CLIO HEALTH INNOVATORS NOMINATION
In order to nominate an individual for the Clio Health Innovators list, please complete this form to the best of your ability.
Nominator Information
Please provide the following information about yourself, the nominator.
Your Full Name
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Your Email Address
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Your Phone Number
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Your City
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Your Country
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Your Job Title
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Your Company
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Your Company Type
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Advertising Agency
PR, Media & Communications
Health Awareness & Advocacy
Health Institutions & Services
Other
If you selected Other for Your Company Type, please insert Your Company Type here
Your Agency Network (If Applicable)
What is your relationship to the nominee?
*
Nominee Information
Please provide the following information about the individual you are nominating for the 2024 Clio Health Innovators list.
Nominee Full Name
*
Nominee Email Address
*
Nominee Phone Number
*
Nominee City
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Nominee Country
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Nominee Job Title
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Nominee Company
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Nominee Company Type
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Advertising Agency
PR, Media & Communications
Technology
Health Awareness & Advocacy
Health Institutions & Services
Lifestyle & Wellness Brand
Over-the-Counter Brand
Pharmaceutical
Other
If you selected Other for Nominee Company Type, please insert the nominee's Company Type here
Nominee Agency Network (If Applicable)
Please share why this individual should be included on the Clio Health Innovators list.
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Include a story or specific details that showcase this individual’s unique efforts and achievements in the past year. If available, please provide links to marketing efforts or work this individual has contributed to.
Upload a headshot of the person you are nominating for the Clio Health Innovators list.
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