Massachusetts Medical Law Report
Nomination Ballot
Rx for Excellence Awards 2008

In a gala ceremony in fall 2008, Rx for Excellence will showcase the people and places of the Massachusetts medical community who take extra steps to promote safety and quality in health care and medical products.

We are seeking to honor individuals and institutions that succeed in all the things our readers value: risk management, regulatory compliance, safety and quality.

Nominee Information Required:

Name of Nominee:
Place of employment:
Position:
E-mail:
Phone number:

Outside/Community activities(if any):

Nominator Information Required:

Your name:
Your relationship with Nominee:
Your place of employment:
Your email address:
Your phone number:

Reason for nomination: