OSHP Health-System Pharmacist of the Year
To recognize a health-system pharmacist and Ohio Society of Health-System Pharmacists (OSHP) member of high integrity, high professional ideals, and who best exemplifies the profession of health-system pharmacy practice.
Nominee Information
Nominee Name
First Name
Last Name
List significant contribution to the profession or healthcare institution within the last 2 years. This could include FTE expansion, expansion or creation of new pharmacy services, innovation, technology expansion, panel presentations, committee/taskforce work. This list is not all inclusive. Please attach additional evidence to support as warranted
List OSHP involvement over the last 5 years. This could include membership on a specific division, volunteer efforts, etc. This does not include only OSHP membership.
Please list the years the nominee has been a member of OSHP
List leadership experience which is non-OSHP related within the last 2 years. This could be ASHP involvement, other pharmacy organizations, non-pharmacy organization, institution specific such as a supervisor role. This list is not all inclusive
Please document any advocacy efforts at the local, state, or national level for advancing pharmacy within the last 5 years
List the nominee's research projects and presentations over the last 2 years. This could be local, state, institution, or national presentations. Research projects do not need to be presented to count, though poster presentations should also be listed
List the nominee's community engagement within the last 2 years. This does not include any volunteer efforts with OSHP or ASHP. This also should be independent of any engagement as listed above.
List the nominee's awards over the last 5 years. This could include local, state, institution or national awards
Please describe one recognizable and/or outstanding effort the nominee has completed for practice, patient care, innovation, education, or advocacy within the last 3 years. Please provide any objective data to support this accomplishment. Please also note impact on local, state, and/or national level. Please attach additional evidence as warranted to support this content (attachments are not necessary to be awarded points in this section)
Additional Significant Information
Nominator Information
Nominator Name
*
Nominator Employer
*
Nominator Phone
*
-
Area Code
Phone Number
Nominator Email Address
*
example@example.com
By checking below, I hereby: Attest that all information I have provided in conjunction with this application is true and completed by myself as the nominator. Attest that this individual is of upmost ethical and professional standing. Acknowledge and agree that if during the application process, I make any false or misleading statements—including material omission—that this may be considered grounds for removal of the application from award consideration
*
I have read and agree with the above statement
Attachments
Additional Evidence- Limit attachment to no more than 2 pages
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