Regional EMS Award for Innovation Excellence in EMS

Regional EMS Award for Innovation Excellence in EMS NOMINATION FORM

  • If nominating an agency, please include the agency license number here.
  • Read each statement below carefully and answer completely. Limit documentation to the information requested. Up to three documents may be attached to the nomination form. Of these items, one letter of support written by someone other than nominator must be included. Other documents may include a resume or CV, a newspaper article written about the nominee, etc.
  • Drop files here or
    Max. file size: 100 MB, Max. files: 3.
    • a. How has this individual /organization made a difference in Virginia’s EMS System through innovative contributions and initiatives? i. How has this innovative initiative been utilized to address a problem that affects the EMS community? ii. How has this individual or organization identified challenges or gaps in patient care and how have they worked to enhance patient satisfaction? b. How has this innovation accelerated the development of advanced EMS systems in Virginia? c. What areas of the EMS system have been greatly influenced by the work of the individual or organization being nominated?
    • a. What changes or outcome examples have occurred following the implementation of the new or enhanced program/product developed by the nominee? b. How were the objectives met? c. Consider providing detailed result analysis of the program/product.
    • Accepted file types: jpg, jpeg, png, gif.
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