Application form
please fill in the form with attention to the details and provide as much information as you can in order to make the evaluation process robust and rational

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Give details of what your company/product/you have accomplished within the last 24 months

  • Why do you fit to participate in this nomination and category?

  • What were the objectives/goals of your actions that prove your connection to the nomination?
  • What benefits does it give to the patients/team/company/you (choose about whom you are going to write)
  • How benefits were measured?

  • What were the difficulties in reaching your goals?
  • How did you/the company solve them?

  • How did the team show itself in the implementation process? (optional question)
  • What were the changes between the team in the process? (optional question)

  • To what extent was it possible to meet the originally planned budget and time frame?
  • What was especially creative and innovative about the initiative?
  • Was there anything unique that proved an interesting twist and contributed to the overall success?

  • What was the result and how did you measure it?
  • Are the results sustainable and may be scaled further to add more value or expand to a new market?

  • Are the supporting documents proves this statement? (if yes, include them in the field "additional information")

If you do not know which nomination to submit, then you can leave it in the appropriate field
"I am still thinking (need advice)"

We will contact you after reviewing your case and by it, we will offer t
Explain why you, your company or your product should be considered a Winner this year
I want to participate in...
choose the category
write the nomination you want to participate
name of the person filling in the data
Job title
role in a company of the person filling in the data
e-mail of the person filling in the data (for communication)
Company name
which company plans to participate
(in case if you don't participate from company - write "negative")
Company website or link to social network corporate page | LinkedIn/Facebook link
(in case if you don't participate from company - write "negative")
About your case
summary for up to 1500 words
Additional information
Add a link to google drive (or similar websites) where you added additional information confirming your case (documents, certificates, video, photo, statistics, etc)
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