2017 Carolinas HealthCare System: Healthy Charlotte Award

Once you have completed this form, please email it to Ashley Hedrick at .

All entry formsare due no later than 5:00p.m.April 21, 2017.

The 2017 Healthy Charlotte Awards will be presented at the Charlotte Chamber’s Health Care Summit May 12, 8 a.m. – 1:15 p.m. at the Westin. If submitting a nomination, please protect this time on your calendar.

NOMINEE FORM

Nominee Primary Contact Name: Click here to enter text.

Nominee (Organization) Name:Click here to enter text.

Nominee Primary Contact Email Address: Click here to enter text.

Nominee (Organization) Address:Click here to enter text.

Nominee Website:Click here to enter text.

Nominee Office Phone Number:Click here to enter text.

Nominee Mobile Phone Number: Click here to enter text.

Healthy Initiative Name(if applicable): Click here to enter text.

The 2017 Carolina HealthCare System Healthy Charlotte award is based on one (1) essay and five (5) short answer categories.

Responses should be less than 100 words unless otherwise noted below.

NARRATIVE:

Describe how your organization has embraced and promoted healthy initiatives in your workplace. Describe in detail the initiatives your organization has implemented. (Response: 400 words maximum)

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IMPACT:

What was the most impactful component of your organization’s initiative(s)? Please include both internal and external audiences (i.e., employees, community, etc.).

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INNOVATION:

What was the primary challenge your organization faced when implementing your healthy initiative(s)?

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How is your organization’s initiative(s) considered innovative?

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INFLUENCE:

How did your organization’s initiative(s) serve as to influence yourworkplace and the community?

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ENGAGING:

How did your organization engage with internal and external audiences through the development and implementation of the initiative(s)?

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LEADERSHIP:

How did your organization exhibit a healthy leadership role within our community?

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How is your organization committed to promoting and maintaining the healthy initiative?

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RESULTS:

What were the measureable results of your initiative(s)?

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Please explain how you’ve used or plan to use any elements from the Healthy Charlotte Employer Toolkit (i.e.,Walking Wednesdays, Try It! Tuesday, healthier food and beverage choices, Tobacco Prevention techniques, etc.).

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