Zynx Health CITE Award Nomination Form

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For excellence in the use of CDS

Name of submitting person *

Email address of submitting person *

Phone number of submitting person *

Names and titles of nurses you are nominating *

(you may include yourself in this list)

Name of Hospital/Organization of nurses you are nominating *

Brief organizational overview (100 words or fewer) *

The CITE Award is intended to recognize a nursing-led team for excellence in the use of Clinical Decision Support (CDS). Please describe in 500 words or fewer why you are nominating this team. *

Include a description of how this nursing-led team has used CDS including a detailed overview of the process, objectives, and any outcomes achieved.

Release Authorization

The below statement is required to allow Zynx Health to promote submissions and winners via social media and other media channels.

I authorize Zynx Health to use my attached statement and such other written materials as I may provide (collectively, statement"), at the sole discretion of Zynx health, in any manner of media whatsoever, for any an all promotional or commerical purposes, and to use my name, likeness, and biographic or other information in connection with the same. *

I accept

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