2024 Nomination Form
Choose the Award
If you pick multiple categories, please note why your nominee deserves to win in that area?
Is your nomination for Adult or Pediatrics Category?
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Adult
Pediatrics
Other
Healthcare Providers
Primary Care Physician
Dentist
Speech Therapist
Cardiologist
Endicrinologist
Chiropractor
OBGYN
Other
Fitness & Nutrition
Best Fitness Program
Top Nutritionist/Dietitian
Best Fitness Facility
Innovative Fitness Product
Other
Community Impact
Community Wellness Leader
Best Community Health Initiative
Outstanding Volunteer in Health and Wellness
Outstanding Non-Profit in Health and Wellness
Other
Mental Health and Wellbeing
Excellence in Mental Health Services
Best Mindfulness Program
Mental Health Advocate
Top Stress Management Program
Other
Technology and Innovation
Best Health and Wellness App
Innovative Health Tech Product
Other
Education and Awareness
Best Health Education Program
Outstanding Health and Wellness Content Creator
Excellence in Health Awareness Campaigns
Top Wellness Workshop or Seminar
Other
Individual Achievements
Health and Wellness Advocate of the Year
Personal Transformation Award
Fitness Enthusiast of the Year
Mental Health Champion
Other
2. Your Information (Nominator)
Nominator's Name
First Name
Last Name
Nominator's Phone Number
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Area Code
Phone Number
Nominator's Email
example@example.com
3. Nominee's Information
Nominee's Name
*
First Name
Last Name
Nominee's Company/Business Name
*
Nominee's Email
*
example@example.com
4. Nominee's Profile
Personal profile introducing the person being nominated and why you nominated them for the chosen award?
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250-300 words
Upload business logo or image of the business/provider you nominated.
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6. Nominee's Qualifications and Experience
List qualifications and experience relevant to nomination category.
*
Please verify that you are human
*
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