MAPS PSO Patient Safety Champion Nomination

We’re committed to member excellence. Our Patient Safety Champion program is an opportunity to recognize individuals and teams who’ve prevented patient harm. Nominate your champions today!

Please select your nomination category:

Individual Nominee Team Nomination

MAPS PSO Organization:

Full Name of Individual Nominee:

Title of Nominee:

Email Address of Nominee:

Team Name:

List full names of team members using semicolons between names:

Nominee Supervisor's Name:

Nominee Supervisor's Email:

Name of Nominator:

Nominator's Email:

Brief Description of the "good catch" or patient safety improvement project:

Upload file:

Please select a file

MAPS PSO Patient Safety Champion Nomination

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