Champion for Spiritual Care Award Nomination Form

ACPE Champion for Spiritual Care Award Nomination Form

The Champion for Spiritual Care Award recipient will be recognized at the 2025 ACPE Annual Conference & Centennial Celebration of CPE May 18 - 25, 2025 in Minneapolis, Minnesota.
Please note: There is no option to save your submission. Please complete all fields before submitting your application.

Award Description

The Champion for Spiritual Care Award recognizes healthcare leaders and other related industry leaders who exemplify exceptional dedication to promoting spiritual care and whole-person health within their organizations. These leaders understand the vital role of spiritual health in enhancing patient experiences and outcomes and actively work to ensure that spiritual care is integrated into the fabric of their healthcare and/or organizational systems.

Criteria for Selection

Nominees for the Champion for Spiritual Care Award must demonstrate the following characteristics:

1. Leadership in Spiritual Care: Proven track record of advocating for and implementing spiritual care education and initiatives within their organization.

2. Commitment to Patient Outcomes & Whole Person Health: Demonstrated understanding of the correlation between spiritual health and overall patient well-being, as well as efforts to enhance patient experiences through spiritual care.

3. Collaboration and Community Engagement: Ability to foster collaboration among various healthcare professionals and community organizations to promote holistic care.

4. Vision and Innovation: Demonstrated innovative practices or programs that have advanced the integration of spiritual care into clinical, business and/or community settings.

5. Upholding ACPE Values: Commitment to the mission, vision, and values of ACPE and the field of spiritual care.
Nominator’s Information
Date

MonthDayYear
Date
Name of Person Submitting Nomination

First NameLast Name
Relationship to the Award Nominee
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Are you a member of ACPE?

YesNo
If yes, what is your membership category?
If you are not a member of the ACPE, please list how you are affiliated with the organization.

Nominee’s Information
Name of Person Nominated for the Champion for Spiritual Care Award

First NameLast Name
Is this person a member of ACPE?

YesNo
If yes, what is their membership category?
If no, how are they affiliated with ACPE?
Please explain why the Nominee should receive the inaugural ACPE Champion for Spiritual Care Award. Share any significant contributions or accomplishments this person has made by advocating for the importance of CPE and/or spiritual care in their unique context.
500 words or less
Nomination Attachments:

Please upload the following documents with your Champion for Spiritual Care Award nomination form:

1. A one-page biographical statement about the Nominee

2. Two letters of support

a. One from an ACPE colleague other than the Nominator
b. One from a healthcare leader / related industry partner or community leader familiar with the nominee's work
One-page biographical statement about the nominee

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Please attach two letters of support:
One statement from an ACPE colleague other than the Nominator

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One from a healthcare leader / related industry partner or community leader familiar with the nominee's work

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Signature
Nominator's Printed Name

First NameLast Name
Nominator's Signature

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ACPE Champion for Spiritual Care Award Nomination Form