National Respiratory Patient Advocacy Award Nomination Form

National Respiratory Patient Advocacy Award

The National Respiratory Patient Advocacy Award is the only nationally-recognized advocacy program dedicated to honoring outstanding registered respiratory therapists nominated by leadership.

Use the form below to nominate a respiratory therapist for this prestigious award or learn more about the National Respiratory Patient Advocacy Award.

  •  
  • Nominator Information

  •  
  • Nominee Information

  •  
  • Nomation Criteria

  •  
  • Letter of Support

  • Attach a file containing a narrative or letter of recommendation describing the nominee’s advocacy. Files can be images (tiff, jpeg) or text (.doc, pdf)
  •  
  • Qualifications

    All nominations must include the following information.
  • Provide evidence as testimonials or other documentation that nominee is actively engaged or champion of patient/family centered respiratory care within their hospital, department, clinic, post-acute setting and or community.
  • Provide evidence that nominee is actively engaged in efforts to improve quality and safety of the respiratory care provided by their department and they champion these efforts with their department, institution or at the state or national level.
  • Provide evidence that nominee sets exemplary level of professionalism and clearly demonstrates advocacy for the profession.
  • Provide evidence that nominee is a Champion, Supporter, Promoter, Fighter, Crusader and Proponent. Do they contribute to the science, technology, ethics and the art of respiratory therapy? Does this person also suggest and/or develop support that leads to public policy change?
  • Provide evidence that work results in increased integration of programs and services, resulting in improved outcomes for the patients and clients.
  • Provide evidence that their work results in improved outcomes for patients and clients.
  • Provide evidence that nominee’s idea resulted in a change of service delivery model, cost savings, time savings, workflow improvement, or general safety improvement.
  • This field is for validation purposes and should be left unchanged.