2024 Ohio EMSC Pediatric Clinical Save Awards Nomination Form


Please complete the form below to nominate a prehospital EMS or Emergency Department team for the 2024 Ohio EMSC Pediatric Clinical Save Awards. The specific encounters must have occurred in Ohio during 2024. (Children's hospitals and pediatric transport teams are not eligible.)

Submissions for nominations are due by January 18, 2025.

Please do not include any patient identifying information in this nomination form.

Your information
Nominee information
Encounter information
Incident information
Please describe the encounter and why you feel your nominee(s) deserve a Pediatric Clinical Save Award. Do not include patient identifying information (unless you are the patient/guardian).