Regional EMS Council Awards Quick Form

Thank you for recommending an EMS colleague, program, agency or organization for their exemplary service, dedication and contribution to Virginia’s Emergency Medical Services (EMS) system. This quick form is available for nominators to submit a Regional EMS Council award recommendation on behalf of a nominee, year-round, and a member of the respective Regional EMS Council will be in touch to request additional information.

Please note: This is not a formal award submission. This is only a quick form to collect the initial award nomination information, which will be sent to the corresponding Regional EMS Council for review and follow-up. If this form is submitted before the Regional EMS Council’s award nomination deadline, it may be considered for that award year. If it falls after the award nomination deadline, then it will be held for consideration the following year.

Learn more about the Governor’s EMS Awards program at: www.vdh.virginia.gov/emergency-medical-services/other-ems-programs-and-links/governors-ems-awards-program-2/

Regional EMS Council Award Form