Stereotype Threat Experiences

What happened? Please describe what you experienced or witnessed including what triggered the stereotype.

Anything you tell us will be kept strictly confidential unless you give us explicit permission to share it.

You indicated that the experience was witnessed by another person. How did they respond?

You indicated you talked about the experience with a supervisor, Human Resources representative, or other person with a leadership or authority role. Please let us know how they responded and what happened as a result of the conversation.

The questions below are entirely optional. If you prefer not to answer them, feel free to skip to the bottom and click "submit form".

Job position (optional)

Examples include (but are not limited to): doctor, nurse, chiropractor, medical assistant, medical scribe, nurses assistant, physical therapist, mental health counselor, receptionist, human resource coordinator, executive, director, business analyst

Stereotype Threat Experiences

Have you experienced or witnessed stereotype threat while at your workplace?

The questions below are entirely optional. If you prefer not to answer them, feel free to skip to the bottom and click "submit form".

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