2024 Grace Diaz Blue Light Award Nomination Form

Each year the Rhode Island World Diabetes Day (RIWDD) Committee recognizes an individual or organization that has positively impacted diabetes in the state of Rhode Island by awarding the Grace Diaz Blue Light Award. In keeping with the 2024 World Diabetes Day theme, "Diabetes and Wellbeing," this year's Blue Light Award will be presented to an individual or organization who demonstrates a strong commitment to supporting the well-being of individuals with diabetes through care, personal support, and a focus on their overall health and wellness.
Please complete the form below to place your nomination for a deserving person or organization. Be sure to submit your nomination by November 1, 2024.

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* 1. Name of Person/Organization you are nominating:

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* 2. Email of nominee:

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* 3. Phone number of nominee:

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* 4. Please provide a description of the person/organization you are nominating and how this nominee has met the criteria noted above:

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* 5. What is unique about this person/organization in their role?

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* 6. How has this person/organization advocated for the health and wellbeing of their patients with diabetes?

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* 7. How has this person/organization influenced diabetes and/or pre-diabetes care in Rhode Island?

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* 8. Your name:

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* 9. Your email address:

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* 10. Your phone number:

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