Nominations

Upload your completed Summit Award nomination form(s) to our website

HealthCare Service Excellence Conference

"Thriving on Health Care Reform: Creating a quality patient experience in the midst of change and chaos" January 16-18, 2012 in Dallas, TX.

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Summit Awards

2012 marks the 12th Anniversary of the Health Care Service Excellence Conference and the prestigious Summit Awards. Over the past 11 years we have awarded 158 Summit Achievers and over 270 Pinnacle Achievers (introduced in 2005) to individuals and organizations who represent the very "Best of the Best" in Service Excellence.

Nomination Info

Click the arrow (below) to download the nomination to your computer. Please be patient as the form may take some time to download. (No handwritten nominations will be accepted.) When you have finished filling in the nomination form (one form per nominee) you may:

Upload your nomination directly to the Summit Awards Committee:
- Save each nomination on your computer
- Submit each nomination form seperately using the Upload Page; or,
Print your compleated form(s) and Fax each printed form to the Summit Nomination Committee at 1-403-228-6776

NOTE: Deadline for all nominations is 12:00 midnight MST on Friday, October 14, 2011

Nomination Forms

Individual Summit Award

I-1   Service Excellence Advisor - 1st Year
A trainer and team leader who encourages and supports team members to improve service.

I-2   Service Excellence Mentor
A role model with a positive attitude who assists and guides SEAs.

I-3   Exceptional Nurse
Provides caring and quality care, devoted, supportive, good listener, a friend who is always improving.

I-4   Exceptional Employee
A unique individual who supports and listens to patients and co-workers and goes above and beyond their job description.

I-5   Empowering Manager
A leader who provides the challenge and then trusts and supports initiatives.

I-6   Customer Focused Physician/Provider
Professional and respectful with consideration for those they serve.

Team Summit Award Nomination Form

T-7   Service Excellence Advisor
A team with a positive attitude who combine their front line experience and skills for the betterment of all.

T-8   OASIS Team
A support group to achieve mutual goals.

T- 9   DOIT Improvement of the Year
An innovative team that challenges change for improvement.

Leadership Summit Award Nomination Form

L-10  Super Coach
Provides co-ordinating leadership and assistance to teams and the Program director.

L-11   Service Excellence Program Director
A leader, supporter, motivator, listener, advocate, communicator, coach and mentor who recognizes improvement.

L-12   Service Excellence Executive Sponsor
Visionary risk-taker, committed to improvement, provides support when needed, and embraces success.

L-13  Service Excellence Council
Dedicated group who are committed to the visions and expect participation to move forward with exceptional teamwork.

L-14   Inspiring Administrator
Exhibits leadership with a winning friendly attitude, high energy, professional, and considerate of others.

Organizational Summit Award Nomination Forms

A market leader for patient service, recruits and retains talent, and keeps their promises.

O-15   Medical Clinic of Choice

O-16   Continuing Care Community of Choice

O-17   Hospital Provider of Choice

Special Recognition

F-18 Founder's Award (Lamplighter)
One of healthcares most prestigious honors, the Annual "Founder's Award", is presented by HealthCare Service Excellence Conference Founder, Brian Lee.

This award is presented to recognize the individual who best demonstrates personal leadership in the delivery of World-Class patient satisfaction.

This award requires no nomination form or submission. It is awarded to the recipient based on Brian's personal observations and the feedback from Implementation Specialists and co-workers.

Director's Planning Guide

A step-by-step guide in helping to make perfect nomination forms. Download, print, and review the guide before submitting nominations.

Summit and Breakthrough Awards Nomination Form Information Document

Outlines the rules, regulations, and other information needed for proper nomination form submission.

If you will be sending supporting documents (ie. newspaper clippings, awards, brochures, etc.) please fill out and print the fax cover sheet.

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