1st Annual Health Care Impact Purchasing Award
Nomination Form
1. Your Information (Nominator)
Nominator's Name
*
First Name
Last Name
Nominator's Phone Number
*
-
Area Code
Phone Number
Nominator's Email
*
example@example.com
2. Nominee's Information
Nominee Name (Person or Organization)
*
You are able either a person or healthcare organization
Nominee Contact Email
*
Email to contact the person or organization
3. Nominee's Profile
Brief profile introducing the person or organization being nominated.
*
250-500 words
0/500
5. Nominee's Photo and Bio
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4. Nomination
The reason for the nomination is relevant to the nomination award criteria.
*
No less than 200 words
Summary describing the hospital or health system nominee’s impact on purchasing and supplier diversity program or initiative efforts (e.g., workshops, campaigns, policy change).
*
250-500 words
0/500
Description of target audiences, engagement outcomes, and metrics of reach or impact of the purchasing or social procurement initiative.
*
250-500 words
0/800
Upload Supporting Documents: Recommendation Letter from an executive leader and a diverse vendor/supplier.
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Max file size: 10mb
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