SWORBHP Medical Directors Commendation Award

Award Criteria:

The Medical Director’s Commendation Award will be awarded to Paramedics who have been recognized for delivering exceptional care to a patient(s) in the prehospital setting. This award is based on recommendation by the Local Medical Director or the receiving hospital Emergency Physician.

All actions taken by the paramedic(s) must be in compliance with the current Basic Life Support Patient Care Standards and Advanced Medical Directives
The Paramedic(s) being recommended for this award must be a certified paramedic in good standing with the Southwest Ontario Regional Base Hospital Program (SWORBHP).

Please note that you will be receiving an email of this form once submitted.

To comply with privacy, please ensure that you DO NOT include any patient or private information within your submission.

Call Date:

Service:

Run #:

First Name:

Last Name:

OASIS #:

Add Another Paramedic?

First Name:

Last Name:

OASIS #:

Add Another Paramedic?

First Name:

Last Name:

OASIS #:

Add Another Paramedic?

First Name:

Last Name:

OASIS #:

Add Another Paramedic?

First Name:

Last Name:

OASIS #:

Add Another Paramedic?

First Name:

Last Name:

OASIS #:

Add Another Paramedic?

First Name:

Last Name:

OASIS #:

Add Another Paramedic?

First Name:

Last Name:

OASIS #:

Add Another Paramedic?

First Name:

Last Name:

OASIS #:

Add Another Paramedic?

First Name:

Last Name:

OASIS #:

Name of Physician submitting recommendation:

Email:

Briefly describe (no more than 250 words) the actions taken by the paramedic(s), and your rationale as to why he/she is deserving of the Medical Director’s Commendation Award. Please do not include any personal patient identifiers.