2017 Western Virginia EMS Region Award Forms

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Western Virginia EMS Council's Regional Award for Excellence in EMS Nomination Form
CRITERIA: An individual who exemplifies outstanding dedication and service to the statewide Virginia emergency medical services system, and has demonstrated a commitment to a comprehensive, integrated system of emergency medical services throughout the Commonwealth.
ELIGIBILITY: Any individual engaged in emergency medical services in the Western Virginia Region.

Western Virginia EMS Council's Regional Award for Outstanding EMS Administrator Nomination Form
CRITERIA: An individual who has demonstrated ability to organize, conduct, manage, problem solve and evaluate within his or her organization and, by exemplary leadership and administrative skills, improve the effectiveness, response and delivery of EMS.
ELIGIBILITY: Any person responsible for chairing, presiding over, supervising or administering EMS organizations and/or personnel in the Western Virginia Region.

Western Virginia EMS Council's Regional Outstanding EMS Agency Nomination Form
CRITERIA: An EMS agency that exemplifies outstanding professionalism and service to its community; whose high level of patient care is evident by innovative training, community awareness, preventive health programs, public relations efforts and participation in local, regional and statewide EMS systems.
ELIGIBILITY: Any currently licensed or official agency that is recognized by the state or federal government that is based in Western Virginia Region and is directly responsible for responding to emergencies or disasters and providing the direct delivery of care. Includes governmental, commercial, volunteer, hospital, industrial and air ambulance services.

Western Virginia EMS Council's Regional Outstanding Prehospital Provider Nomination Form
CRITERIA: An individual who exemplifies outstanding dedication and service to his or her community through involvement with EMS. 
ELIGIBILITY: Any individual who routinely provides prehospital care, primarily in Virginia, is affiliated with at least one Western Virginia Region licensed EMS agency, and who is certified as a prehospital EMS provider by the Commonwealth of Virginia.

Western Virginia EMS Council's Regional Award for Pre-Hospital Physician Award Nomination Form
CRITERIA: An EMS physician who exemplifies outstanding leadership and dedication in the exercise of prehospital care. 
ELIGIBILITY: Any licensed physician who is actively involved with prehospital care, training or mentorship of prehospital providers in the Commonwealth. This can include emergency room physicians, operational medical directors, or other physicians who dedicate their time and knowledge to furthering education and patient care in EMS in the Western Virginia Region.

Western Virginia EMS Council's Regional Nurse with Outstanding Contribution to EMS Nomination Form
CRITERIA: A nurse who exemplifies outstanding service in emergency medical services; knowledge and performance of EMS nursing skills; and high standards of cooperation and leadership with other EMS personnel and agencies. Highest consideration is given to performing a nursing role in a hospital or clinical setting such as precepting or quality assurance programs. Nurses who have demonstrated excellence as a prehospital provider or instructor should be nominated for those categories.
ELIGIBILITY: Any Virginia licensed nurse serving in an active position in the Western Virginia Region.

Western Virginia EMS Council's Regional Award for Outstanding Prehospital Educator Nomination Form
CRITERIA: A provider who exemplifies outstanding teaching and leadership qualities while participating as an educator in an EMS program. Must have coordinated or consistently demonstrated excellence and a dedication to the education of prehospital EMS providers. The nominee must have participated as an instructor, coordinator or adjunct faculty in an EMS program for at least two years. Educational programs include: First Responder, EMT-Basic, EMT Enhanced, EMT Intermediate, EMT Paramedic, continuing education courses, preceptor programs or equivalent EMS training. 
ELIGIBILITY: A Virginia EMS educator in the Western Virginia Region.

Western Virginia EMS Council's Regional Outstanding Contribution to EMS for Children Nomination Form
CRITERIA: An individual, organization or program that exemplifies outstanding dedication and service to the contribution, development and/or enhancement of EMS for children in Virginia. 
ELIGIBILITY: An individual, organization or program with a significant contribution to the development or enhancement of EMS for children in Virginia. Services may cover a continuum of care, from injury prevention to pre-hospital care, emergency department and hospital services, and rehabilitation in the Western Virginia Region.

Western Virginia EMS Council's Regional Outstanding EMS Telecommunications Dispatcher Nomination Form
CRITERIA: An emergency medical telecommunicator, public safety answering point administrator, supervisor or training officer whose outstanding dedication and service has demonstrated an exceptional contribution to the improved delivery of emergency medical services in the local, regional or statewide EMS system.
ELIGIBILITY: An emergency medical telecommunicator, public safety answering point administrator, supervisor or training officer who is employed by or volunteers with an organized emergency medical services dispatch center or public safety answering point in Western Virginia Region.

Western Virginia EMS Council's Regional Outstanding Contribution to EMS Health & Safety Nomination Form
CRITERIA: Any individual, program, business or licensed EMS agency within the Commonwealth of Virginia that has demonstrated comprehensive and/or significant accomplishments/programs that make a significant contribution to or provide for the health, safety and welfare of EMS providers.
ELIGIBILITY: Any individual, program, business or licensed EMS Agency within the Commonwealth of Virginia. Examples of programs meeting eligibility for this award would include EMS provider health and wellness programs (fitness and wellness, cardiovascular health), scene safety programs (aeromedical operations, emergency vehicle operations), and provider injury prevention programs (injury prevention at violent scenes) designed to prevent line of duty death and injury. Eligible applicants include persons or entities developing or managing such programs in the Western Virginia Region.

Western Virginia EMS Council's Regional Emergency Preparedness Award
CRITERIA: Any individual, EMS organization or EMS response group within the Commonwealth of Virginia that has demonstrated comprehensive and/or significant accomplishments for programs that provide preparedness, response and recovery from natural, man-made and preplanned events, which cause a significant impact on the agency and the community. These activities should directly relate to and impact the provision of emergency medical care during these events.
ELIGIBILITY: Any individual, EMS organization or EMS response group within the Commonwealth of Virginia

Western Virginia EMS Council's Regional Outstanding Contribution to EMS by a High School Senior Nomination Form
This competitive $1,000 scholarship will be awarded to a high school senior who has been affiliated with an EMS agency within the Western Virginia EMS Region for at least six months, and who is currently enrolled or will be enrolled in an institution of higher learning or an accredited ALS training program in the coming year.

Western Virginia EMS Council's Regional Benny Summerlin Award for Service to Local Government

The Summerlin Award is awarded by the Western Virginia EMS Council Executive Committee to recognize outstanding contributions to local government by current or former EMS providers. It is named for Benny Summerlin, a former WVEMS president, who dedicated his life to serving citizens in the community where he lived. As a young teenager in 1973, he began serving as a volunteer junior member of Martinsville – Henry County Rescue Squad and he continued serving his community until his passing at age 53, as he served as the County Administrator for Henry County.

Benny Summerlin’s dedication and service to EMS alone sets an exemplary standard. This award honors other EMS providers who lead the community in which they live through excellent service in other areas of local government. 

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