Outstanding EMS Physician

Outstanding EMS Physician

Award Nomination Form

AWARD CRITERIA: An EMS physician who exemplifies outstanding leadership and dedication in the exercise of pre-hospital care.

ELIGIBILITY: Any licensed physician who is actively involved with pre-hospital care, training or mentorship of pre-hospital providers in the Commonwealth. This can include emergency room physicians, operational medical directors, or other physicians who dedicate their time and knowledge to furthering education and patient care in EMS.

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 the nominee’s qualities and contributions to EMS in Virginia at the local, regional and state level.

-Explain why this EMS physician exemplifies outstanding leadership and dedication in the exercise of pre-hospital care.
-How does this physician go above and beyond their duties to enhance EMS care, education and support of the EMS system in their region/community and the state?
-Give specific examples (when applicable) of programs, new technologies or procedures that they have researched or implemented.

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.