Request edit access
To celebrate National Public Health Week (April 2-8, 2018) the Wicomico County Health Department will recognize an individual that has made an outstanding contribution to the public health of the citizens of Wicomico County.

The Outstanding Public Health Leader will be honored at an awards ceremony on Monday, April 2, 2018 at 3:00 p.m. at the Great Hall in Holloway Hall, Salisbury University, 1101 Camden Ave, Salisbury, MD. The celebration honors an outstanding individual in the area of public health and provides the public with information about public health and services provided for our community. A plaque will be presented to the selected individual and a perpetual plaque will remain on display at the Seth H. Hurdle Health Center.

* Nominees must be 18 years old or older;
* Nominees must work in Wicomico County;
* Nominees must be living;
* Nominees must have made a contribution to the citizens of Wicomico County; (examples follow)
* Demonstrate thoughtful attention, energy and innovation in his/her position;
* Make use of current theories and practices in public health.
*Wicomico County Health Department employees are not eligible.

EXAMPLES OF PUBLIC HEALTH CONTRIBUTIONS: (Examples only, others may apply.)
Assess health status to identify community health problems.
Diagnose and investigate health hazards in the community.
Form community partnerships to identify and solve health problems (for example, APEXpH, or Assessment Protocol for Excellence in Public Health subcommittees that perform community needs assessments).
Develop policies and plans to support individual and community health efforts.
Enforce laws and regulations that protect health and ensure safety.
Provide or link people to needed personal health services and assure care is received when otherwise unavailable.
Assure a competent public health and personal health care work force.
Evaluate effectiveness, accessibility and quality of health services.
Conduct research for new insights and innovative solutions to health problems.
Improve existing or develop new systems of health care.

Nominations must be received by Friday, March 23, 2018. (NO EXCEPTIONS.)

Nominations may also be printed and mailed to:

Cara Rozaieski
Wicomico County Health Department
108 East Main St
Salisbury, MD 21801

Name of Nominee *
(First and Last Name)
Your answer
Nominee's Agency or Organization *
Your answer
Nominee's Mailing Address *
(A formal invitation to the recognition ceremony will be mailed to the nominee.)
Your answer
Nominee's Email Address or Contact Telephone Number *
Your answer
Nomination Narrative *
Please limit to 300 - 400 words, and include as much detail as possible.
Your answer
"I have read the selection criteria and wish to nominate the individual identified above."
Your Name *
(First and Last Name)
Your answer
Your Email Address *
Your answer
Your Telephone Number *
Your answer
Never submit passwords through Google Forms.
This form was created inside of Report Abuse - Terms of Service - Additional Terms