Practitioner of the Year Award Nomination form

This award recognizes a respiratory care practitioner who has demonstrated considerable involvement, motivation and value to the profession of respiratory care. This award is designed specifically to recognize an active AARC member in the NYSSRC who most exemplifies what it means to be a truly dedicated and ideal respiratory care practitioner. This is not a service award recognizing professional / political / committee work. Rather, it recognizes the practitioner who, day in and day out, works to improve patient care in whatever arena he or she may be working.

Please complete each field below with as much information you know about the individual you are nominating. It is not necessary to complete each field with your nominee information, but the more detailed, the better informed decision the Awards committee and Board of Directors can make.

Any categories below indicated with an asterisk (*) are required fields.