2024 Healthy Hall Award of Excellence Nomination Form

The Greater Hall Chamber's Healthcare Awards Program seeks to spotlight those in the healthcare industry making a significant impact on our quality of life through excellence in health and wellness. Nominate an individual, business or organization for a Healthy Hall Award of Excellence by completing this survey. Nominees must be located in the Greater Hall area. Awards will be presented at the 7th Annual Healthy Hall Awards Luncheon on Wednesday, March 20, 2024.

Question Title

* 1. Please list YOUR name and contact information here:

Name

Phone

E-mail

Question Title

* 2. Please provide the contact information of individual, business or organization you are nominating:

Contact Name:

Company:

Address:

Phone:

E-mail:

Question Title

* 3. Please select the award(s) you are nominating this individual/company for (select any that apply):

Corporate Achievement Recognition

Community Impact

Visionary Leader

Healthcare Education

Outstanding Achievement in Behavioral Health

Healthcare Worker of the Year

Advanced Practice Provider of the Year

Nurse of the Year

Dentist of the Year

Physician of the Year

Lifetime Achievement Award (may be awarded posthumously)

Question Title

* 1. Please list YOUR name and contact information here:

Question Title

* 2. Please provide the contact information of individual, business or organization you are nominating:

Question Title

* 3. Please select the award(s) you are nominating this individual/company for (select any that apply):

Question Title

* 4. Please tell us why you are nominating this individual, business or organization for this award: