If nominating an agency, please include the agency license number here.
a.) Why does this individual or agency’s program or accomplishment deserve to be recognized?
b.) Describe the accomplishment/program, including its objectives and target population being served and how it contributes to or provide for the physical and or mental health, safety and well-being of EMS providers.
c.) Describe how the physical and or mental health, safety and well-being objectives were met. Provide examples and outcome measurements when possible.
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