BEST IMPROVEMENT IN PATIENT SAFETY
NOMINATION FORM

This year’s IMSTA Med Tech Awards are being held on

THURSDAY 28th September in CROKE PARK CONFERENCE CENTRE, Dublin 3

This is an opportunity to highlight the quality of your products / services and excellence of your company. The annual awards event is a platform for the supply industry to showcase the state-of-the-art medical technologies we bring to the market and demonstrate the valuable contribution our industry is making to healthcare in Ireland.

The award categories are shown overleaf, and below is a summary of the rules and some notes for your information. If you require clarification on aspect of these Awards, please contact Doreen O’Reilly of 01 4847828 or .

Rules
1. Awards are open to all members of IMSTA.
2. Each entry must be in the name of an individual /team / company. In the case of a team, one individual must be identified to represent the team.
3. All entries will be treated as confidential. Any requests for media access will be passed on to the nominees, who must decide on any appropriate access.
4. Separate forms must be completed for each category of award.
5. Where necessary, give as much information as possible with emphasis on patient outcomes.
6. Returned forms to IMSTA, Kandoy House, 2 Fairview Strand, Dublin 3 before 18th August 2017.
7. The Judging Panel’s decision is final.
Notes and Information
(i) You will ONLY be judged on the information submitted to us, including the quality of your nomination. Further information will only be sought if necessary.
(ii) Nominees should provide evidence of outcomes to support their nomination (if applicable).
(iii) A shortlist of 3 will apply to each category and members should have a representative available at the Awards Dinner to collect their Award.
(iv) The judging panel will consist of independent experts nominated by IMSTA.
BEST IMPROVEMENT IN PATIENT SAFETY
NOMINATION FORM
Name of Nominee/COMPANY
Name of Product/ Service
Brief Description of Product/Service
Reason for Nomination
Is there any evidence in support of the success of this Product/Service
Nominated by
Contact Details
Additional comments/ why Nominee is deserving of this award - Provide additional materials where applicable