2025 Health Care Award

Award Application

The Healthiest State Annual Awards is our annual recognition program that celebrates Iowa-based health care champions for their extraordinary contribution to improve the physical, social and mental health of their pediatric patients.

Please share specific and detailed examples of the work that has been done in 2024 to continue the mission of 5-2-1-0 Healthy Choices Count! in the nominated clinic.

Nominate a fellow clinic who has inspired you through their own 5-2-1-0 Healthy Choices Count! work.

The selection committee will not be provided the name of the nominee and only has your answers to the questions below to base their decision on so be specific on the accomplishments.

Nominees shall exhibit the following characteristics:
· Build bridges among people with different backgrounds or viewpoints.
· Achieves positive change to support 5-2-1-0 Healthy Choices Count! in their clinic.
· Work to ensure every child in their care has access to and is motivated to make healthy choices for a happy & healthy life.

Question Title

* 1. Clinic Information:

Name *

Clinic Name

Address *

City/Town *

State/Province *

ZIP/Postal Code *

County *

Email Address *

Phone Number *

Question Title

* 2. Nominator Information:

Name

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 3. Is the nominated clinic a 5-2-1-0 registered health care site?

Yes

Unsure

Question Title

* 4. I have informed the nominee of this award and nomination.

Yes

Question Title

* 5. Briefly describe how 5-2-1-0 Healthy Choices Count! is incorporated into the clinic.

Question Title

* 6. Bonus Question Alert: It’s Their Time to Shine!

Why does your nominee deserve the Healthiest State Initiative Health Care Award?

Here’s your chance to showcase what makes your nominee truly exceptional. Highlight their passion, dedication, and creativity in promoting health and well-being. Share specific examples of their leadership, innovation, and the positive impact they’ve made on their community.

Use this opportunity to inspire the review committee and demonstrate why your nominee stands out as a leader in supporting health and well-being!