2020 Grace Diaz Blue Light Award Nomination Form

Each year the Rhode Island World Diabetes Day (RIWDD) Committee recognizes an individual or organization that has positively impacted diabetes in the state of Rhode Island by awarding the Grace Diaz Blue Light Award. In keeping with the international theme of World Diabetes Day 2020, "The Nurse and Diabetes", this year's Blue Light Award will be presented to a Rhode Island Nurse. The criteria for the nominee is a commitment to the health and well-being of people living with chronic disease, being a role model to others and exhibiting a devotion to improving the health of the community. Please complete the form below to nominate a RI Nurse who deserves to be considered for this award.

Question Title

* 1. Name of the Nurse you are nominating:

Question Title

* 2. Email of nominee:

Question Title

* 3. Phone number of nominee:

Question Title

* 4. Please provide a description of the Nurse you are nominating and how this person has met the criteria noted above:

Question Title

* 5. What is unique about this nurse in his/her role?

Question Title

* 6. How has this nurse advocated for patients during the COVID-19 pandemic?

Question Title

* 7. How has this nurse influenced diabetes and/or pre-diabetes in his/her nursing practice?

Question Title

* 8. Your name:

Question Title

* 9. Your email address:

Question Title

* 10. Your phone number:

T