GHHS Induction Form

The Gold Humanism Honor Society (GHHS) recognizes individuals who exemplify humanistic patient care and who can serve as role models, mentors, and leaders in medicine. Individuals selected to the GHHS are recognized and celebrated in a formal induction ceremony and given a certificate and pin.

Chapter advisors and liaisons, please complete the form below prior to the date of your induction ceremony to receive pins for your nominees. You will receive the induction certificates electronically.

Kindly allow 21 business days for processing your request.

Chapter Contact Directions
Please add the names and contact information of all Chapter Advisors and liaisons.
Chapter Advisor name(s): *	50 of 50 characters remaining
Chapter Advisor email(s): *
Chapter Advisor Phone number(s): *
Chapter Liaison Name(s):
Chapter Liaison email address(s):
Name of institution (exactly as it should appear on certificates): *
Induction Date: *
Number of students being inducted (must be 15% of class size): *
Overall number of inductees (including any HETA/Tow Award winners, faculty and residents): *
Graduation year of students: *
Overall class size at the time of membership selection as defined by the office of the Dean of Med *
Induction Spreadsheet Directions
Please download the inductee spreadsheet template below and fill in the information for all inductees. Double-check the spelling of all names, as this information will be used to create the certificates. Please do not manipulate or alter this spreadsheet in any way. This spreadsheet will be used to import inductee information into the database; therefore, do not add any notes or additional comments to this sheet. Induction Spreadsheet: chapter_advisor_sheet_2025_.xlsx
Upload Here: *
Certificate and Pin Directions
Please fill out the shipping contact information and address where you would like the inductees' GHHS pins to be mailed.
Contact Name: *
Contact email address: *
Address Line 1: *
Address Line 2:
City: *
State: *
Zip/Postal Code: *
Country:
FedEx Account Number:
Additional comments:
Check here to indicate the above named advisor has reviewed and approved this form before submitting *	Yes

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