2024 California TB Elimination Heroes Nomination Form Question Title * 1. Name and title of person recommending nominee (please print) Nominator Name: First and Last Title of Nominator: Organization: Phone Email Question Title * 2. Nominee (Individual or Group) Name Credentials Title Organization Phone Email City/County Question Title * 3. TB Elimination heroes criteria, check all that apply: Initiated or led new TB prevention activity in their community clinic or CBO Mentored colleagues in TB prevention efforts Inspired colleagues to initiate TB prevention activities Supported at risk populations/individuals to access TB prevention services Facilitated support for current TB patients/high risk individuals Question Title * 4. Please be specific as you describe why you are nominating this individual/group. Your description of their TB elimination efforts, when shared during World TB Day 2024, can inspire others to join this movement (~500 words). The 2023 TB Elimination Hero descriptions are great examples of inspiring nominations. Done