Super Steward Awards Nomination Form | Carolina Antimicrobial Stewardship Program

Your Name(Required)

First and last name of person who is nominating

Your Email(Required)

Your Role and Dept/Service

Name of Person You are Nominating(Required)

Please include the name of one person only. You may submit more than one nomination, however, we are unable to recognize groups with this award at this time.

Nominated Person's Role and Dept/Service

Please describe the reason(s) you are nominating this person for a Super Steward Award.

Super Steward Awards recognize colleagues' meaningful contributions to support the appropriate and effective use of antimicrobials. Please include specific example(s) of the individual's contribution(s) if possible.

To your knowledge, is this person a UNC Medical Center or University employee?

Yes

Anything else you would like to add? (Optional)