Regional EMS Award for Outstanding EMS Agency Nomination Form

Regional EMS Award for Outstanding EMS Agency NOMINATION FORM

  • 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.) Why is this nominee exceptionally qualified and selected for this award? b.) How does this EMS agency support their providers? c.) Describe this EMS agency’s enhanced programs, which provide a high level of patient care that is evident through innovative training, community awareness, preventative health programs, public relations efforts and participation in the local, regional, state and national EMS systems.
    • Accepted file types: jpg, jpeg, png, gif.
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