Outstanding EMS Agency

Outstanding EMS Agency

Award Nomination Form

AWARD CRITERIA: An EMS agency that exemplifies outstanding professionalism and service to its community; whose high level of patient care is evident by innovative training, community awareness, preventive health programs, public relations efforts and participation in local, regional and statewide EMS systems.

ELIGIBILITY: Any currently licensed or official agency that is recognized by the state or federal government that is based in Virginia and is directly responsible for responding to emergencies or disasters and providing the direct delivery of care. Includes governmental, commercial, volunteer, hospital, industrial and air ambulance services.

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 this EMS agency’s qualities and contributions as a leader and educator in their community and within their agency.

-How does this EMS agency exemplify outstanding professionalism and service to their community?
-Do they participate in illness and injury prevention programs?
-Do they provide services to their community that go above answering calls for EMS?
-How does this EMS agency support their providers?

Nominator Contact Information

This information is required to process the nomination.


-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.