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Excellence in Healthcare Award Nominee

2018 Nomination Form

Recognizing Excellence

Nominees for the Greater Fort Lauderdale Chamber of Commerce Excellence in Healthcare Awards are those individuals, programs and entities who provide care, services and innovative programs above and beyond all expectations. These nominees are shining examples of the best and the brightest in our healthcare community.

The deadline for submitting your nominee is October 8, 2018.


♦ Your Contact Information ♦


First Name
Last Name
Phone Number
Email

♦ Nominee Information ♦


First Name
Last Name
Organization/Business/Institution
Phone Number
Email
Profession
Nature of Relationship

♦ I Am Nominating (Check One) 


 Individual Health Care Professional: A caregiver or healthcare professional whose contribution demonstrates servant leadership with qualities like compassion, kindness, perseverance and humility.

 Nurse: Honoring a nurse whose contributions may include any part of nursing from the bedside to the boardroom.

 Healthcare Program: A community-based program administered by a Broward-based non-profit organization whose influence extends beyond the population it serves.

 First Responder: Certified first responder, individual or service (fire, medical, police, military), that has made significant impact in South Florida for dedication, responsibility, professional behavior, special skill or insight in the Emergency Medical Services environment.

 Volunteer: An individual, regardless of age, who provides service above self in a healthcare related setting.

 By checking off this box you elect to allow the judges the freedom to consider the nomination for a category other than the one indicated above.

♦  Nomination  ♦


Suggested talking points to show that the nominee's achievements qualify for the 2018 Excellence in Healthcare Award:

• Nominee’s primary responsibilities of duties
• Leadership, mentoring or inspirational qualities
• New/Improved processes or discoveries
• Measurable or beneficial gains made possible by nominee
• Community/Industry services/Industry improvement
• Patient satisfaction/Advocacy/Quality of Life Improvement

(maximum 1,000 words)

Before submitting this form, please click on the link below to move the contents of box "A" into box "B" leaving the first box empty.

A: B: Click to Move