Application Form

Tick the appropriate Industry where your company falls:

Diagnostics

Pharma

Medical Equipment

Healthcare Service Provider

Hospitals

Pharmacy

Machinery/Packaging

Categories to showcase your Companies Excellence

Medical Equipment Company of the Year

Medical Equipment SME of the Year

Medical Equipment Exports Company of the Year

Pharma Company of the Year

Pharma SME of the Year

Pharma Exports Company of the Year

Health Insurance Provider of the Year

Telemedicine Provider of the Year

Healthcare Technical Consultants of the Year

Healthcare Legal Consultants of the Year

Single Specialty Hospital of the Year

Multi-Specialty Hospital of the Year

Maximum Outreach Hospital of the Year

Diagnostic Service Provider of the Year

Pharmacy of the Year

Pharmaceutical Machinery Manufacturer of the Year

General information

  1. Award Assessment Process:

The ASSOCHAM HEALTHACRE EXCELLENCE AWARDS 2017comprises of two-staged selection process consisting of questionnaire assessment, and evaluation by jury members for final selection.

Questionnaire assessmentincludes : -

  • An assessment on how the company has integrated innovation policy, technological advancement, healthcare improvement, cost effectiveness, corporate social responsibility, sustainability, employee welfare and quality management
  • Awards will be given to winner from each category and jury will objectify and prioritize the excellence on the basis of supportive relevant documents submitted by the company.
  1. Instructions for filling the Questionnaire:

Categories for ASSOCHAMHEALTHCARE EXCELLENCE AWARDS 2016

The ASSOCHAM HEALTHCARE EXCELLENCE AWARDS 2016has the following 15categoriesso as to distinguish oneself from peers, co level and other competitors

Category / Basis of Evaluation / Who Can Apply
Medical Equipment Company of the Year /
  • Innovation and Research
  • Patentability
  • Growth Percentage
  • Marketing Techniques
  • Employee Benefits
  • Corporate Social Responsibility
  • Quality Management
/ Companies
Medical Equipment SME of the Year /
  • Research and Development
  • Patentability
  • Growth Percentage
  • Marketing Techniques
  • Employee Benefits
  • Corporate Social Responsibility
  • Quality Management
/ Companies
Medical Equipment Exports Company of the Year /
  • Percentage revenue from exports
  • Growth Percentage
  • Innovation
  • Technological Development
  • Quality Management
  • Use of Export Assistance Schemes and FTAs
/ Companies
Pharma Company of the Year /
  • Innovation and Research
  • Patentability
  • Growth Percentage
  • Marketing Techniques
  • Employee Benefits
  • Corporate Social Responsibility
  • Quality Management
/ Companies
Pharma SME of the Year /
  • Research and Development
  • Patentability
  • Growth Percentage
  • Marketing Techniques
  • Employee Benefits
  • Corporate Social Responsibility
  • Quality Management
/ Companies
Pharma Exports Company of the Year /
  • Percentage revenue from exports
  • Growth Percentage
  • Innovation
  • Technological Development
  • Quality Management
  • Use of Export Assistance Schemes and FTAs
/ Companies
Health Insurance Provider of the Year /
  • Insurance Coverage
  • Pre/Post Hospitalization Expenses
  • Co-Pay Option
  • Renewability
  • Hospital Coverage
  • Claim Waiting Period
/ Companies
Telemedicine Provider of the Year /
  • Type of Services
  • Growth Percentage
  • No. of centers and telemedicine network
  • National Coverage through telemedicine
  • Global patient outreach
/ Companies/Hospitals
Healthcare Technical Consultants of the Year /
  • Type of Services
  • Growth Percentage
  • Customer Retention
  • Research and Development
  • Accreditations/Certifications
/ Companies
Healthcare Legal Consultants of the Year /
  • Type of Services
  • Growth Percentage
  • Customer Retention
  • Accreditations/Certifications
/ Companies
Single Specialty Hospital of the Year /
  • Patient to nurse ratio
  • Teaching Facility
  • Training and Development
  • Imaging Facilities, Support Services and other additional facilities
  • Hospital Accreditation
  • Quality Management System
  • Hospital-acquired infection prevention
  • Employee Safety
/ Hospitals
Multi-Specialty Hospital of the Year /
  • Patient to nurse ratio
  • Teaching Facility
  • Training and Development
  • Imaging Facilities, Support Services and other additional facilities
  • Hospital Accreditation
  • Quality Management System
  • Hospital-acquired infection prevention
  • Employee Safety
/ Hospitals
Maximum Outreach Hospital of the Year /
  • National Coverage
  • Global Coverage
  • Growth percentage in outreach patients
/ Hospitals
Diagnostic Service Provider of the Year /
  • Diagnostic and Imaging Facilities
  • Availability of special equipment for claustrophobic, and overweight patients
  • Portable imaging equipment
  • Availability of Radiologists
  • Prevention from infections
  • Employee Safety
  • Laboratory Accreditation
/ Diagnostic and Imaging Labs
Pharmacy of the Year /
  • No. of working hours
  • Storage facilities
  • Type of Inventory Management
  • Tracking Information System
  • Delivery Services
  • Accreditations/Certifications
/ Pharmacies
Pharmaceutical Machinery Manufacturer of the Year /
  • Research and Development
  • Patentability
  • Growth Percentage
  • Marketing Techniques
  • Employee Benefits
  • Corporate Social Responsibility
  • Quality Management
/ Companies including Machinery Manufacturers & Packaging Firms

