The Das Pillay Antimicrobial Stewardship Memorial Award 2020
This award is to recognise innovation the field of antimicrobial stewardship at a junior level. The nomination may occur through others or through self nomination. The award is open to junior doctors, nurses and pharmacists who have excelled in delivering antimicrobial stewardship quality improvement.

We would welcome nominations from:
* Doctors up to Specialist Trainee Level
* Nursing staff up to Band 7
* Pharmacists and Pharmacy Technicians up to band 7
Nominees Details
Self nomination is accepted
What is the name of the person you are nominating for this award? *
Your answer
Their email address *
Your answer
Their phone Number
Your answer
Their current job title/role *
Your answer
What category best describes the person current role *
What organisation do they currently work in? *
Your answer
Why are you nominating them for this award? Please provide clear reasons/evidence of how the person has excelled in delivering antimicrobial stewardship quality improvement. (max 300 words) *
Your answer
Do you have supporting evidence (images, figures, videos, YouTube links)?
On clicking submit, details for submitting supporting evidence will be provided
Your answer
Details of the person nominating (if self nominating please provide your details)
Your Name?
Your answer
Your email address
Your answer
Your relationship to the nominee?
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.