AAMI & GE Healthcare BMET of the Year Award

PRO TIPS:

Please fill out the following form carefully and completely, noting all of the required fields.
All email addresses must be in valid xx@xx.xx format.
16 MB limit on all file uploads.
Your nomination is only submitted once you have reached a screen with a green top bar saying “Thank you for taking this survey”.
Files and supplemental materials may be emailed to awards@aami.org.
Please direct any questions or support needs to awards@aami.org.

Nominee Information:

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* 1. Nominee's Name:

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* 2. Title:

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* 3. Company/Affiliation:

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* 4. Mailing Address:

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* 5. Phone Number:

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* 6. Email Address:

Nominator Information:

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* 7. Nominator's Name:

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* 8. Title:

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* 9. Company/Affiliation:

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* 10. Mailing Address:

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* 11. Phone Number:

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* 12. Email Address:

Award Criteria: Nominees must meet all of the following:

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* 13. Nominee demonstrates achievement and sustained excellence through specific contributions to the healthcare technology management (HTM) profession. Please describe:

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* 14. Nominee has obtained ICC Certification. Please specify CBET, CRES, CLES, CHTM, CABT or another certification:

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* 15. Nominee has been employed in the HTM field for five years or more. Please specify "yes":

Award Criteria: Nominees should meet the following:

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* 16. Nominee is currently serving in a technician/technologist role. Please list the approximate percentage of time spent in a direct technician/technologist role in their current position:

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* 17. Nominee actively participates in a local, state, or regional HTM association. Please list the affiliated organizations and role:

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* 18. Nominee has made contributions to share knowledge and experience through speaking engagements or authorship of articles related to HTM. Please list published articles:

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* 19. Nominee has participated in the resolution of an HTM challenge or problem in a patient care environment and/or played a role in special projects or studies that made a difference to the field. Please describe:

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* 20. Nominator Cover Letter:

Upload nominator’s cover letter that provides a rationale statement describing the nominee’s role in special projects or studies that have made a difference to the field as well as any HTM challenge or problem they worked to resolve while highlighting their excellence in the HTM field.

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