Annual Awards Nomination Form

The OAMSS Advocate Award and The OAMSS Professional Achievement Award were created in 2016 to recognize individual accomplishments as a member of the Ohio Association of Medical Staff Services.

General Criteria:

Nominee must be a current member of OAMSS in good standing.
Nominee must hold active CPCS or CPMSM certification in good standing with no ethics violations.
Nominee will be judged upon the information provided on the application form and narrative prepared by the nominator.

Criteria OAMSS Advocate Award:

Nominee must demonstrate a strong commitment to OAMSS through their contributions to the Medical Staff Services profession and OAMSS at the local, state and/or national level.

Criteria OAMSS Professional Achievement Award:

Nominee must demonstrate a strong commitment to the medical staff services profession by mentoring, sharing knowledge, fostering education opportunities and encouraging growth of the medical staff services profession.

Award Type

Submitting nomination for the

OAMSS Advocate Award
OAMSS Professional Achievement Award

ABOUT THE NOMINEE

* Nominee - First Name

* Nominee - Last Name

* Nominee - Title

* Nominee - Certification(s) held

* Nominee - Employer

* Nominee - Employer Address

* Nominee - City

* Nominee - State

* Nominee - Zip Code

* Nominee - Years in industry

* Nominee - Years in OAMSS

* Nominee - OAMSS Region

* Nominee - Email

* Nominee - Phone

Nominee - Fax

ABOUT THE NOMINATOR

* Nominator - First Name

* Nominator - Last Name

* Nominator - Title

* Nominator - Certification(s) held

* Nominator - Employer

* Nominator - Employer Address

* Nominator - City

* Nominator - State

* Nominator - Zip Code

* Nominator - Years in industry

* Nominator - Years in OAMSS

* Nominator - OAMSS Region

* Nominator - Email

* Nominator - Phone

Nominator - Fax

* Please attach a narrative to this form describing how the nominee’s characteristics and activities / achievements meet the criteria for the OAMSS Advocate Award or the OAMSS Professional Achievement Award. Nominations received without the narrative will n

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