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Star of Public Dentistry nomination form Star of Public Dentistry Nomination form
Star of Public Dentistry nomination form
Star of Public Dentistry Nomination form
Nominee details Your details (if applicable)
Name Click here to enter text. Name Click here to enter text.
Organisation Click here to enter text. Address Click here to enter text.
Phone Click here to enter text. Phone Click here to enter text.
Email Click here to enter text. Email Click here to enter text.
In 500 words or less, please outline how your nominee has shown excellence in public dentistry.
The judging panel will take into account the following considerations in reaching their decision:
How the nominee’s individual performance has helped to improve patient satisfaction and treatment outcomes
How the nominee has encouraged and supported other professionals in the public oral health sector
Terms and conditions of the awards can be found on www.dhsv.org.au/awards.
Click here to enter text.
Please remember to attach any supporting documentation to your nomination upon submission.
Star of Public Dentistry nomination form
Nominee details Your details (if applicable)
Name Click here to enter text. Name Click here to enter text.
Organisation Click here to enter text. Address Click here to enter text.
Phone Click here to enter text. Phone Click here to enter text.
Email Click here to enter text. Email Click here to enter text.
In 500 words or less, please outline how your nominee has shown excellence in public dentistry.
The judging panel will take into account the following considerations in reaching their decision:
How the nominee’s individual performance has helped to improve patient satisfaction and treatment outcomes
How the nominee has encouraged and supported other professionals in the public oral health sector
Terms and conditions of the awards can be found on www.dhsv.org.au/awards.
Click here to enter text.
Send your completed nomination to [email protected] or submit an online nomination. Nominations close on September 25.
Winners will be announced at the 2015 DHSV AGM on November 26.
