The Aesthetic Foundation Patient Safety Award - Nomination Form

Established by Dr. Mark Jewell and Mary Lind Jewell, RPT, with a generous donation to The Aesthetic Foundation, this award recognizes individuals who have made a meaningful contribution to improve the quality and safety (minimize risk) of aesthetic plastic surgery and cosmetic medicine through innovation, process engineering, operational excellence, and/or research. The award(s) will be presented during The Aesthetic Foundation/Aesthetic Society Member Business Meeting, Saturday, May 4, at the Vancouver Convention Center.

Nominations will be accepted until January 31, 2024, and individuals may self-nominate. To be eligible, nominees must be one of the following:

an Active or International Active Member of The Aesthetic Society and/or The Aesthetic Foundation
an Associate Member of The Aesthetic Society
a current Aesthetic Society Endorsed Fellow
enrolled in The Aesthetic Society's Residents and Fellows Program

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* 1. Your name and contact information

Name *

City/Town

State/Province

Country

Email Address *

Phone Number *

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* 2. Your nominee

Full Name with Credentials

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* 3. In 500 words or less, share why you have nominated the person noted above. Please include the individual's achievements in patient safety in aesthetic plastic surgery and cosmetic medicine in one or more of the following categories: Innovation, Process Engineering, Operational Excellence, and/or Research.

The Aesthetic Foundation Patient Safety Award - Nomination Form

Question Title

* 1. Your name and contact information

Question Title

* 2. Your nominee

Question Title

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* 4. Any additional comments you would like to provide.