CRITERIA: An EMS physician who exemplifies outstanding leadership and dedication in the exercise of prehospital care.
ELIGIBILITY: Any licensed physician who is actively involved with prehospital care, training or mentorship of prehospital 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.
You will need the following to submit your nomination:
- Nominee’s full name
- Nominee’s Current address
- Nominee’s best contact phone number
- Nominee’s email address that they check regularly
- Agency or Hospital affiliation and position
- Supporting documentation (Please note: Only three attachments in total will be accepted)
- The nominee’s Resume or CV
- One letter of support written by someone other than the nominator
- Newspaper/periodical articles or other materials
- A high-quality photo of the nominee must be included.
- Try to send a color photo (with good lighting) with just the nominee in it.
- If it is an agency or organization, the photo can be a group shot of agency members, a picture of agency headquarters, or a logo.
You will need to answer the following about the nominee:
- Summary and justification for why this physician should receive this award.
- Explain why this EMS physician exemplifies outstanding leadership and dedication in the exercise of prehospital 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.
- Provide a description of the success and accomplishments of this person in EMS to include honors, awards (civic or professional) that highlights their contribution to EMS and their community.