Nomination Form 2015

EUROPEAN SOCIETY FOR PERSON CENTERED HEALTHCARE
Nomination Form 2015
Dear Colleague
EUROPEAN SOCIETY FOR PERSON CENTERED HEALTHCARE – ANNUAL AWARDS 2015
You are cordially invited to nominate a clinician or scientist working in the field of person-centered care/
humanistic medicine for one of the Society’s annual awards.
The Society’s awards are intended to recognise various degrees of excellence and achievement in the
promotion and implementation of person-centered approaches to healthcare design and delivery and
also scholarship and teaching.
Individual members and non-members of the Society are eligible for consideration of the awards with
the exception of the President and Senior Vice President. Awards can also be made to institutions, e.g.,
hospitals and universities, where progress has been achieved by a team.
The Nomination Form is found below. If you have only one nomination for one prize we are grateful. If you
can nominate more than one individual for the other awards, then we are most grateful.
The successful candidates will be awarded their medals and prizes by the President at the Annual
Awards Ceremony which will take place 18th & 19th June 2015, following the conclusion of Day 1 of the
Society’s Second Annual Conference (Details of the Conference are attached).
We look forward to receiving your advice and in the interim send kind collegial regards.
Yours sincerely
Professor Andrew Miles MSc MPhil PhD DSc (hc)
Senior Vice President & Secretary General
Professor Sir Jonathan Asbridge DSc (hc)
President & Chairman of Council
Dear President and Senior VP
My nominations
I would like to nominate the following individuals or institutions for the Society’s awards:
For the Platinum Medal
Criterion: Unequivocal excellence in the promotion and development of PCH
Name
Title
Position
Email Address
Institution
Statement in support of the Nomination (circa 300 – 600 words. Please identify as many key achievements of the nominee as possible, including seminal publications in peer reviewed journals and any
other awards received).
For the Gold Medal
Criterion: A very high level of achievement in the promotion and development of PCH
Name
Title
Position
Email Address
Institution
Statement in support of the Nomination (circa 300 – 600 words. Please identify as many key achievements of the nominee as possible, including seminal publications in peer reviewed journals and any
other awards received).
For the Silver Medal
Criterion: A high level of achievement in the promotion and development of PCH
Name
Title
Position
Email Address
Institution
Statement in support of the Nomination (circa 300 – 600 words. Please identify as many key achievements of the nominee as possible, including seminal publications in peer reviewed journals and any
other awards received).
For the Bronze Medal
Criterion: A significant level of achievement in the promotion and development of PCH
Name
Title
Position
Email Address
Institution
Statement in support of the Nomination (circa 300 – 600 words. Please identify as many key achievements of the nominee as possible, including seminal publications in peer reviewed journals and any
other awards received).
For the Book Prize
Name
Title
Position
Email Address
Institution
Statement in support of the Nomination (circa 300 – 600 words. Please identify the book, including
the title, author/authors or editor/editors, the publisher and an evaluation of how the book contributes to
the advancement of person-centered healthcare).
For the Essay Prize
Name
Title
Position
Email Address
Institution
Statement in support of the Nomination (circa 300 – 600 words. Please identify the Essay itself, including the title, author/authors, the place of publication and an evaluation of how the Essay contributes
to the understanding and advancement of person-centered healthcare).
Statement
I have read the criteria for the awards and confirm that I have no conflicts of interest in making my
nominations.
Name of
Nominator
Title
Position
Email Address
Institution
Date dd/mm/yyyy
Signature (electronic if possible)
Please return this form by Friday 1st May 2015 by e-mail to Professor Andrew Miles: [email protected]

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