AAMI MedCrypt Cybersecurity Visionary 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:

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* 7. Group Nominee Information

If this nomination is for a group or team, please attach the information from the previous entry for each member of the group/team.

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Nominator Information:

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* 8. Nominator's Name:

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* 9. Title:

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* 10. Company/Affiliation:

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* 11. Mailing Address:

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* 12. Phone Number:

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* 13. Email Address:

Award Criteria: Nominees must meet all of the following:

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* 14. Nominee demonstrates leadership by identifying the larger challenges and mapping out a path on how to address them. Please describe:

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* 15. Nominee demonstrates strategic thinking and leadership among stakeholders in the medical device cybersecurity risk management space, combined with the ability to execute tactically on specific challenges. Please describe:

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* 16. Nominee has demonstrated the ability to work across stakeholders and constituencies in government, care delivery, security research, academia, and manufacturers. Please describe:

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* 17. Evidence provided through either: a body of work that reflects consistent and substantial contributions in reducing medical device cybersecurity risks; breakthrough accomplishment(s) that substantially improve(s) critical aspects of the industry's cybersecurity posture; or, proposed solutions and blazed a way forward that led to reduction of the identified risks. Please describe:

Award Criteria: Nominees should meet the following:

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* 18. The ability to elevate the industry through research, education, publication, practice and/or mentorship. Please describe:

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* 19. Evidence of leadership in the development of medical device cybersecurity risk management standards, guidances, and best practices. Please describe:

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* 20. Success within real world constraints and scaling of solutions that are implementable and lead to steady progress. Please describe:

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* 21. Nominator Cover Letter:

Upload nominator’s cover letter that provides a rationale statement describing the nominee’s qualifications.

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* 22. CV/Resume:

Upload a current CV/Resume for the nominee here.

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* 23. Letter of Recommendation:

Upload a letter of recommendation (from the past year) supporting this nomination from supervisors, colleagues, and industry partners here.

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* 24. 2nd Letter of Recommendation:

Upload the second letter of recommendation (from the past year) supporting this nomination from supervisors, colleagues, and industry partners here.

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* 25. Nominators are encouraged to submit examples and/or supporting documents that highlight additional activities relevant to this award.

Please upload any desired supporting documents here.

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