TSHP Awards (Member Recognition) Program

Nominee Name*

First NameLast NameDesignations
Nominee Email*
example@example.com
Award*
Describe the nominee's significant contributions to the practice of health-system pharmacy.*
Please provide all relevant details to best represent this nominee to the committee. Your provided narrative is a critical item of review.
I confirm I am a:*
Unfortunately you are ineligible to complete this nomination. Please discontinue the application at this time.
Letter of Nomination*

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Director of this Practice is a TSHP member?*

YesNoI don't know.
Provide Director's Name*

First NameLast Name
Nominee has been licensed to practice for less than 5 years?*

YesNo
Nominator (You) are a member of the TSHP Technician Section?*

YesNo
Reason(s) for Nomination*
Please be as descriptive and detailed in your nomination statement for best results as possible.

Distinguished Service Award
Award Criteria: Contributions to practice may be in the form of sustained exemplary service, an outstanding single achievement or a combination of accomplishments promoting and advancing pharmacy. Accomplishments may be in pharmacy practice, education, or administration; research or development related to pharmacy; organizational activity; contributions to professional literature; improving the image of health-system pharmacy; inter-professional activities serving health-system pharmacy; or contributions in legislation related to pharmacy in organized healthcare settings.
Are you a past recipient of this award, past president of TSHP, an official representative of a local chapter, or have you gathered the support of no less than 10 pharmacist members of TSHP?*
Select the most appropriate option.
List the TSHP pharmacist members (minimum of 10) that support this candidate's nomination.*
Describe this nominee's contributions to pharmacy practice in Texas (and beyond). The described contributions should be validate the concepts of "sustained" and "exemplary." *
Please be as descriptive as possible.
Describe this nominee's professional accomplishments. Include highlights from their career that elevated them personally (such as awards and accolades) or the practice of health-system pharmacy.*
Please be as descriptive as possible.

TSHP Leo F. and Ann Godley Residency Fellowship Award
Award Criteria: Demonstrates a commitment to the profession of pharmacy through service, practice, education, research and/or other activities.
Describe this nominee's commitment to practice. Include any significant milestones, contributions to pharmacy, and/or professional accomplishments. *
Please be as descriptive as possible.
Describe this nominee's commitment to research and education. Include any significant publications, grant research, or other substantial accomplishment(s). *
Please be as descriptive as possible.

TSHP Industry Service Award
Award Criteria: Demonstrates professionalism, support for and participation in the programs of TSHP, leadership in pharmaceutical education and/or research and a commitment to safe, rational, economic drug therapy and healthcare.
Describe this nominee's support of TSHP and Texas pharmacy. Include any significant contributions to the pharmacy community, education, research, and/or safety.
Please be as descriptive as possible.

TSHP Innovative Collaborative Practice Award
Award Criteria: Provides patient care in a creative, interdisciplinary fashion. Director (or head of pharmacy services) must be a TSHP member. Must be nominated by a TSHP member outside of the group nominated. (Personal and facility information is redacted prior to selection of recipients.)
Provide a narrative summary that highlights the innovative and collaborative practice you are nominating. Describe in detail what elevates this practice above others.*
Collaborative Practice Documentation*

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Nominees should provide a document (typically 5 pages or less) describing your collaborative practice. Areas of information that should be included are: background, needs assessment (why this change/improvement was necessary), practice procedures, outcomes, and conclusion. Cancelof
Provide any additional information you feel the review committee should consider when discussing your nominee.
My nomination should remain anonymous.*

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We thank you for your interest in submitting a candidate for Award consideration. Unfortunately, we only accept nominations from TSHP Members.

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TSHP Awards Program