Contribution to EMS for Children

Contribution to EMS for Children

Award Nomination Form


AWARD CRITERIA: An individual, organization or program that exemplifies outstanding dedication and service to the contribution, development and/or enhancement of EMS for children in Virginia.

ELIGIBILITY: An individual, organization or program with a significant contribution to the development or enhancement of EMS for children in Virginia. Services cover a continuum of care, from injury prevention to pre-hospital care, emergency department and hospital services, and rehabilitation.

Nominee Information

Do your best to provide as much information as possible to assure the individual qualifies for the nomination.

Nominee's Qualifications & Award Justification


Describe how this nominee has gone above and beyond to enhance care for pediatrics or provide injury and illness prevention programs for children.

What are some examples of how these programs have made a significant contribution to the development or enhancement of EMS for children in Virginia?

Nominator Contact Information

This information is required to process the nomination.

Guidelines


-Anyone may submit nominations for the Regional EMS Awards.
-For all categories the nomination may be based on a pattern of conduct/activities that has culminated in an exceptional improvement of the emergency medical services system in the locality, region or state.
-The nomination may also be based on a single unusual event that was beyond ordinary duty.
-The person making the nomination should have extensive knowledge of the nominee’s qualifications and carefully select the category that most appropriately matches the nominee’s accomplishments.
-The nominee must have current licensure or certification in the category in which he or she has been nominated.
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