Council Chair – Randy Pierson Vice-Chair – Lana Duff

AWARD CRITERIA FOR THE

Region One EMT OF THE YEAR

Please note that the original application on a CD or Flash Drive in Adobe or MS WORD formatincluding a jpeg formatted picture of the nominee must be submitted, including evidence as to why the nominee is deserving of this award. Packets are limitedto 5 single-sided, typed pages using 1" margins and 12-point type. Failure to adhere to the guidelines may result in disqualification of the nomination.

REGION 1 EMERGENCY MEDICAL TECHNICIAN OF THE YEAR:

CRITERIA: This award is presented to a currently licensed Region 1 EMT-B, EMT-I, or A-EMTand is employed by, or volunteers with, a Region 1 Licensed EMS Provider (Ambulance, 1st Responder or Air Service) who has contributed significantly to EMS at the community, regional, and/or state level. Contributed significantly is defined as going far above and beyond the call of duty, whether in the direct delivery of patient care or in programs offered to the community that enhance the standing of EMS and/or the education of the public.

Criteria to be considered in selecting your nominee are listed below. Please review these desired qualifications very carefully and describe how well your nominee meets the criteria and why you feel he/she should be named EMT OF THE YEAR.

CRITERIA:

___Compliance with acceptable standards of patient care

___Adherence to local and/or regional treatment protocols

___Accuracy, completeness, legibility, and timeliness of required records

___Willingness to accept assignments outside normal duties

___Previous awards and recognition by peers

___Activities to improve EMS program’s visibility in the community, to create awareness of and confidence in the EMS system -- blood pressure clinics, CPR courses, health promotion activities, presentations to schools, churches and civic groups, routine communications with local public officials, radio programs, newspaper articles, etc.

___Self-improvement efforts, such as participation in continuing education and training programs, enrollment in courses at education institutions, or self-study utilizing professional journals and library materials.

___Involvement, on voluntary basis, in community activities or betterment of public health and welfare, membership in civic groups, voluntary health agencies, programs for children and youth, non-profit organizations, etc.

___Leadership ability, as may be demonstrated at place of employment, or through community activities or active membership in professional or other EMS-related organizations.

___Professionalism exhibited by personal conduct, attitude toward patients and others, personal appearance, initiative, honesty and integrity, resourcefulness, and ability to function effectively in stressful situations

___Sustained high job performance ratings by employer

ELIGIBILITY: Any currently licensed Georgia EMT-B, EMT-I, or A-EMTthat works for a Region 1 Licensed EMS provider whose primary responsibility is providing direct patient care. This award is NOT open to EMS Administrators, Directors, or Supervisors who do not routinely deliver direct patient care as a primary responder.

NOMINATED BY: Anyone,the nomination can be anonymous.

PLEASE COMPLETE THE APPROPRIATE NOMINATION FORM

Submit Completed Form and Packets To:

Region 1 Office of EMS

1309 Redmond Rd

Rome, GA 30165

NOMINATION DEADLINE: February 15, 2012

REGION ONE EMT OF THE YEAR

NOMINATION FORM

NOMINEE’S NAME
NOMINEE’S ADDRESS
CITY / STATE / ZIP
HOME TELEPHONE NUMBER
WORK TELEPHONE NUMBER
EMAIL ADDRESS
PRIMARY EMS EMPLOYER
EMS EMPLOYER’S ADDRESS, INCLUDING CITY/STATE/ZIP
NOMINEE’S SUPERVISOR
SUPERVISOR’S EMAIL
YEARS IN EMS
LICENSE LEVEL OF NOMINEE / EMT-B / EMT-I ‘85 / A-EMT
PLEASE MAKE SURE YOU ADHERE TO ALL THE CRITERIA AS YOU DESCRIBE WHY THIS PERSON SHOULD BE RECOGNIZED AS THE REGION ONE “EMERGENCY MEDICAL TECHNICIAN OF THE YEAR.” IT IS IMPORTANT TO REMEMBER THAT THIS AWARD IS BESTOWED UPON SOMEONE WHO NOT ONLY DOES THE JOB, BUT FAR EXCEEDS THE EXPECTATIONS OF THE EMPLOYER AND THE COMMUNITY. THIS INDIVIDUAL SHOULD BE AN EXAMPLE OF WHAT A TRUE ROLE MODEL / COMMUNITY HERO IS. DO NOT EXCEED THE MAXIMUM AS DESCRIBED IN THE CRITERIA ON THE OTHER SIDE OF THIS FORM.

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