Nominate a Rural Health Award Recipient

Award Categories:

RURAL HEALTH CHAMPION

Presented to an individual or organization that exhibits concern for rural issues and takes steps to address those concerns in the region.

RURAL HEALTH LEADER

Presented to an individual who has made significant contributions to rural health and well-being through advocacy, leadership, or volunteer/professional work.

RURAL HEALTH PARTNER

Presented to an individual or organization who has partnered with Rural Health Network of SCNY to advance our work in serving rural people and communities.

RURAL HEALTH PRACTITIONER

Presented to a healthcare practitioner who works in rural communities and/or works to address rural health issues.

EMERGING RURAL HEALTH LEADER

Presented to an individual in the first five years of their career who is making significant contributions to rural health and well-being through professional or volunteer work.

Please indicate who you are nominating. List an organization in the last name field. *

First NameLast Name OR Organization

Please select the category you are nominating an individual or organization for. Our selection committee reserves the right to consider your nominee in a different category.*

In what county(counties) does the individual or organization have an impact on rural health and well-being? Select as many as apply*

Phone Number for the Nominee*

Please enter a valid phone number.

Email address for the Nominee*

example@example.com

Address of the Nominee*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Nomination Summary - Describe why you are nominating this person/organization for the category you chose. Include their contributions to rural health and well-being. Limited to 500 words or less. *

0/500

Your Name (Nominator)*

First NameLast Name

Your Email Address*

example@example.com

Your Phone Number*

Please enter a valid phone number.

Thank You!