Critical Access Hospitals - 2021 submission form

Thank you for your interest in submitting to this list.

 

This nomination form indicates word count for questions where appropriate. No section should exceed 500 words.

Please only submit one nomination per individual. Multiple nominations does not increase the chances of being recognized on this list.

Please contact Laura Dyrda at ldyrda@beckershealthcare.com with any questions you have about the nomination process.

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