Skip survey header

Request for LGBTQ Champion Designation

1. 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 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 requested 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 here:

This question requires a valid email address.
Please specify whether you are able to provide the following specific types of care:
Security Check