Submit a nomination for the Vitiligo Innovators Program™ (VIP)

Nominations are due October 29, 2026.

Thank you for your interest in the Vitiligo Innovators Program™ (VIP). You can nominate someone by filling out the below form or by downloading this PDF and submitting it via email to VIP@realchemistry.com.

Before you begin to fill out your nomination form, please ensure you review the following carefully:

Before submitting your nomination, please ensure that all information is accurate and correct, as you will not be able to edit or save the form after submitting. For questions, please review the FAQs or email us at VIP@realchemistry.com.

01: Select a nomination category:

Healthcare Innovator: Healthcare professional who provides extraordinary care or education for people with vitiligo.Rising Innovator: Promising resident, medical student, researcher or early-career physician (up to 10 years post-residency) who focuses on advancing vitiligo research.Community Innovator: Advocate or non-medical individual who has made a significant positive impact in supporting, or caring for, people with vitiligo. Required field

02: Who are you nominating?

Name Required field

Vitiligo Community Affiliation Required field

Email Invalid Email address

Phone Number Required field Invalid Phone Number

03: What is your connection to the nominee?

Required field

IMPORTANT! An independent judging panel will review your written explanation of why your nominee should be recognized.

04: Please describe your nominee’s actions and accomplishments in as much detail as possible.

What extraordinary efforts in the last 3-5 years highlight your nominee’s commitment to making a positive impact on the lives of people with vitiligo? For example, how has the nominee gone above and beyond for the community? What specific projects or initiatives has the nominee led or significantly contributed to? Please include dates and/or years, where possible.

(750 words maximum) Required field

05: If applicable, please provide links to supporting resources (e.g. online articles, newsletters) to provide additional context to the nominee’s accomplishments listed above.

(750 words maximum) Required field

06: Please describe how you heard about the Vitiligo Innovators Program.

(100 words maximum) Required field

07: Please provide the following contact information so we may reach you directly, as needed:

My Name Required field

My Email Invalid Email address

My Phone Number Required field Invalid Phone Number

I attest that the responses provided in this form are true and accurate to the best of my knowledge and that the nominee will be made aware of the nomination and that the nomination will need to be approved by and compliant with any institutional rules and guidelines. Required field

Submit Your Nomination