50%

*1.Please choose the category and proposed award from the list given below.(Required.)

Medical Tourism Person of the Year Award

Hospital Leadership Award

Employer Leadership Award for Medical Tourism

Insurance Leadership Award

Facilitator Leadership Award

Individual Leadership Award

Accreditation / Quality Leadership Award

Government Organization Leadership Award

Innovation in Medical Tourism Award

Travel Agency Leadership Award

Hotel/Hospitality Leadership Award

Health & Wellness Leadership Award

Dental Tourism Leadership Award

Specialty Center Leadership Award

Healthcare Cluster/Association/Council Leadership Award

International Firsts Award

Top Hospital Website Design (Aesthetics/Design)

Top Facilitator Website Design (Aesthetics/Design)

Excellence in Social Networking

Best Medical Insurance Blog

Best Medical Tourism Blog

Best Healthcare Provider Directory Website

Top Hospital Website Design (Functionality)

Top Facilitator Website Design (Functionality)

*2.Please enter the following information for the individual being nominated:(Required.)

Name: *

Company: *

Title

Address:

City/Town:

State/Province:

ZIP/Postal Code:

Country:

Email Address:

Phone Number: