Nomination form

One award will be presented along with two certificates of recognition.

Award criteria: It can be an individual, a team or establishment who has championed the cause of an individual or group of people needing intravenous or enteral feeding; people with feeding tubes relating to their treatment, personal goals and ambitions in the UK. Someone/people who have gone the extra mile!

Who can submit a nomination?

· Anyone who believes they have a suitable candidate(s).
· You can self-nominate.
· PINNT members and non-members.

Who can be nominated?

Those who meet the criteria. A family member(s), a friend(s), an individual healthcare professional (hospital or community based), a carer (paid or unpaid), a clinical team, a homecare nurse/employee, homecare supplier, anyone who is part of your support network who has made a different - the list is endless...

* required field

Terms and conditions
- You can submit more than one nomination for different candidates.
- All nominations will be viewed equally.
- An independent panel will review the nominations.
- The awards will be announced and presented during Home Artificial Nutrition (HAN) Week; 5-11 August 2024.
- There is no cash alternative.
- The panel’s decision will be final.

Nominations close on Friday 19 July 2024 at 5 pm.

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* 1. Your personal contact details:

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* 2. Are you a PINNT member?

Your nomination

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* 3. The name of the individual/people/team/company you are nominating:

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* 4. Contact email address for the individual/people/team/company you are nominating:

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* 5. Phone number for the individual/people/team/company you are nominating:

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* 6. Please outline why you are nominating them based on the criteria above.

- Tell us as much as you can to support your nomination.
- Include any specific examples that demonsrate why you feel they are a patient champion.

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* 7. If you had to summarise them in a sentence as to why you feel they are a true Patient Champion, what would it be:

If you have any questions regarding the nomination process please contact PINNT via one of the following:

Email: comms@pinnt.com

Telephone: 020 3004 6193

By post: PINNT, PO Box 3126 Christchurch, Dorset BH23 2XS
Thank you for submitting a nomination for The Tracy Hill Patient Champion Award 2024.

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