Application Process

  • Application form needs to be filled in English language only.
  • Applicant can select multiple options while answering questions in the questionnaire
  • If an applicant selects“others” as an option, he or she needs to specify the same in not more than 100 words.
  • In case of any subjective reply, if the applicant answer does not fit in the space provided, he or she can attach an A4 sheet with clear indication of category and question number.
  • The completed questionnaire should be signed and stamped by the concerned authority in the organization.
  • The questionnaire can be downloaded from the website and applicant could share scanned version of the filled form via email in clearly indicated attachments, along with the scanned copy of the supporting documents.
  • The hard copy of the filled application form can also be sent to ASSOCHAM through courier or registered post to the below mentioned contact address.
  • The entire set of information should also be included on a CD. The last date for submission of application form is March 10, 2017 and sent to the following Corporate Office:

ATTN: Anshul Gupta, ASSOCHAM HOUSE, 5 Sardar Patel Marg, Chanakyapuri, New Delhi, 110021.

In case of any queries, please contact:

Mr. Anuj Mathur
Email:
Mob.: 09810993268 / Ms. Payal Swami
Email:
Mob.: 08527500385 / Mr. Anshul Gupta
Email:
Mob.: 07838242822
  • For more details, log onto

Eligibility Criteria

  • The awards process is open to all Indian Registered Healthcare Companies/Health Insurance Providers/Telemedicine Providers/Healthcare Consultancy Companies/ Hospitals/Diagnostic Service Providers/Pharmacies. In case if participant fails to submit the proof of registration in the country, they may be disqualified from participation.
  • Company can undergo multiple entries for each of the award category and each category needs to be supported by individual relevant supportive documents.
  • If the participating center has more than one branch, only the head office is eligible to apply and other branches will come into consideration automatically.
  1. Terms & Conditions:
  • Assocham will not be responsible for loss of money or time on cancellation or delay of the awards due to some unavoidable serious reason.
  • Incomplete application form and questionnaire form will be liable for disqualification.
  • Any misleading information and inaccurate entry found in the form at any point of time, organization would be considered as disqualified. If organization is found guilty of sharing wrong information after award ceremony, the organization might be asked by Assocham to return the award at any point of time.
  • The organizer will maintain all reasonable precautions but it will not be responsible for disclosure of information concerned with the entry in form.
  • The Jury’s decision would be terminal and no alteration would be produced after the last conclusion and further reasoning would also not be thrown in the judgment. The Jury would have its own approach which would be treated as confidential.
  • The award committee has the right to debar any contestant, if it tries to influence the expert panel or any other member of the award committee.
  1. Application Processing Fees

Category A: INR 10,000/- (Per Entry)

Payment of the processing fee could be done either through online electronic transferor by Cheque in favor of ASSOCHAM and accompany the application

Kindly note that separate fees will be charged while applying for multiple categories.

  1. General Information about the Company

F.1Particulars of Organization

S.No / Item / Particulars
i. / Full name of the Company/ Enterprise
ii. / Address of the Registered Office
iii / Name of the CEO/ Proprietor/ chief functionary with address
iv / Type of Company (Ownership)
v / Industry classification
vi / Nature of business ( Manufacturing, Marketing, Service Provider, Distributor, Other)
vii / Year of incorporation
viii / Annual turnover (as per last audited financial statements) Kindly attach annual report
ix / Employee strength (current)
a)Managerial
b)Non Managerial
c)Workmen
d)Percentage of women employees
e)Percentage of differently-abled personnel
x / Locations of operations
a)Head Office
b)Branch Offices/Regional Offices
c)Factory/Manufacturing Units

F.2Details of the Healthcare excellence in project you wish to highlight for consideration by the jury. (200 words)

F.3Details of Products / Businesses of the Company

S. No. / Nature of Business/Product / Year / Location
I.
II.
III.
IV.
V.

F.4Details of Contact Person

Name
Designation
Address
Pin
Telephone No
Fax
Website/ Email Id

F.5Declaration

I / We certify that all information provided in this application form and attachment is accurate and true to the best of my/our knowledge. I / We am / are willing to provide any supporting documentation / evidence that may be required to verify the information provided herein and I / We agree to abide by the decision of ASSOCHAM in all matters relating to the Award.

Authorized Signatory:

Name & Designation:

Company Seal:

Date:

Place:

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