PROGRAM OF EXCELLENCE CATEGORY -- Official Nomination Form for the TAMHO Awards & Recognition Program

TAMHO Awards and Recognition Program -- 2017 Call for Nominations

This instrument is designed to collect nominations for the Program of Excellence Award category. The general award categories have a separate nomination form [https://www.surveymonkey.com/r/37FRQ2W].

The TAMHO Awards and Recognition Program offers the TAMHO membership an opportunity to recognize and honor remarkable individuals and organizations with the Association’s highest honors. Presented annually, these awards recognize excellence and outstanding achievement within the behavioral health industry. Please block time to review each of the award categories and consider the individuals and events that serve to advance the behavioral healthcare industry.

Question Title

* 1. Please indicate the award category and sub-category(ies) for this Program of Excellence Award. Check all that apply.

Consumer Advocacy

Family Advocacy

Health Information Technology

Service Innovation

Adult

Child & Adolescent

Both Adult and Child & Adolescent

Mental Health

Addictions

Co-Occurring Disorders

Prevention

Question Title

* 2. NOMINATOR INFORMATION

Name

Title

Affiliation

Address

City, State, Zip Code

Telephone

Facsimile

PROGRAM OF EXCELLENCE CATEGORY -- Official Nomination Form for the TAMHO Awards & Recognition Program

TAMHO Awards and Recognition Program -- 2017 Call for Nominations

Question Title

* 1. Please indicate the award category and sub-category(ies) for this Program of Excellence Award. Check all that apply.

Question Title

* 2. NOMINATOR INFORMATION

Question Title

* 3. Program Title

Question Title

* 4. Description

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* 5. Goals and Objectives of the Nominated Program

Question Title

* 6. Outcomes of the Nominated Program

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* 7. Other Pertinent Information Related to the Nominated Program