completed this form for myself and understand the expectations of the NHS rainbow badge initiave Job title Email address This should be your nhs.net email address if you have one—volunteers, governors etc please use a suitable email address Site Chelsea and Westminster Hospital West Middlesex University Hospital 10 Hammersmith Broadway 56 Dean Street John Hunter Clinic Sexual Health Hounslow Other Where you normally work the majority of the time Specific location Where you work at the site above—so we can get a badge to you I would like to wear a badge because: We’d like to know more about what motivates people to wear a rainbow badge—we may use your quote anonymously to promote the badges to others Submit Contributors George Vasilopoulos