Qualtrics Survey | Qualtrics Experience Management

LGBTQ Champions are physicians who have specialized training and experience caring for LGBTQ patients. This virtually connected network of primary and specialty care providers also commit to participate in ongoing education and professional development in LGBTQ health topics.

If you are a provider at UCLA Health and would like to be listed as an LGBTQ Champion on the UCLAHealth.org provider directory, please submit your request by filling out the form below.

LGBTQ Champions are expected to have participated in significant education, research and/or clinical care focused on LGBTQ Health. If you are interested but have had limited experience, you may be requested to complete additional education. LGBTQ Champions will be required to attest every 3 years to having completed significant ongoing education or other meaningful measures to advance knowledge within LGBTQ Health.

Educational and professional resources in LGBTQ Health can be found at resource page website https://www.uclahealth.org/lgbtq/for-providers.

For additional questions or concerns, email us at lgbtq@mednet.ucla.edu.

Please fill out the below:

First Name

Last Name

Direct Phone Number

Specialty

Please provide detailed information about your previous experience and/or training in LGBTQ care.

Please provide a brief bio with particular attention to areas of LGBTQ care. This information will be incorporated into your provider bio in the UCLA provider directory.

Please specify whether you are able to provide the following specific types of care:

HIV prevention including preexposure prophylaxis (PrEP)
HIV treatment and HIV-related care (requires AAHIVS or Infectious Disease certification)
Management of gender-affirming hormone therapy