2023 RC Week Nominations for RCP Survey

Respiratory Care Practitioner- The “RCP Commitment & Excellence” award recognizes an RCP who delivers respiratory care up to and beyond expectations while advocating for the profession and practice. This nomination needs to be supported and evidenced, for example: data, patient feedback story (do not include patient information), highlighting the difference made to patient care and experience in respiratory care. Entries can be self-nominating from the member or from the multidisciplinary team/colleague or manager.

1.Nominator Information(Required.)

Name

Your Position/Title

Employer

Phone

2.RCP Nominee Information

Nominee's Name

The Nominee's Position/Title

CSRC Region

Street Address

City

State

Zip

Phone

3.Is the nominee an active RCP in the State of California?(Required.)

Yes

Don't know

4.Is the nominee a CSRC member?(Required.)

Yes

Don't know

5.Professionalism*

Provide evidence as testimonials or other documentation/links that nominee is actively engaged or champion of professionalism within a respiratory care setting (i.e., within their hospital, department, clinic, post-acute setting, educational facility, and/or community).(Required.)

6.Commitment Through Advocacy*

Provide evidence that nominee is actively engaged in efforts to advocate for the respiratory care profession at the local, state, national level, or within their facility by evidence of active policy/protocol development.(Required.)

7.Strives for Excellence*

Provide evidence that nominee sets exemplary level of professionalism and clearly demonstrates patient and family centered care.(Required.)