Membership Application

Please fill out this form to apply to be a member of the Collaborative Centre.

Members will be listed on our new website. If you have any questions, please email climate.health@utoronto.ca

This survey contains two sections. We expect this will take 5-10 minutes to complete:

  • Membership Application
  • Membership Tags

We also have an Initiatives Directory (for related research, education, or practice/policy change initiatives). If you have initiatives feel free to submit a form.

Initiatives Form

Contact Information

Name(Required)
If you submit a UofT email, you will have direct access to update your bio.

Membership Information

If there is a different email from the above that you would like to have displayed on your bio in the membership directory, please include it here
Faculty with which you have your primary University of Toronto affiliation, if applicable *(Required)
TAHSN organization with which you have your primary affiliation(Required)
The Collaborative Centre is developing a membership structure. Please select which type of Collaborative Centre fellow you think would be most appropriate.(Required)
To launch our membership, we are starting with the following categories (more are in process):

Please submit a Title describing your primary role and affiliation, for display under your name on the directory
Please include a brief bio, which includes your key affiliations, roles and professional responsibilities (you can also include a link to your primary bio elsewhere, which we will reproduce). If your key affiliations, roles and professional responsibilities do not make this clear, please discuss how your work is connected to the mission of the Collaborative Centre. This will be displayed on our membership directory. (suggested max 300 words)
We are curating a list of members to whom we could redirect media inquiries, as appropriate. If this is of interest, please indicate which topics you would be willing to speak to the media about below. We also encourage you to sign-up for the UofT Blue Book to be listed as an expert who can comment on news, and include tags related climate, health & sustainable care: https://www.utsc.utoronto.ca/research/blue-book
Enter one per line (e.g. LinkedIn, Twitter, etc.)
Sponsorship & Industry Engagement Policy:(Required)
To maintain the credibility of our mission and a high degree of public assurance in the work that we – collectively – do in the Collaborative Centre’s name, we have adopted a sponsorship and industry engagement policy that sets some limits on Members’ ability to use their affiliation with the Collaborative Centre in their work (e.g., mobilizing the affiliation in grant applications or publications, or to co-brand events). These limits arise when Members would use their affiliation with the Collaborative Centre for an activity that is sponsored by a commercial entity (including the entity’s foundations or the third parties that act on their behalf, such as public relations firms) – for example, for an industry-sponsored study, speaking engagement, or event. We ask Members to reach out if these specific situations arise (or if they are unsure), to clarify whether it is appropriate to involve the Collaborative Centre in such an activity. We are developing a process to adjudicate these situations, using an established risk-based approach (e.g., risks to credibility, governance, neutrality, etc.). NB. The policy does not apply to Members of the Collaborative Centre who engage in these activities in any capacity that is independent of their relationship with the Collaborative Centre.
How developed is your work in this space?(Required)

How would you characterize your career stage?(Required)

Ideally, choose a bio headshot or similar
Max. file size: 128 MB.

Areas of Focus Tags for Collaborative Centre Website

Members will be searchable on the Collaborative Centre website by tags that identify your relevant areas of focus. Please fill out this section to indicate which tags should be listed on your bio. If you have any questions, please email climate.health@utoronto.ca Please select the tags (at any level) that apply to your work. Select 4 max from each area:

  • Environment / Sustainability focus (required to select at least 1)
  • Health / Health system focus (required to select at least 1)
  • Research Disciplines / Approaches (optional)

A) ENVIRONMENT/ SUSTAINABILITY FOCUS.

Please select the tags (at any level) that apply to your work. Select 4 max from the list below (required to select at least 1).
Environment / ecology
Global health
Sustainable, resilient, low carbon health services & systems

B) HEALTH/ HEALTH SYSTEM FOCUS.

Please select the tags (at any level) that apply to your work. Select 4 max from the list below (required to select at least 1).
Disaster and emergency management / preparedness
Health education
Health equity
Health / clinical domains
Health systems, services & settings
Social & structural determinants of health
Others

C) RESEARCH DISCIPLINES/ APPROACHES.

Please select the tags (at any level) that apply to your work. Select 4 max from the list below (optional).
Research Disciplines/Approaches

Consent

By completing this form, I am providing my consent for the University of Toronto Collaborative Centre for Climate, Health & Sustainable Care to share my bio on the website.(Required)