International Patient Safety Awards 2025

Nomination Form

Note:

  • Participants need to fill up the below form for each nomination. One organization can submit more than one nomination and can also apply for different categories.
  • This nomination template will assist you to ensure that you clearly address all the required information. This is very important for the judges to evaluate your nomination.
  • Keep your answers as clear and precise as possible. Please adhere to the word limitations for each section.
  • Don’t forget to attach any supporting evidence, i.e. documents and/or high-resolution photograph or videos of the initiative/project/successful endeavor.

Please upload supporting evidences below:
( only PDF format )

Information submitted is true and accurate to the best of my knowledge. I understand that any mis-presentation or falsification in submitted information will disqualify the nomination from the award competition.