North American Federation of Healthcare Clowning Organizations (NAFHCO)

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The North American Federation of Healthcare Clowning Organizations (NAFHCO) was created in 2018 after several years of developing the concept and identifying organizations who meet the code of ethics and criteria of professionalism set forth by the Federation.

There are nine founding organizations, representing Massachusetts, Georgia, Texas, Illinois, Missouri, Ohio, California, Washington and Rhode Island, as well as Montreal and Toronto in Canada.


To advocate the acceptance of professional healthcare clowns as an integrated partner in the circle of care by creating a nationally accepted standard for the work that can be monitored and supported by the North American Federation of Healthcare ClownING Organizations.


NAFHCO advances the field of healthcare clowning by establishing and maintaining best practices, enhancing the professional growth and development of members, and advancing credibility of the healthcare clown profession by setting a national standard, fostering research and promoting the efficacy of humor in healing.



Demonstrated by organizational and financial decisions focused on moving the profession forward, empowering members, and sustaining a viable member-centric association.


Demonstrated by personal and organizational integrity, transparency, fairness, and credibility in relationships and communications.


Shown through our commitment to including performing artists of all cultural backgrounds, as well as remaining steadfastly inclusive of all patients and families we serve regardless of their background.


Maintaining a high level of artistry across all members through constant training, continuing education and sharing of ideas and best practices.


All members will provide unwavering advocacy for this work through their deeds and their words.


Demonstrated by leadership consistently open and responsive to new ideas that will advance the healthcare clown profession.

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