Contribution to Health and Safety

Contribution to Health and Safety

Award Nomination Form


AWARD CRITERIA: Any individual, program, business or licensed EMS Agency within the Commonwealth of Virginia that has demonstrated comprehensive and/or significant accomplishments/programs that make a significant contribution to or provide for the health, safety and welfare of EMS providers.

ELIGIBILITY: Any individual, program, business or licensed EMS Agency within the Commonwealth of Virginia.

Examples of programs meeting eligibility for this award would include EMS provider health and wellness programs (fitness and wellness, cardiovascular health), scene safety programs (aeromedical operations, emergency vehicle operations), and provider injury prevention programs (injury prevention at violent scenes) designed to prevent line of duty death and injury. Eligible applicants include persons or entities developing or managing such programs.

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

Summarize the justification and criteria for why this nominee’s accomplishment/program should be recognized.

Describe the accomplishment/program, including its objectives and clientele being served.

Describe the demonstrated comprehensive and/or significant accomplishments/programs that make a contribution to or provide for the health, safety and welfare of EMS providers.

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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