Personal Commitment Agreement

Your pledge to yourself, your community, and the patients you serve

The Power of Commitment

This personal commitment agreement is more than a formality—it is the foundation of your transformation journey. Research shows that written commitments create powerful psychological contracts that significantly increase the likelihood of achieving meaningful change.

By signing this agreement, you are making a conscious choice to become an active participant in dismantling racism within healthcare systems. This commitment will serve as your north star throughout your training and beyond.

I commit to:

Approaching this training with an open mind and willingness to examine my own biases and assumptions
Engaging honestly and respectfully in all learning activities, even when content challenges my comfort zone
Maintaining confidentiality and creating safe spaces for vulnerable discussions with fellow participants
Taking responsibility for my own learning journey and actively participating in all required activities
Applying the principles and practices learned in this training to my professional healthcare practice
Becoming an advocate for health equity and anti-racism within my organization and community
Continuing my growth and learning beyond this program through ongoing education and self-reflection
Supporting and mentoring others in their anti-racism journey
Speaking up against racist practices and policies when I encounter them
Measuring my progress through regular self-assessment and seeking feedback from others

Your Commitment to Growth

This training will challenge you to examine deeply held beliefs, confront uncomfortable truths, and take action in ways that may feel unfamiliar. Your commitment today ensures that you will persist through these challenges and emerge as a more effective, culturally responsive healthcare leader.

⚠️ Important

By signing this agreement, you acknowledge that meaningful change requires sustained effort and commitment. This program is designed for healthcare professionals who are ready to do the deep personal work required for genuine transformation.

Digital Signature

Full Name *

Healthcare Organization/Practice *

Professional Role *

Email Address *

Date *

I have read and fully understand this Personal Commitment Agreement. I voluntarily commit to upholding these principles throughout my training and professional practice. I understand that this commitment is essential for my growth as an anti-racism healthcare leader.

I understand that following this commitment, I will complete a baseline self-assessment that will help track my progress throughout the program. I commit to approaching this assessment with honesty and self-reflection.